Cholecystitis: Is
the swelling of gallbladder. Gallbladder is a small shape organ connected to
the liver on the right side of the abdomen, the gallbladder store bile which realizes
them into the stomach to assist fat digestion. Almost case of cholecystits are
cause by gallstone which form from cholesterol and bilirubin pigment, but some
case of the problem are cause by trauma treatment in the hospital or treatment
of sickness related to liver and bile.
Cholangitis: this are common
bile duct infection, bile duct is a channel that carries bile from liver to the
gallbladder. Cholangitis are mostly cause by bacteria infection and it occur
when the bile duct is blocked by some material such as gallstone, and this
infection can also spread to liver which may cause liver problem.
Treatment
Surgical implication
As a result of accumulation of pus in
the affected area, one of the best of medical therapy of the effected area is
by removing the accumulated pus in the affected area by surgical procedure,
called cholecystectomy. But this should be done base on the condition of the
patient, and what the doctor see that it will be the best option for treatment.
Drugs Therapy
Acute cholecystitis
Mild and asymptomatic cases without risk factors may not require
antibiotic
treatment. If signs of infection present and/or risk factors for
severe disease
present:
» Elderly patients (older than 60 years)
» Co-morbidity
» Immune compromise
Acute cholecystitis and acute cholangitis
• Ampicillin, IV, 1 g 6
hourly.
PLUS
• Gentamicin, IV, 6 mg/kg
daily.
PLUS
• Metronidazole, IV, 500 mg
8 hourly.
REFERRAL
» Clinical deterioration or failure to improve.
» Fistulae or perforation.
» Need for complicated surgery.
1.3 DIARRHOEA, GASTROINTESTINAL
1.3.1 CHOLERA
A00.9
*This is a notifiable disease.
DESCRIPTION
Diarrhoea due to Vibrio cholerae, often in outbreaks.
GENERAL MEASURES
Rehydration is the cornerstone of management. This should be
done with
oral rehydration solution (ORS) unless the patient is vomiting
or profoundly
dehydrated.
MEDICINE TREATMENT
• Ciprofloxacin, oral, 1 g
immediately as a single dose
o Adjust according to the sensitivity of the isolate responsible
for the
local epidemic.
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