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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Persistent Abdominal Pain Even After Taking Medicines For Acute Cholecystitis. Suggestive Treatment?

My father aged 70 years, heinght 5.5 feet, weight 60 kg had an abdominal ultrasound done around 6 months back when he complained of severe abdominal pain . The ultrasound report suggests that he has acute cholecystisis, diffuse irrugular thickening of urinary bladder wall and enlarged prostate . Gall bladder wall with diffuse edematous thickening of gall bladder wall mesuring 0.58cm however no calculus is seen within the lumen. After taking medication, he was fine however even now sometimes he complains of stomach pain. Please suggest what treatment needs to be done?
Wed, 5 Dec 2012
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Urologist 's  Response
Hello
Thanks for your query.Your father had acute Cholecystitis and his Ultrasound revealed findings suggestive of Acute Cholecystitis As he is getting repeated attacks of pain due to Cholecystitis It is better to get it removed by Laproscopic Surgery which is safe and gives permanent remedy.
As regards his Enlarged Prostate consult some Urologist who will advise some medication like Tomsulosin ,Dutasteride or Syrgery(TURP)depending upon the severity of his Urinary symptoms and Ultrasound findings.
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General Surgeon Dr. Dr. Ivan Romich's  Response
Dear pompyc, medications which your father was taking were probably antibiotics which healed galbladder acute inflammation, but this inflammation is usually caused by calculus and this inflamamtion usually goes to subacute or chronic phase. Modern medical opinion is that acute cholecystitis should be treated conservatively (except for gangrenous and perforated type) but also cholecystectomy should be performed after regression of inflamation, usually 2-3months after the acute attack episode. Calculus dont need to be seen on US ,also cholecystitis can be caused by gallblader sand/sludge. I cant tell you reasons why cholecystectomy wasnt performed in your case because i dont know enough infos about comorbidity. This age isnt contraindication for surgery, laparoscopic as well. Today it is a routine procedure with low incidence of complications and best way to treat biliary collics. He may be able to relieve biliary colic by following a bland diet but I suggest surgical treatment definitely.



Wish you good health, Dr. Ivan Romich(Rominho)
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Persistent Abdominal Pain Even After Taking Medicines For Acute Cholecystitis. Suggestive Treatment?

Hello Thanks for your query.Your father had acute Cholecystitis and his Ultrasound revealed findings suggestive of Acute Cholecystitis As he is getting repeated attacks of pain due to Cholecystitis It is better to get it removed by Laproscopic Surgery which is safe and gives permanent remedy. As regards his Enlarged Prostate consult some Urologist who will advise some medication like Tomsulosin ,Dutasteride or Syrgery(TURP)depending upon the severity of his Urinary symptoms and Ultrasound findings.