Acute Cholecystitis

Among inflammatory diseases of bile ducts the most frequent is cholecystitis or the inflammation of the gallbladder. Cholecystitis is known to occur rarely in isolated condition, inflammatory processes both in the intrahepatic and extrahepatic ducts, sometimes with the involvement of the liver being associated with it. The main forms of cholecystitis are the following: catarrhal, purulent and gangrenous.

The patient with cholecystitis is known to complain of intense pain, it being localized in the right hypochondrium and in the umbilical area. An attack of pain is usually preceded by physical and mental overstrain, sharp physical movements or abnormalities in diet, fatty food and alcohol being responsible for the onset of pain. But sometimes pain is observed to appear suddenly in quite healthy persons. Pain may radiate to the right shoulder, right arm, sternum, and lumbar area, its intensity depending on the form of cholecystitis and the patient’s sensitivity. The pain grows much worse when the patient is lying on his right side.

Dryness in the mouth, vomiting, nausea, and constipation are the characteristic clinical manifestations of the disease.

During the attack of pain the face is moist with cold perspiration, the skin is pale, the tongue and lips are dry. Even a slight palpation reveals severe tenderness, it being due to irritation of the peritoneum. Approximately in 40–50% of cases there is slight jaundice of sclerae. The biochemical blood analysis is known to reveal some changes, they resulting from the effect of toxic substances in the liver.

Purulent form of cholecystitis is highly dangerous to life and requires an emergency operation. And even more severe course is observed in gangrenous cholecystitis. Recovery is achieved by surgical treatment, it being followed by prolonged antibiotic therapy and chemotherapy.

Home Assignments 6

Task 1 Form the verbs using the suffixes and translate them:

-ize: general, local, sterile, character;

-en: thick, wide, deep, strength.

Task 2 Define the conjunction that is omitted. Translate the sentences:

1 When the urinalysis was ready the physician received all the findings he had insisted on.

2 The surgeon considered the appendix had to be removed immediately because its rupture might cause peritonitis.

3 Almost everything the physician had determined by physical methods of examination was confirmed by laboratory findings.

4 In all the patients except the one the cardiologist has not yet examined the diagnosis of cardiac insufficiency was made.

Task 3 Choose the proper form of the participle in Absolute Participle Construction:

1 The abdominal pain … by nausea and vomiting of 20 hours’ duration, the patient was hospitalized for an emergency surgery.

a) accompanied;b) being accompanied;

c) having accompanied;d) having been accompanied.

2There … permanent dryness in the mouth, nausea, and constipation, the diagnosis of acute cholecystitis may be suggested.

a) being;b) been;c) having been.

3 The severity of jaundice …, a considerably elevated amount of bilirubin was found in the blood on the following analysis.

a) increasing;b) being increased;c) having increased;

d) having been increased.

4 The postoperative course was smooth for a week, no recurrence of bleeding … .

a) observed;b) being observed;c) having observed;

d) having been observed

Task 4 Translate the following sentences into English using the Absolute Participle Construction:

1 Коли лікар пальпував печінку, болісність відмічалася на три пальці нижче реберного краю.

2 Іноді жовчнокамяна хвороба супроводжується ускладненнями, при цьому поява холіциститу є найчастішою.

Task 5 Read the text. Say what diseases are typically accompanied by jaundice. Write the English equivalents of the following word combinations:

стають жовтуватими, сильний свербіж, важкий випадок, типове ускладнення.