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Cholelesthasis
Reflection on cholecystitis
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Cholecystitis /cholelithiasis
Cholecystitis is an inflammation of the gallbladder. Cholecystitis can be acute or chronic.
Risk factors:
Risk factors for both Cholecystitis /cholelithiasis includes obesity; rapid weight loss in obese individuals; middle age; female gender; use of oral contraceptives; American Indian ancestry; gallbladder, pancreatic, or ileal disease; low HDL cholesterol level and hypertriglyceridemia; and gene-environmental interactions (Doig &Huether, 2014).
Causes:
The housing of a gallstone in the cystic duct almost always causes both forms. This occlusion produces the gallbladder to become enlarged and inflamed. Pressure against the distended wall of the gallbladder decreases blood flow. Ischemia, necrosis, and perforation
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The gallbladder has interstitial fluid with dilated capillaries and lymphatics and edematous gallbladder wall (Catena et al., 2014).
Necrotizing Cholecystitis - second stage,which last for 3–5 days. Along with the edematous changes in the gall bladder there are areas of hemorrhage and necrosis. With the elevated internal pressure to gallbladder wall, the blood flow gets obstructed, and histological evidence of vascular thrombosis and occlusion. Superficial areas of scattered necrosis, the full thickness of the gallbladder wall doesn’t involve (Catena et al., 2014).
Suppurative Cholecystitis - third stage ranges from 7–10 days. White blood cells in the gallbladder wall along with areas of necrosis and suppuration. During this time, the active repair process of inflammation is apparent with abscess formation (Catena et al.,
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Fever, leukocytosis, rebound tenderness, and abdominal muscle guarding are common findings. Blood test shows an increase in white blood count. Serum bilirubin and alkaline phosphatase levels may be elevated. Epigastric and right hypochondrium pain and intolerance to fatty foods are the cardinal manifestations of cholelithiasis. Vague symptoms include heartburn, flatulence, epigastric discomfort, pruritus, jaundice, and food intolerances, particularly to fats and cabbage. The pain, often called biliary colic, is most characteristic and is caused by the lodging of one or more gallstones in the cystic or common duct. The pain can be intermittent or steady. It usually is located in the right upper quadrant and radiates to the midupper back. Jaundice indicates that the stone is located in the common bile duct. Abdominal tenderness and fever indicate Cholecystitis (Doig &Huether,
Gallstones form when the liquid stored in the gallbladder hardens into pieces of stone-like material. The liquid, called bile is used to help the body digest fats. Bile is made in the liver, and then stored in the gallbladder until the body needs to digest fat. At that time, the gallbladder contracts and pushes the bile into a tube—called the common bile duct—that carries it to the small intestine, where it help with digestion.
Strasberg SM (2008). "Acute Calculous Cholecystitis". New England Journal of Medicine 358 (26): 2804–2811. doi: 10.1056/NEJMcp0800929. PMID 18579815
They can be enumerated as difficult entry to the right hypochondrium owing to the adhesions, difficulty in exposure can also arise due to diseased gallbladder and Liver ,acutely inflamed and tense gallbladder ,gallbladder packed with stones ,thick walled gallbladder ,fibrotic gallbladder ,gallbladder mass and abnormality can also arise due to anomalous anatomy of hepatobiliary system like situs inversus, malposition of the gallbladder, arterial anomalies and short cystic duct, a huge stone impacted in the cystic duct, Hartmann’s pouch adherent to the common hepatic duct and anomalous insertion of the cystic duct.
Cholesteatoma is a growth of excess skin or a skin cyst (epithelial cyst) that contains desquamated keratin and grows in the middle ear and mastoid (Thio, Ahmed, & Bickerton, 2005). A cholesteatoma can grow and spread, destroying the ossicles, tympanic membrane and other parts of the ear. They appear on the pars flaccida and pars tensa sections of the tympanic membrane. A cholesteatoma can occur when a part of a perforated tympanic membrane is pushed back into the middle ear space, debris and skin cells can build up forming a growth. It can obstruct tympanic membrane movement and movement of the ossicles. As the layers grow, the amount of hearing loss can increase. A cholesteatoma can be congenital (present at birth) or be acquired as a result of another disease. They can also be formed as a result of a surgery, trauma, chronic ear infection, chronic otitis media, or tympanic membrane perforation. It can develop beyond the tympanic membrane and cause intracranial and extracranial complications. Due to this patients can experience permanent hearing loss as a result of an infection of the inner ear as well as other serious health concerns. These include dizziness, facial nerve weakness and infections of the skull (Hall, 2013). Patients may present chronically discharging ear, hearing loss, dizziness, otalgia (ear pain), and perforations (marginal or attic).
•The forty five year old patient is diagnosed with the progressive cirrhosis inflaming the liver along with the parenchymal cells. The plain symptoms is manifested primarily because of the augmentation of edema internally in the lower abdomen.
When someone first finds out they have Crohn’s disease, they will probably feel overwhelmed. There are so many questions. Will I be able to work, travel and exercise? Should I be on a special diet? Could my medications have side effects? How will Crohn’s disease change my life? The better informed they can become, the more equipped they will be to be an active member in your healthcare (Crohn’s & Colitis Foundation of America, 2009).
