Many people do not even suspect what functions in the body are performed by certain organs. Only when faced with violations in their work, we begin to understand how necessary they really are. Any deviations are instantly reflected in the well-being of a person, his mood.
One of the important organs is the gallbladder. It constantly accumulates a special secret necessary to complete the digestion process. This organ is subject to various pathologies. Among all diseases, empyema of the gallbladder deserves special attention. The clinic, diagnosis, treatment of this insidious pathology - these are just some of the issues that we will now consider.
Description of the disease
Under the empyema of the gallbladder, it is customary to understand an acute inflammatory process that develops within this organ. It is characterized by a gradual accumulation of purulent exudate. The disease is manifested by severe pain, fever, symptoms of intoxication. Development of pathologicalprocess is possible in two ways. Inflammation passes from neighboring organs or is the result of exposure to infectious agents.
Empyema of the gallbladder occurs in 5-15% of patients with acute cholecystitis. Mostly middle-aged women with pronounced signs of obesity are ill. Empyema belongs to the category of progressive disorders, therefore, after its detection, immediate hospitalization is required. In the absence of adequate treatment, the probability of death of the patient is high.
Stages of pathology
Empyema of the gallbladder develops gradually. Let's look at each of the steps in this process.
In a he althy body, the liver actively secretes a secret that accumulates in the gallbladder. One part of it is excreted into the intestine, where it further takes part in the digestion of food. The other is resorbed by the walls of the bladder.
As a result of the inflammatory process, purulent exudate begins to be produced in the organ cavity. The resorbing abilities of its walls are lost. Fluid gradually accumulates in the gallbladder. The inflammatory process from the serous form very quickly turns into a purulent one. The concomitant obturation of the common bile duct interferes with the full excretion of bile. Further stretching of the organ walls can lead to tissue atrophy.
Dropsy and empyema of the gallbladder
These two diseases have a similar etiology and clinical presentation. Therefore, it is advisable to consider them together.
Dropsy and empyema of the gallbladder are most often the result of a blockageduct. A detached calculus or neoplasm can lead to this violation. Unlike dropsy, the development of empyema is always preceded by acute cholecystitis, i.e., an inflammatory process.
As for the clinical picture, both diseases are manifested by fever, discomfort in the right hypochondrium. Patients with dropsy also complain of persistent vomiting of bile and intestinal colic.
Some doctors consider dropsy to be one of the underlying causes of empyema. However, there are other factors that contribute to the development of the pathological process.
Other causes of empyema
As mentioned earlier, the disease often develops against the background of cholecystitis. The calculus clogs the ducts, and the result of this violation is inflammation. The secret inside the gallbladder gradually accumulates. It is considered a favorable environment for the life of pathogenic flora. Clostridia, staphylococci, Klebsiella and other microorganisms can act as infectious agents.
Another common cause of disorder is a malignant tumor. If the neoplasm is not removed from the bladder in a timely manner, the inflammatory process will continue to progress. In this case, the result for the patient is disappointing - tissue necrosis.
Medics identify a group of patients who are more prone to the appearance of empyema of the gallbladder. Includes:
- overweight people;
- diabetics;
- patients withvarious kinds of immunodeficiencies.
Determining the cause of a disease often helps guide treatment.
How to recognize the disease at an early stage?
Developing empyema of the gallbladder has symptoms similar to those of acute cholecystitis. Patients complain of discomfort in the area of the right hypochondrium, a sharp increase in temperature. Sometimes symptoms are accompanied by severe chills.
Indirect signs of the disease include lack of appetite, excessive sweating and dry mouth. Pain in the area of the right hypochondrium is not always present. They may get worse when you take a deep breath or cough.
It is worth noting that in diabetes and immunodeficiency disorders, the listed symptoms are less pronounced. Therefore, patients seek medical help too late. Lack of treatment is fraught with perforation of the bladder and sepsis. The development of these pathological conditions is evidenced by an even greater increase in temperature. There may also be confusion, a decrease in blood pressure.
