急性胆囊炎

最后审阅: 7 九月 2022
最后更新: 05 五月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 右上腹疼痛
  • 右上腹压痛
  • 炎症的症状和体征
  • 可触及肿块
  • 存在的危险因素
完整详情

其他诊断因素

  • 发热/寒战
  • 恶心
  • 右肩痛
  • 厌食
  • 呕吐
  • 黄疸
完整详情

危险因素

  • 结石
  • 缺乏体力活动
  • 低纤维摄入
  • 严重疾病
  • 创伤
  • 重度烧伤
  • 全胃肠外营养 (TPN)
  • 糖尿病
  • 头孢曲松钠
  • 环孢素
  • 肝动脉栓塞形成
  • 感染
完整详情

诊断性检查

首要检查

  • 腹部 CT 或 MRI
  • 腹部超声
  • 全血细胞计数 (FBC)
  • C 反应蛋白 (CRP)
  • 胆红素
  • 肝功能检查 (LFT)
  • 血清脂肪酶或者淀粉酶
  • 血培养和/或胆汁培养
完整详情

需考虑的检查

  • 磁共振胰胆管造影术 (MRCP)
  • 超声内镜 (EUS)
完整详情

治疗流程

急症处理

相关器官功能障碍(重度;东京指南 III 级)

无相关器官功能障碍(轻度或中度;东京指南 I 级或 II 级)

撰稿人

专家顾问

John Abercrombie, FRCS

General and Colorectal Surgeon

Queen's Medical Centre

Nottingham

UK

简介

JA is Clinical Lead for General Surgery, Getting It Right First Time.

利益声明

JA is a council member of the Royal College of Surgeons of England. He also provides expert advice to Spire Healthcare on clinical management of selected cases and on improving processes for review of cases resulting in mortality.

Acknowledgements,

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Charles Bellows MD

Professor of Surgery

University of New Mexico School of Medicine

Albuquerque

NM

利益声明

CB is an author of one study referenced in this topic. CB declares that he has no other competing interests.

同行评议者

Christian Macutkiewicz, MD, FHEA, FRCS

Consultant General and Hepato-Pancreato-Biliary Surgeon

Clinical Lead for Emergency General Surgery, Gastrointestinal Medicine, and Surgery CSU

Manchester Royal Infirmary

Manchester

Director of Scientific Programme

Association of Surgeons of Great Britain and Ireland

UK

利益声明

CM declares that he has no competing interests.

编辑

Emma Quigley,

Section Editor, BMJ Best Practice

利益声明

EQ declares that she has no competing interests.

Sue Mayor,

Lead Section Editor, BMJ Best Practice

利益声明

SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including NICE, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, NCEPOD, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare, and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Tannaz Aliabadi-Oglesby,

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Julie Costello,

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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