Positive signs of cholecystitis

If you have chest pain, be sure to go to the hospital for examination in time. Chest pain is a symptom of cholecystitis. If you suffer from cholecystitis, you must receive timely targeted treatment to prevent the disease from worsening. If the cholecystitis is too severe, surgical treatment is necessary, which is not worth the cost. Therefore, we must have a clear understanding of cholecystitis and pay attention to our bodies. So, what are the positive signs of cholecystitis?

1. Acute cholecystitis

The clinical manifestations of acute calculous cholecystitis are basically the same as those of acute acalculous cholecystitis.

(1) Symptoms

① Pain: Severe pain or colic in the right upper abdomen is mostly caused by acute cholecystitis due to stones or parasites blocking the neck of the gallbladder. The pain often occurs suddenly and is very severe, or presents a colic-like state. It often occurs after eating high-fat foods and often occurs at night. General pain in the right upper abdomen is seen in acute cholecystitis without obstruction of the cystic duct. The pain in the right upper abdomen is generally not severe and is mostly persistent bloating. As the gallbladder inflammation progresses, the pain may also worsen. The pain is radiating, and the most common radiating sites are the right shoulder and the lower angle of the right scapula. It is caused by the stimulation of the right phrenic nerve endings and the peripheral nerves of the abdominal wall by gallbladder inflammation. ②Nausea and vomiting

The most common symptoms include persistent or frequent nausea and vomiting, which can cause dehydration, collapse and electrolyte imbalance, and are more common when stones or ascaris block the gallbladder duct. ③ Chills, chills, and fever. Mild cases often have chills and low fever; severe cases may have chills and high fever, the temperature may reach above 39°C, and mental symptoms such as delirium and delirium may occur. ④ Jaundice is less common. If jaundice occurs, it is generally mild, indicating that the infection has spread to the liver through the lymphatic vessels, causing liver damage, or the inflammation has invaded the common bile duct.

(2) Main signs

Abdominal examination revealed tense abdominal muscles, tenderness, rebound tenderness, and positive Murphy's sign in the right upper abdomen and mid-upper abdomen. In patients with cholecystectomy or pericholecystic abscess, a tender mass or a significantly enlarged gallbladder may be felt in the right upper abdomen. When abdominal tenderness and abdominal muscle tension extend to other areas of the abdomen or the entire abdomen, it indicates gallbladder perforation. Or there is acute peritonitis. 15% to 20% of patients suffer from liver damage due to edema around the cystic duct, gallstone compression and pericholecystitis, or inflammation involving the common bile duct, causing spasm and edema of the sphincter of Oddi, leading to bile excretion obstruction and mild jaundice. If the jaundice becomes significantly worse, it may indicate common bile duct obstruction with stones or concurrent common bile duct inflammation. In severe cases, signs of peripheral circulatory failure may occur. Blood pressure is often low and even infectious shock may occur, which is particularly common in severe cases of purulent gangrene.

2. Chronic cholecystitis

(1) Symptoms

Persistent dull pain or discomfort in the right upper abdomen; symptoms of indigestion such as nausea, belching, acid reflux, abdominal distension and heartburn; pain in the right lower scapular area; symptoms worsen after eating high-fat or greasy food; long course of disease, with alternating acute attacks and remissions. Acute attacks are the same as symptoms of acute cholecystitis, and remission may sometimes be without any symptoms.

(2) Physical signs

There may be mild tenderness and percussion pain in the gallbladder area, but no rebound tenderness; in cases of cholestasis, an enlarged gallbladder may be palpated; in acute attacks, there may be muscle tension in the right upper abdomen, normal body temperature or low fever, and occasionally jaundice. The tenderness point of the gallbladder is at the intersection of the outer edge of the right rectus abdominis and the costal arch, the tenderness point of the thoracic spine is beside the 8th to 10th thoracic vertebrae, and the tenderness point of the right phrenic nerve is between the two lower corners of the sternocleidomastoid muscle on the right side of the neck.