What are the main points of diagnosis of cholecystitis?

Clinically, it is believed that cholecystitis is not a very common disease, and many people suffer from cholecystitis often due to treatment errors, resulting in more serious cholecystitis, so when suffering from cholecystitis, it is necessary for patients to make a systematic diagnosis.So what are the key points in the diagnosis of cholecystitis?

Typical acute cholecystitis is easy to diagnose clinically, and some mild cases or early onset are easy to misdiagnose, because there are many diseases that can cause pain in the right upper quadrant clinically. For example, diseases such as acute viral hepatitis, acute pancreatitis, acute appendicitis, biliary roundworms, perforated peptic ulcers, and right-sided heart failure are often confused with acute cholecystitis.

(1) Acute pancreatitis: the disease can be secondary to acute cholecystitis and cholangitis, abdominal pain is more severe than acute cholecystitis, persistent, wide range and biased to the left side of the abdomen, tender range is also wider, blood and urine amylase are generally elevated.

(2) Acute appendicitis: The difference between high-level acute appendicitis and acute cholecystitis is mainly in the detailed analysis of medical history and signs.

(3) Biliary ascariasis: the onset is sudden, abdominal pain is paroxysmal colic under the xiphoid process, vomiting is frequent, there is often a history of ascariasis, and abdominal pain can be relieved by itself. In the early stage, epigastric tenderness is not obvious, and there is no abdominal muscle tension.

(4) Ulcer perforation: patients mostly have a history of gastric and duodenal ulcers, and the abdominal pain occurs suddenly and persistently, which is more severe than acute cholecystitis, and soon affects the entire abdomen, and the abdominal muscles are rigid, but there is rarely vomiting. It can be confused with acute cholecystitis because of a small duodenal perforation, or when a localized inflammatory lesion forms soon after the perforation.

(5) Liver abscess: an abscess located in the anterior and lower part of the right lobe of the liver, and the enlarged liver is easy to be mistaken for a gallbladder inflammatory mass when palpated.

In addition, young women should be distinguished from Fitz-Hugh-Curtis syndrome due to perihepatitis associated with acute salpingitis, which may have right upper quadrant pain and can be easily confused with cholecystitis, with adnexal tenderness on gynecologic examination and gonococcal or trachoma inclusions on cervical smear.

From the introduction of the above content, we can find that the onset of cholecystitis has certain similarities with many digestive diseases, which requires patients to make a diagnosis when receiving treatment, see which disease belongs to and then treat, which will reduce the misdiagnosis rate of treatment, and at the same time, it is also recommended that patients can follow the doctor's steps in the treatment process.