Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /home/ki516568/public_html/libraries/f0f/dispatcher/dispatcher.php on line 524

Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /home/ki516568/public_html/libraries/f0f/dispatcher/dispatcher.php on line 529

Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /home/ki516568/public_html/libraries/f0f/dispatcher/dispatcher.php on line 534

Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /home/ki516568/public_html/libraries/f0f/dispatcher/dispatcher.php on line 539

Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /home/ki516568/public_html/libraries/f0f/dispatcher/dispatcher.php on line 552

Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /home/ki516568/public_html/libraries/f0f/dispatcher/dispatcher.php on line 561

Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /home/ki516568/public_html/libraries/f0f/dispatcher/dispatcher.php on line 566

Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /home/ki516568/public_html/libraries/f0f/dispatcher/dispatcher.php on line 580

Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /home/ki516568/public_html/libraries/f0f/dispatcher/dispatcher.php on line 609
MedenoSrce - Akutni holecistitis

Akutni holecistitis

Datoteke:
DatotekaVelikost
Snemi datoteko (akutni_holecistitis.ppt)akutni_holecistitis.ppt837 kB
Akutni holecistitis
Epidemiologija
10-20 ljudi ima žolčne kamne (nad 65 let 30),
Holesterolni, pigmentni, mešani,
80 je asimptomatskih
1-3 simptomatskih pojav akutnega holecistitisa
Patogeneza


žolčni kamni (90)
zapora
povišanje intraluminalnega tlaka
mikrotravma
mediatorji vnetja
sekundarna okužba


Klinična slika
Diagnoza 1
UZ trebuha

povečan, napet žolčnik,
nad 3 mm zadebeljena stena,
kamni v lumnu, zagozden kamen,
prosta tekočina okoli žolčnika (periholecistitis),
bolečina ob pritisku sonde na trebušno steno, nad žolčnikom (Murphyjev znak).
Daignoza 2
CT trebuha




RTG trebuha
Zapleti
Hidrops holeciste
Empiem žolčnika
Gangrenozni holecistitis (abscesi, peritonitis)
Akutni emfizemski holecistitis


Akutni akalkulozni holecistitis
Simptomatsko zdravljenje

Počitek žolčnika:
strogi post,
IV hidracija, skrb za elektrolitno in acidobazno ravnotežje,
analgezija,
antibiotiki

Kirurško zdravljenje
20 bolnikov mora biti urgentno operiranih zaradi gangrenoznega vnetja ali perforacije žolčnika.
Zgodnja holecistektomija v prvih 24 do 48 urah je najprimernejša metoda zdravljenja akutnega holecistitisa.

Kirurško zdravljenje
Laparoskopska holecistektomija

Manjša operativna rana
Manjša pooperativna bolečina
Manjša možnost gnojenja
Krajša hospitalizacija
Kirurško zdravljenje

Klasična holecistektomija
Sklep

Akutni holecistitis najpogosteje povzročijo žolčni kamni.
Bolniki z akutnim holecistitisom morajo biti nemudoma napoteni v bolnico.
Prvo zdravljenje je simptomatsko s postom, z dodajanjem tekočin in analgetično in antibiotično terapijo.
Zgodnja holecistektomija v prvih 24 do 48 urah je najprimernejša metoda zdravljenja akutnega holecistitisa.
HVALA!