Patients with acute cholecystitis or gallbladder tumors need to pay special attention to their own he alth. When the above symptoms appear, you should immediately call a team of medical workers. Only hospitalization and proper treatment in such cases can save a life.
Medical examination
Empyema of the gallbladder is detectedbased on the patient's complaints, his anamnesis and test results. The patient should tell how long ago the symptoms appeared, under what conditions their intensity increases, what treatment he had previously received. All data is important for the doctor. Without this information, it is impossible to choose an adequate treatment.
It is mandatory for all patients to undergo an examination of the body. If a disease such as gallbladder empyema is suspected, diagnosis includes the following activities:
- Blood test. An increase in leukocytes indicates an inflammatory process.
- Microbiological blood test. Allows you to determine the presence of infectious agents, their sensitivity to antibiotics.
- Biochemistry of blood. With this test, you can evaluate the functioning of the liver. Increased bilirubin activity indicates empyema.
- Ultrasound. With a progressive inflammatory process, the gallbladder is usually enlarged, fluid accumulation can be seen around it.
Additionally, differential diagnosis of dropsy and empyema of the gallbladder is carried out.
Recommended Therapy
The only treatment for empyema is removal of the gallbladder. The operation is called cholecystectomy. Before it is carried out, the patient is prescribed a course of antibiotics. Drug therapy helps to reduce associated symptoms, reduces the risk of postoperative complications.
Ampicillin is used in the initial stages of the inflammatory process, andalso first-generation cephalosporins. If its course is complicated by sepsis or perforation of the gallbladder, more massive antibiotic therapy is required. Usually, the patient is prescribed the simultaneous administration of three drugs: "Gentamicin", "Ampicillin" and "Metronidazole". Dosage and treatment regimen are selected individually.
Cholecystectomy is performed either through a full abdominal incision or laparoscopically. Which option to choose from the proposed, the doctor decides. After surgery, when empyema of the gallbladder remains in the past, antibiotic treatment is continued. The duration of therapy depends on how quickly the temperature and blood indicators return to normal. Sometimes patients have to take medication even after being discharged from the hospital.
Recipes of folk healers
Only conservative medicine can help patients with empyema. Self-medication is often fatal or leads to complications.
However, some medicinal plants are used to combat one of the causes of the disease - cholecystitis. Healers are advised to pay attention to horseradish. The roots of this plant help with many ailments. To eliminate the symptoms of cholecystitis, it is necessary to prepare a decoction. A glass of raw materials should be poured with a liter of hot water and left in a container under the lid. A day later, the resulting infusion should be filtered. It is recommended to store such a medicine in the refrigerator, and take it warm in small portions.
Possible Complications
Empyema of gallbladderbubble, provided it is detected in a timely manner, does not pose a threat to life. The greatest danger is the complications of the pathological process, which are not uncommon in patients with this diagnosis.
Stretching and atrophy of the walls of the gallbladder can lead to perforation of the organ. There are two types of perforation: covered and full. In the latter case, peritonitis develops rapidly. When infectious agents enter the bloodstream, sepsis occurs, which is characterized in most cases by an unfavorable outcome.
Postoperative complications include wound infection and subhepatic abscess.
Prognosis for recovery
What should patients with a diagnosis of gallbladder empyema expect? Types and stages of any pathological process determine its outcome. If the disease is diagnosed in a timely manner, and the patient is provided with the necessary assistance, one should hope for a favorable prognosis. In the case of blood poisoning, the outcome of therapy is not always positive. The probability of death of the patient with such complications is quite high.
Prevention measures
Can empyema of the gallbladder be prevented? The signs of the pathological process, which are presented a little higher in the article, make many people think about the seriousness of the disease.
To prevent its development, doctors advise periodically undergoing a complete medical examination of the body. Particular attention should be paid to ultrasound of the pelvic organs. Detailed diagnosticsgallbladder allows you to identify any pathology at the initial stage of its development. The sooner the patient starts the prescribed treatment, the sooner he will recover.
