What causes cholecystitis in older people
Among gallbladder diseases, cholecystitis is the most common disease, especially in the elderly, who are prone to the disease of cholecystitis in the elderly. In recent years, cholecystitis is a disease that tends to occur at a younger age, and some young people are unfortunately infected with cholecystitis. So, do you know the causes of cholecystitis? Next, let's take a look at the editor's explanation for this.
What causes cholecystitis in older adults?
Acute cholecystitis is caused by abrupt obstruction of gallstones or incarcerated cystic ducts, which can also be caused by cystic duct torsion, stricture, and obstruction of biliary roundworms or biliary tract tumors.
In addition, in the process of aging, the gallbladder wall gradually becomes hypertrophied or atrophied, and the contractile function decreases, resulting in cholestasis, concentration and the formation of cholates; The end of the common bile duct and the sphincter of Oddi become flaccid, making retrograde infection more susceptible; Systemic atherosclerosis, increased blood viscosity can exacerbate gallbladder artery ischemia.
These pathophysiological changes are the reason why the incidence of cholecystitis and gallstone disease is higher in the elderly than in the younger, and it is also the reason why acute gangrenous cholecystitis and gallbladder perforation are more common in older patients.
After obstruction of the cystic duct or gallbladder neck, stagnant bile in the gallbladder concentrates to form bile salts, which irritate the gallbladder mucosa and cause chemical cholecystitis (early stage); At the same time, bile retention increases the pressure in the gallbladder, the swollen gallbladder first affects the venous and lymphatic reflux of the gallbladder wall, the gallbladder appears congested and edema, when the internal pressure of the gallbladder > 5.39kpa(55cmH2O), the arterial blood flow in the gallbladder wall is blocked, the gallbladder undergoes ischemic injury, and the ischemic gallbladder is prone to secondary bacterial infection, aggravating the process of cholecystitis, and finally complicating gallbladder gangrene or perforation.
If the cystic duct is obstructed without circulatory disorders and bacterial infections of the gallbladder wall, a gallbladder effusion develops. Recent studies have shown that phospholipase A can be released from the damaged gallbladder mucosal epithelium due to cholestasis or stone incarceration, and the lecithin in the bile is hydrolyzed into lysolecithin, which in turn changes the integrity of mucosal epithelial cells and causes acute cholecystitis.
The above is the more common cause of cholecystitis in the elderly, gallbladder disease experts remind cholecystitis patients: for the treatment of cholecystitis, the earlier the diagnosis and treatment, the easier it is to cure, if it is not treated for a long time, it will not only increase the difficulty of treatment, but also the patient needs to bear greater pain. Therefore, for patients who unfortunately suffer from cholecystitis in the elderly, early treatment is the right choice.