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| Chronic cholecystitis |
| Etiology •Unknown |
| Pathogenesis •The pathogenesis of chronic cholecystitis is not well understood. •There may be a history of repeated attacks of acute cholecystitis. •However, in many instances, it appears to arise without any antecedent disease. •In one-third to one-quarter of cases, bacteria may be cultured from the fluids from within the gall bladder., |
| Epidemiology •Chronic cholecystitits occurs in the same age group as acute cholecystitis, predominantly women in the 30-50 year age group. •This is almost always associated with cholelithiasis. |
| General Gross Description •Grossly, the gall bladder may be enlarged, normal in size, or shrunken. •This serosa also shows evidence of prior inflammatory processes in the form of fibrin or fibrous deposition. •The wall is often thickened 2-3 times normal size. |
| General Microscopic Description •Microscopically, the walls shows involvement of chronic inflammation in the form of macrophages, lymphocytes and plasma cells. •Outpouchings of the mucosa through the muscle of the gall bladder wall (Rokitansky - Aschoff Sinuses) are a characteristic, but not diagnostic, feature of chronic cholecystitis. |
| Clinical Correlation •May be aymptomatic or present as acute cholecystitis on a background of chronic disease. •Other manifestations may be of biliary colic (due to the stones invariably present with chronic cholecystitis), fistula formation, hydrops of the gallbladder or perforation. |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 889 • Harrison's Principles of Internal Medicine, 13th Ed: Isselbach et. al. (eds). New York, McGraw-Hill, 1994, pp. 1510 |
| Chronic cholecystitis |
| Synopsis by: T.V.Rajan, M.D., Ph.D. (T57000M43000)[598] |
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