Тақырыбы: Acute cholecystitis
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COЖ СД21 АНГЛ
| Treatment
Supportive care (hydration, analgesics, antibiotics) Cholecystectomy Management includes hospital admission, IV fluids, and analgesics, such as an NSAID (ketorolac) or opioid. Nothing is given orally, and nasogastric suction is instituted if vomiting or an ileus is present. Parenteral antibiotics are usually initiated to treat possible infection, but evidence of benefit is lacking. Empiric coverage, directed at gram-negative enteric organisms, involves IV regimens such as ceftriaxone 2 g q 24 h plus metronidazole 500 mg q 8 h, piperacillin/tazobactam 4 g q 6 h, or ticarcillin/clavulanate 4 g q 6 h. Cholecystectomy cures acute cholecystitis and relieves biliary pain. Early cholecystectomy is generally preferred, best done during the first 24 to 48 h in the following situations: The diagnosis is clear and patients are at low surgical risk. Patients are elderly or have diabetes and are thus at higher risk of infectious complications. Patients have empyema, gangrene, perforation, or acalculous cholecystitis. жүктеу/скачать 4,63 Mb. Достарыңызбен бөлісу:
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