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CLINICAL MANIFESTATM ☐
Pain → It's constant
;
not
colicky
follows fatty^
meal intake^ , inducing gallbladder
contraction .
- pain
is localised^ ⑨^ Rt-
epigastrium 1-
Radiate to Rt. shoulder 1-Back
3) Gallstone associated I *artiste
of AB carcinoma 8048*8TTIITTTI$ Inflammation of^ gallbladder^ which could^ be ① (^) Acute ② (^) Chronic ③ Acute -
superimposed on
chronic
- ACUTE^ CHOLECYSTITIS^
- : In (^) 90% cases it's (^) caused
by
obstruction (^) on week of (^) gallbladder as
cystic
duct by stones ① comp LICATN (^) Acute (^) Calculous Cholecystitis Emergency surgery^
is needed.
10% (^) cases tf → A^ calculous^ cholecystitis
released within^ wall
of
distended gallbladder contribute to^ mucosal (^) + Mural
inflammation
- teeter bacterial^ infectious Tweede
Acute^
calculous cholecystitis
→ is common ein
☆☆* diabetic^ patients
having
symptomatic
Goku Acute acidulous^
cholecystitis
:
resulting
from ischemia
→Rt^ + No^ co-^ lateral^ uaeculatu
m¥¥Jfwpia
attic (^) arty
% an end
artery
! artery Tuflamatt edema^ of a. B ↓ compromising
blood flow
inferior
cptieyey
+ a.^ B stasis due^ to^ accumulator
of micro
crystal of^
cholesterol
#Risk factor (^) fare Acute (^) Acalculus cholecystitis
☐ sepsis +^ Hypotnsn # MORPHOLOGY
- Maltings^
organfail^ ① Acute
cholecystitis
ᵗETʰʰ
- Immuno. suppresn a) Jemima^ +^ Burns^ Red / blotchy snbserosal (^1) , to
- (^) PM G) Infections (^) haemorrhage Green -
Black
discolouration ← ②
Calculous
cholecystitis
obstructing
stone @ neekofa ' B' cloudy
bite + Fibrin
pees this^ % ,• is called (^) as - Gallbladder empyema
MORPHOLOGY^
-8 ① CHRONIC^ CHOLECYSTITIS^
- : ⑥ (^) Serosa -6 smooth *allstaring ᵗ# Dull fibrosis ② Thickened^ wall^ + opaque Grey
- (^) white appearance ③ Mucosa^ preserved -^ green
yellow mucoid bite (^) - stones ⑥ flisbo^ -4^ ☐^ lymphocyte +^ plasma cells^ +
of bet^ ⑨^ Mucosa^ tsubserosal^ fibrous
- subenpitheliwm &^ dumbaerosol fibrosis time!
- (^) ROKITANSKY
- ASCHOFF SINUSES outpouring of^
mucosal epithelium
Ñ_
a) PORCELAIN GALLBLADDER^
calcification
8) HYALINE22h14 CHOLECYSTITIS ÷ mucosa →fihoeosed
- (^) Manthegranulomatous cholecystitis ÷ Thickened (^) wall + shrunken +modular + (^) inflamed c- foie (^) of necrosis + hemorrhage
- lipid - containing all + foamy cytoplasm = Xanthoma cells
a) tlydeops^ of^ Gallbladder
tonically obstructed (^) + dictated^ + (^) clear secretion
Gallbladder Carcinoma
COMPELCATH
☐ Bae. superinfect " (^) c- cholangitis/^ sepsis
2) a.^ B.^
perforate
- GB^ rupture
diffuse
peritonitis
a)
Biliary
enteric fistula → a.stone^ induced^ intestinal obstructs
Aggrenatw of^ preexisting med. illness → 1 ¥ (^) ☒ 8 ☒
→ (^) Most common 1-. pts with gallstone
develops (^) gallbladder carcinoma.
# MORPHOLOGY÷
☐ Flat +iusifu lesion c-
varying dysplasia mass farming adenoma -^ cessions Interchangeable papillary^ tubular (^) neoplasm
Adenocarcinoma -^ detected^ in^ fundus 1-, Glands unheeded^ eh^ dlsuioplastic stroma^ + peri neural^ &
portagesculler^ invasion^ is^ also^ seen
