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m (→Cholelithiasis) |
(split 'cholecystitis' -- into 'chronic' and 'acute') |
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=Common= | =Common= | ||
== | ==Chronic cholecystitis== | ||
===General=== | ===General=== | ||
====Epidemiology==== | ====Epidemiology==== | ||
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===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
*Rokitansky-Aschoff sinuses.<ref>URL: [http://www.whonamedit.com/synd.cfm/983.html http://www.whonamedit.com/synd.cfm/983.html]. Accessed on: 29 October 2011.</ref> | *Rokitansky-Aschoff sinuses.<ref>URL: [http://www.whonamedit.com/synd.cfm/983.html http://www.whonamedit.com/synd.cfm/983.html]. Accessed on: 29 October 2011.</ref> | ||
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*Chronic inflammatory cells (lymphocytes - most common). | *Chronic inflammatory cells (lymphocytes - most common). | ||
*Fibrotic thickening of the gallbladder wall. | *Fibrotic thickening of the gallbladder wall. | ||
====Gangrenous cholecystitis==== | ====Gangrenous cholecystitis==== | ||
*[[Necrosis]] of gallbladder wall (muscularis propria).<ref>STC. 25 February 2009.</ref> | *[[Necrosis]] of gallbladder wall (muscularis propria).<ref>STC. 25 February 2009.</ref> | ||
==Acute cholecystitis== | |||
===General=== | |||
*Less common than ''chronic cholecystitis''. | |||
*Usually due to gallstones.<ref name=Ref_Sternberg5_1606>{{Sternberg5|1606}}</ref> | |||
*Classically older individuals (50s and 60s) with a slight female predominance.<ref name=Ref_Sternberg5_1606>{{Sternberg5|1606}}</ref> | |||
===Gross=== | |||
Features:<ref name=Ref_Sternberg5_1606>{{Sternberg5|1606}}</ref> | |||
*Wall thickening - due to edema and hemorrhage. | |||
*Gallstone(s) - classically obstructing the gallbladder neck. | |||
===Microscopic=== | |||
Features:<ref name=Ref_Sternberg5_1606>{{Sternberg5|1606}}</ref> | |||
*Edema. | |||
*Hemorrhage. | |||
*+/-Fibrin thrombi in small veins. | |||
*+/-Mucosal erosions. | |||
*+/-[[Neutrophils]]. | |||
**Not essential for the Dx of ''acute cholecystitis''. | |||
**Neutrophils usually secondary to [[necrosis]]/ulceration or infection.<ref name=Ref_DCHH174>{{Ref DCHH|174}}</ref> | |||
==Gallbladder cholesterolosis== | ==Gallbladder cholesterolosis== |
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