Mr. X, a 57 year-old, presented with pain at the right hypochondrium for 3 days prior to admission. The pain radiated from right hypochondrium to right iliac fossa. The pain was of sudden onset, throbbing in nature and constant. He complained of bloated abdomen, feeling nausea and fever with chills and rigors upon admission. He had no vomiting. His urine was tea-coloured and complained of watery stools. He did not have any chronic illnesses and was not allergic to any drugs or foods. He smokes 20 to 40 sticks per day for 46 years. He doesn’t drink alcohol.
Upon physical examination, he was afebrile with blood pressure of 130/88 mmHg, heart rate of 60 beats/min. and respiratory rate of 12 breaths/min. He was jaundice but not anaemic. His hydration status was fair. The abdomen was distended.T here was tenderness and guarding in the right side of abdomen but no mass palpated. Liver and spleen were not palpable. Bowel sounds were normal. There were no significant findings in the cardiovascular and respiratory examination.
Differential Diagnosis: Acute cholecystitis, acute hepatitis
Investigations: Ultrasound showed liver is homogenous with smooth outline and no focal lesion seen. Gall bladder is well distended and there is a single 1.0cm calculus seen within it.
Final Diagnosis: Acute cholecystitis
Q1) How do gall stones precipitate acute cholecystitis?
Q2) Why is there jaundice in acute cholecystitis?
Q2) Why is there jaundice in acute cholecystitis?