Hypercholesterolemia is the presence of high levels of cholesterol in the blood. Cholesterol is a waxy fat-like substance and is a major class of lipid, so it gets into the blood by lipoproteins [1]. A high level of lipoproteins is unhealthy. A high level can result in an elevated risk of atherosclerosis and coronary heart disease [2]. The high levels of lipoproteins are often influenced by a combination of genetic and environmental factors such as obesity or dieting habits [2]. High cholesterol can be caused by mutations in the following genes: APOB, LDLR, LDLRAP1, and PCSK9 [3]. Mutations in the LDLR gene are responsible for causing familial hypercholesterolemia, which is the most commonly seen form of inherited high cholesterol [3]. The LDLR gene contains instructions for making LDL receptors or low-density lipoprotein receptors. LDL receptors play critical roles in regulating levels of cholesterol in the blood by removing low-density lipoproteins from the bloodstream. Mutations in the LDLR gene can make the amount of LDL receptors produced less than normal or affect their job of removing the low-density lipoproteins in the blood [4]. People who have these mutations will have higher levels of cholesterol. There are many ways that the environment can affect the levels of cholesterol in the blood. Reducing the amount of dietary fat you consume lowers the total amount of cholesterol in the blood [5]. Sucrose and fructose can raise the amount of LDL in the blood. Reducing fatty foods will however lower the amount of LDL [5]. Having a healthy body and maintaining physical exercise plays a key role in keeping your cholesterol at a healthy level. If you are overweight or obese you can lower your cholesterol levels by simply losing ...
According to Bowen, There are four different types of ducts which all end up emptying into the main pancreatic duct. Intercalated ducts are lined by cuboidal epithelium and receive the secretions from acinar and duct cells. (“Pancreatic Histology”). Intralobular ducts receive secretions from the intercalated ducts and are lined by cuboidal epithelium (“Pancreatic Histology”). Interlobular ducts receive secretions from the intralobular ducts into the main pancreatic duct and reside in connective tissue between the lobules that divide up the pancreas (“Pancreatic Histology”). Finally, the main pancreatic duct transmits secretions from the interlobular ducts and empties into the duodenum after joining with the bile duct (“Pancreatic
Alessio Fasano, MD; Irene Berti, MD; Tania Gerarduzzi, MD; Tarcisio Not, MD; Richard B. Colletti, MD; Sandro Drago, MS; Yoram Elitsur, MD; Peter H. R. Green, MD; Stefano Guandalini, MD; Ivor D. Hill, MD; Michelle Pietzak, MD; Alessandro Ventura, MD; Mary Thorpe, MS; Debbie Kryszak, BS; Fabiola Fornaroli, MD; Steven S. Wasserman, PhD; Joseph A. Murray, MD; Karoly Horvath, MD, PhDP 2003 Prevalence of Celiac Disease in At-Risk and Not-At-Risk Groups in the United States Arch Intern Med. 2003;163(3):286-292
Excessive alcohol intake and gallstones are the major risk factors for pancreatitis. Other risk factors include a family history of pancreatitis, high levels of fat in the blood, cigarette smoking, certain inherited disease such as cystic fibrosis and taking certain medications.
Typical symptoms of a flare-up include abdominal pain and diarrhea containing blood. A full blood count, liver function tests and a series of three stool cultures should be taken for diagnosis. Patients with severe ulcerative colitis can have low hemoglobin levels and a raised platelet count. Stool cultures should also be tested for Clostridium difficile toxin. Studies have shown that many with a flare-up will have complications from the Clostridium difficile toxin. A flexible-sigmoidoscopy should be performed to assess colonic mucosa and biopsies taken to rule out infection and diagnose ulcerative
Bursitis Does it hurt to move your arm? Is it tender and radiating pain to your neck and finger tips? Do you have a fever? If you answered yes to two or more of these questions, then you may have a typical joint injury called bursitis. Bursitis is an inflammation of the bursa that is easily prevented, detected, and treated.
The tendency to build up high cholesterol may run in families, but extremely high levels are usually the result of a poor diet high in saturated fats and calories, along with little or no exercise. In some cases, high levels of cholesterol may be associated with undiagnosed medical symptoms such as diabetes or low thyroid function. According to the American Heart Association, there would eventually be a 50 percent lower rate of heart disease if Americans would lower their blood cholesterol levels by 25 percent. These statements find confirmation in a 1984 report done by the National Heart, Lung and Blood Institution on the results of a 10 year study. It showed that for every 1 percent of lowered cholesterol, the chances of a heart attack are lowered by 2 percent.
Following a gluten free diet heals the damage to the intestines and prevent further damage (Rubio-tapia A). recovery may take two to three years in adults if they keep the consistence of their diet. Furthermore, setting up a schedule so that patient can get help for a registered dietitian. A support group may also help you cope the disease and diet (Rubio-tapia A).
Food poisoning is a condition that results from eating contaminated food. It is also referred to as food-borne illness. These may attack people from any age group and lasts from few hours to several days. Food poisoning in severe case may cause chronic and fatal disease like arthritis and can attack lungs and kidneys.