Empyema of the gallbladder: signs, diagnosis and treatment

Many people do not even suspect what functions in the body are performed by those or other organs. Only when faced with violations in their work, we begin to understand how much they really need. Any deviations instantly affect the person's well-being, his mood.

One of the important organs is the gallbladder. It constantly accumulates a special secret, necessary for the completion of the process of digestion. This organ is prone to various pathologies. Among all diseases, empyema of the gallbladder deserves special attention. The clinic, diagnostics, treatment of this insidious pathology are just some of the issues that we will now turn to.

Description of the disease

Under the empyema of the gallbladder is commonly understood as an acute inflammatory process developing within this organ. It is characterized by a gradual accumulation of purulent exudate. The disease is manifested by severe pain, fever, symptoms of intoxication. The development of the pathological process is possible in two ways. Inflammation passes from neighboring organs or is the result of exposure to infectious agents.

The empyema of the gallbladder occurs in 5-15% of patients with acute cholecystitis. Mostly middle-aged women with severe signs of obesity are ill. The 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 the patient's death is high.

Stages of the emergence of pathology

The empyema of the gallbladder develops gradually. Let's consider each of the stages of this process.

In a healthy body, the liver actively secretes a secret that accumulates in the gallbladder. One part of it is excreted into the intestine, where it takes part in the digestion of food. The other is resorbed by the walls of the bladder.

As a result of inflammation in the body cavity begins to develop purulent exudate. Resorptive abilities of its walls are lost. The gall bladder gradually accumulates fluid. Inflammatory process from a serous form very quickly passes in purulent. Concomitant obturation of choledocha interferes with the complete excretion of bile. Further stretching of the walls of the organ can lead to tissue atrophy.

Dropsy and empyema of the gallbladder

These two diseases have a similar etiology and clinical picture. Therefore, it is advisable to consider them together.

Dropsy and empyema of the gallbladder are most often the result of blockage of the duct. This disruption may result in a detached stone or tumor. Unlike hydrocephalus, the development of empyema is always preceded by acute cholecystitis, ie, 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 constant vomiting of bile and intestinal colic.

Some doctors believe that dropsy is one of the underlying causes of empyema. However, there are other factors contributing to the development of the pathological process.

Other causes of empyema

As already mentioned earlier, the disease often develops against the background of cholecystitis. The concrement clogs the ducts, and the result of this disorder is inflammation. The secret inside the gall bladder gradually accumulates. It is considered a favorable environment for the life of pathogenic flora. Clostridia, staphylococci, Klebsiella and other microorganisms may act as infectious agents.

Another common cause of the disorder is a malignant tumor. If the neoplasm is not removed in a timely manner from the bladder, the inflammatory process will continue to progress. In this case, the result for the patient is disappointing - tissue necrosis.

Physicians identify a group of patients who are more predisposed to the appearance of empyema of the gallbladder. It includes:

• People with excessive body weight;
• Patients with diabetes mellitus;
• Patients with various types of immunodeficiency.

Determining the cause of the disease often helps to choose the tactics of treatment.

How to recognize the disease at an early stage?

Developing empyema of the gallbladder symptoms has similarities to those that are characteristic of acute cholecystitis. Patients complain of discomfort in the right hypochondrium, a sharp increase in temperature. Sometimes the symptoms are accompanied by a strong chill.

Indirect signs of the disease include a lack of appetite, excessive sweating and dry mouth. Painful sensations in the zone of the right hypochondrium are not present constantly. They can intensify with a deep breath or cough.

It is worth noting that with diabetes and immunodeficiency disorders, these symptoms are less pronounced. Therefore, patients too late seek medical help. Absence of treatment is fraught with perforation of the bladder and sepsis. The development of these pathological conditions is further evidenced by an even greater temperature increase. There can also be confusion, a decrease in blood pressure.

Patients with acute cholecystitis or gall bladder tumors need to pay special attention to their own health. If you have the above symptoms, you should immediately call a team of health professionals. Only hospitalization and competent treatment in such cases can save a life.

Medical Examination

The empyema of the gallbladder is revealed on the basis of the patient's complaints, his anamnesis and the results of the tests. The patient should tell you how long the symptoms have appeared, under what conditions their intensity is increasing, what treatment he has undergone earlier. All data is important for the doctor. Without this information it is impossible to select an adequate treatment.

On an obligatory basis all patients are given an examination of the body. If you suspect a disease such as empyema of the gallbladder, the diagnosis includes the following activities:

1. Blood test. The increase in leukocytes indicates an inflammatory process.
2. Microbiological examination of blood. It allows to determine the presence of infectious agents, their sensitivity to antibiotics.
3. Biochemistry of blood. With this test, you can evaluate the performance of the liver. Increased activity of bilirubin indicates empyema.
4. Ultrasound. With a progressive inflammatory process, the gallbladder is usually enlarged, a cluster of fluid can be considered around it.

In addition, differential diagnosis of dropsy and empyema of the gallbladder is performed.

Recommended therapy

The only way to treat empyema is to remove the gallbladder. The operation is called "cholecystectomy." Before it is carried out, the patient is prescribed a course of antibiotics. Drug therapy helps reduce associated symptoms, reduces the risk of postoperative complications.

At the initial stages of the inflammatory process, use "Ampicillin", as well as cephalosporins of the first generation. If its course is complicated by sepsis or perforation of the gallbladder, more massive antibiotic therapy is required. Usually, the patient is prescribed a simultaneous intake of three drugs: Gentamycin, Ampicillin and Metronidazole. Dosage and treatment regimen are selected individually.

Cholecystectomy is performed either through a full-blown cutaneous incision, or laparoscopically. What option to choose from, the doctor decides. After surgery, when the empyema of the gallbladder remains in the past, antibiotic treatment continues. The duration of therapy depends on how quickly the temperature and blood levels come back to normal. Sometimes patients have to take medication even after they leave the hospital.

Recipes of folk healers

Only conservative medicine can help patients with empyema. Self-medication often ends with a fatal outcome or leads to the development of complications.

However, some medicinal plants are used to combat one of the causes of the disease - cholecystitis. Wizards are advised to pay attention to horseradish. The roots of this plant help from many ailments. To eliminate the symptoms of cholecystitis, you must prepare a decoction. A glass of raw material should be filled 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 this medicine in the refrigerator, but to take it in warm form in small portions.

Possible complications

The empyema of the gallbladder, provided it is detected in a timely manner, does not pose a threat to life. The greatest danger lies in the complications of the pathological process, which in patients with such a diagnosis are not uncommon.

Stretching and atrophy of the walls of the gallbladder can lead to perforation of the organ. Perforation can be of two types: 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? The 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 a patient with such complications is quite high.

Preventive measures

Is it possible to prevent the onset of such a disease as empyema of the gallbladder? The signs of the pathological process, which are presented just above in the article, make many think about the seriousness of the ailment.

To prevent its development, doctors advise to periodically undergo a full medical examination of the body. Particular attention should be paid to pelvic ultrasound. Detailed diagnosis of the gallbladder can reveal any pathology at the initial stage of its development. The sooner the patient proceeds to the prescribed treatment, the sooner he will recover.