PERICHOLECYSTITIS (pericholecystitis; Greek peri around + cholecystitis) — inflammatory process of a serous cover of a gall bladder.
Distinguish the plastic and purulent Item. Plastic P. develops as a complication of cholecystitis, a peptic ulcer, appendicitis, especially at atypically high arrangement of a worm-shaped shoot, tubercular peritonitis, etc. Purulent P. meets less often and the hl develops. obr. as a result of perforation of a wall of a gall bladder at its empyema and spread of a purulent infection on a serous cover.
On a serous cover of a gall bladder develop commissures (see) that leads to deformation, disturbance of sokratitelny and concentration function of a gall bladder, change of qualitative and quantitative composition of bile and emergence as a result of it disturbances of digestion.
In a wedge, a picture note moderate pains of constant character in right hypochondrium, the irradiating to the lumbar area to the right of a backbone, and also surrounding and semi-girdle pains, obviously, connected with involvement in process of a pancreas or a duodenum. Idiosyncrasy of P. is strengthening of pain at the sharp movement of the patient. The unpleasant subjective feelings characteristic of cholecystitis (bitter taste in a mouth, dispeptic frustration), at P. amplify. At a palpation of a stomach morbidity in a point of a gall bladder is noted, also other symptoms characteristic can be expressed for cholecystitis (see). At considerable commissures in right the hypochondrium is noted muscular tension, consolidation is sometimes palpated.
By means of chromatic fractional duodenal sounding (see) and rentgenol, researches, napr, cholecystographies (see), reveal disturbances of process of a zhelchevydeleniye, change of normal position of a gall bladder and lack of changes in its situation at a postural change of a body, deformation of a shadow of a bubble, including roughness of its contours. Radio isotope and ultrasonic investigation allows to reveal change of a form and the sizes gall bladder (see). At a laparoscopy (see. Peritoneoskopiya ) find the wrinkled gall bladder covered with the dim serous cover thickened gray color (tsvetn, the tab., the Art. of Ltd company, fig. 00), quite often dense commissures between a bubble and surrounding bodies.
In plastic P.'s treatment along with correctly organized mode, a diet, antiinflammatory and cholagogue therapy the big place belongs to physical therapy and LFK. Purulent P.'s treatment — operational.
Forecast, as a rule, favorable.
Bibliography: Vinogradov V. V., Ma-zayevp.n, and Winter P. I. Diagnosis of cholecystitis, page 112, M., 19 78; Galkin V. A., Lindenbraten L. D. and Loginov A. S. Recognition and treatment of cholecystitis, page 96, 128, M., 1972; Gastroenterology, ed. by H. Bockus, y. 3, Philadelphia — L., 1976.
V. A. Galkin.