414.Acute Cholecystitis（II）

Acute cholecystitis represents acute inflammation of the gallbladder. It is primarily caused by cholelithiasis obstructing the gallbladder neck or cystic duct. The obstruction leads to inflammation of the mucosa due to chemical injury from bile salts and/or superimposed infection. The inflammation causes reactive mucus production, which leads to distention and increased intraluminal pressure. The intraluminal distention restricts blood flow to the gallbladder wall, leading to wall thickening. Eventually, the gallbladder can become necrotic from prolonged ischemia. 

    Complications of untreated cholecystitis include gangrenous cholecystitis, emphysematous cholecystitis, hemorrhagic cholecystitis, and eventually gallbladder perforation. In emphysematous cholecystitis, gas produced by gas-forming bacteria is identified in the wall and lumen of the gallbladder. Because of its rapid progression to gangrene and perforation, emphysematous cholecystitis is a surgical emergency. In gangrenous cholecystitis, the gallbladder wall becomes necrotic with linear echogenicities in the gallbladder lumen, representing sloughed membranes. Small abscesses or hemorrhage in the gallbladder wall may develop. Perforation of the gallbladder can occur in prolonged inflammation with a small defect in the gallbladder wall and adjacent pericholecystic fluid collection/abscess.

Notes：

1. cholelithiasis /ˌkɔlili'θaiəsis/ /ˌkoləlɪˈθaɪəsɪs/ n. 胆石病

2. gangrenous /'gæŋgrənəs/ /'gæŋgrənəs/ adj. 坏疽的，腐败的

3. emphysematous /ˌemfi'semətəs/ adj. 气肿的

4. hemorrhagic  adj. 出血的

5. perforation /ˌpɜːfə'reɪʃn/ /ˌpɝfə'reʃən/ n. 穿孔；穿透

6. echogenicity 回声

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

---