Pathophysiology: Cholecystitis

Non modifiable factors Modifiable factors

-Age (40 years old and above) -Obesity
-Gender/sex (female) -Rapid weight loss and diet
-Genetic predisposition -Lack of physical activity
-Estrogen levels -Long-term total parenteral
-Ethnicity (Native American & nutrition
Hispanics) -Oral contraceptives
-Pregnancy

Genetic & Demography Change in Bile Decreased contractility Increased

Composition of bile flow intraluminal
Pressure
Bile Stasis

Contraction of substances present in bile Stimulates smooth Increase

muscle contraction tension to
Precipitation of bile substances
duodenum

Bile substance will increase in size

Stones migrate to gall bladder RUQ abdominal Pain

Obstruction of the flow in bile Radiating pain to lower

back
Impaired Hepatic uptake Collection of soluble No bile reaches the GIT
of bilirubin bilirubin in the urine

Cholesterol salts Escape of bilirubin to GUT No bile in small Decrease bile

In the skin intestine for fat in the duodenum
Digestion
Jaundice Sterobilin
Emulsification of fats
Clay-colored stool
Presence of Nausea and Vomiting
Bile in the urine

Dark yellow urine

Obstructed cystic duct

Bile duct obstructed already
Gall bladder becomes distended
RUQ pain