What is gallbladder empyema?
Gallbladder empyema is the most serious form of acute cholecystitis. Gallbladder empyema is usually the result of a progression of acute cholecystitis in the context of bile stasis and cystic duct obstruction. This is a surgical emergency that requires immediate treatment with antibiotics and an urgent aspiration/removal of the gallbladder to reduce the risk of septic shock.
Symptoms of gallbladder empyema
Most patients with empyema experience fatigue, fever, chills, perspiring, and loss of appetite, but older patients and those with diabetes may not have exact symptoms.
Other symptoms depend on the site of infection. If you have pleural empyema, you may knowledge shortness of breath, cough, and chest pain, while if you have gallbladder empyema you are likely to involve nausea, vomiting, constant and severe pain in the upper or middle-upper right abdominal area, and radiating pain. to the right shoulder blade.
Diagnosis of gallbladder empyema
Blood tests can help your doctor determine if there is an infection. Doctors can use ultrasound, chest x-ray, and CT to confirm the presence of empyema and indicate its location, thickness, and cause.
Treatment for gallbladder empyema
Management options for suppurative cholecystitis include both emergent cholecystectomy and percutaneous catheter drainage, also called percutaneous cholecystostomy (which can then be followed by cholecystectomy). The last option is generally reserved for those with additional comorbidities 6. The rate of conversion of laparoscopic cholecystectomy to an open procedure is considered higher than that of cases of uncomplicated acute cholecystitis. Gallbladder empyema is related to significant morbidity and humanity.
Your doctor will first try to control the infection with antibiotics. If this is not enough, you may be recommended to undergo a minimally invasive procedure called percutaneous drainage, in which an interventional radiologist uses image guidance to insert a tube and drain the pus.
Complications of gallbladder empyema
The gallbladder can form an abnormal passage, or fistula, between the gallbladder and the intestine to help process bile from the liver. This is usually a complication of chronic inflammation related to gallstones.
Other complications can include:
- Bowel obstruction
- Inflammation and scarring
- Perforation (a hole in the gallbladder)
- Bacterial contamination of the abdomen, known as peritonitis
- Malignant transformation (cells undergo change to become a cancerous tumor)