Introduction to the symptoms and treatment of acute cholecystitis

The most obvious symptom of acute cholecystitis is pain. Pay attention, especially when there is persistent pain in the abdomen and it gets worse. Also, be alert to possible nausea and vomiting. In treatment, pay attention to getting more rest and use some medications scientifically.

1. Symptoms

(1) Pain: The most common symptom. At the beginning of the disease, the pain is mostly limited to the upper abdomen under the xiphoid process, which is mild and continuous. Later, the pain gradually intensifies and moves to the right upper abdomen. It is continuous with paroxysmal aggravation. About half of the cases are accompanied by radiating pain in the right shoulder, back or right waist. If accompanied by cholelithiasis, the pain will be more severe and the paroxysms will be more obvious; if the pain is severe, breathing may be suppressed, and the breathing will be shallow and rapid.

(2) Nausea and vomiting: About half of the patients experience nausea, and more than one-third of the cases experience vomiting. Experiments have shown that simple gallbladder dilatation does not cause vomiting, but people with common bile duct dilatation often cause vomiting; if the symptoms are severe, the possibility of gallbladder duct or common bile duct stones should be considered.

(3) Fever: Patients often have a low-grade fever, generally between 38 and 39°C. The degree of fever is related to the extent and severity of inflammation. Chills and high fever are less common. If these phenomena occur, they usually indicate the presence of common bile duct inflammation or ascending hepatic duct inflammation.

II. Treatment

(1) Rest in bed and fast.

(2) Reduce gastrointestinal decompression and bile and pancreatic juice secretion.

(3) Antispasmodics and analgesics: Commonly used drugs include atropine, scopolamine (654-2) or scopolamine butylbromide (scopolamine), which are injected intramuscularly or dripped intravenously into a small pot.

(4) Intravenous rehydration to provide sufficient calories and correct dehydration and electrolyte imbalance.

(5) Antibiotics: Appropriate antibiotics should be selected, and the type and dosage should be determined based on the condition, age and other factors. Antibiotics against Gram-negative bacteria and anaerobic bacteria are generally preferred. Commonly used ones include ampicillin, gentamicin, amikacin, crotamiton (Ulisin) or sultamicillin (Suanxilin), etc.; for anaerobic bacteria, metronidazole (Flagyl) is generally used, and clindamycin (Clindamycin) can also be used. In addition, cephalosporins can be used.

(6) Traditional Chinese Medicine and Acupuncture: Traditional Chinese Medicine believes that acute cholecystitis is caused by stagnation of liver qi, dysfunction of the spleen, and accumulation of dampness and heat. It is generally a symptom of excess heat and should be treated by soothing the liver and promoting bile secretion, removing dampness and clearing heat. Chaihu Decoction can be used with modifications. Acupuncture therapy has the effect of relieving spasms and pain, reducing intra-biliary pressure, and promoting the disappearance of bile duct inflammation. Commonly used main acupoints include gallbladder point (Ashi point), Zusanli, Yanglingquan, Neiguan, etc., combined with auxiliary acupoints such as livershu, gallbladdershu, and Quchi. Herbal remedies include Centella asiatica, Lycopodiella cernua, Plantago seed, or Houttuynia cordata, Purslane, and Taraxacum officinale.