Assessment of Socio-Demographic Profile and Clinical Presentation among Patients Diagnosed with Acute Cholecystitis of Nepal: An Observational Study

Background: Acute cholecystitis is defined as an inflammation of the wall of the gallbladder. In many cases an impacted gallstone in the gallbladder infundibulum or in the cystic duct is the cause for the inflammatory process. About 80% of patients with acute cholecystitis give a history compatible with chronic cholecystitis. Acute cholecystitis begins as an attack of biliary colic, but in contrast to biliary colic, the pain does not subside. The pain is typically in the right upper quadrant or epigastrium and may radiate to the right upper part of the back or the interscapular area. Objective: To assess the signs, symptoms and radiological findings for the diagnosis of acute cholecystitis. Material: Present study is a hospital based descriptive study conducted at B.P. Koirala Institute of Health Sciences, Dharan, NEPAL. This Study was conducted among patients who attended Emergency or Out-patient department during September 2017 to August 2018. History was taken regarding onset of symptoms (pain, fever, jaundice). Physical examination was done and pulse rate, blood pressure, co-morbid conditions and icterus, abdominal examinations including tenderness, lump. All the patients underwent random blood sugar, complete blood count, Blood group, chest x-ray, serum urea, creatinine, Liver function test and ultrasonography of abdomen and pelvis. Result: Most of the patients were in the age group between 35-65 years. There were a total of 21 males and 39 females. Out of 60 patients 47(78.3%) had history of vomiting. Out of 60 patients 19(31.6%) had fever during presentation. None of them had jaundice. One patient had recurrent attack of cholecystitis during initial conservative period and 7(11.6%) patients had history of biliary colic. Seven (11.6%) patients had history of hypertension. 7 (11.6%) had history of diabetes mellitus. 10 (16.6%) had past history of surgery. On radiological imaging mean gall bladder wall thickness of all patients was 6.09±1.89 and out of 60 patients 11(18.33%) patients had pericholecystic collection.