Acute Cholecystitis

Among inflammatory diseases of bile ducts the most frequent is cholecystitis or the inflammation of the gal bladder. Cholecystitis is known to occur rarely in isolate condition, inflammatory processes both in the intrahepatic and extrahepatic ducts, sometimes with the involvement of the liver being associated with it. The main forms of cholecystitis are the following: catarrhal, purulent and gangrenous.

The patient with cholecystitis is known to complain of intense pain, it being localized in the right hypochondrium and in the umbilical area. An attack of pain is usually preceded by physicaland mentaloverstrain, sharp physic movements or abnormalities in diet, fatty food and alcohol being responsible for the onset of pain. But sometimes pain is observed to appear suddenly in quite healthy persons. Pain may radiate to the right shoulder, right arm, sternum, and lumbar area, its intensity depending on the form of cholecystitis and the patient's sensitivity. The pa grows much worse when the patient is lying on his right side.

Dryness in the mouth, vomiting, nausea, and constipation are the characteristic clinical manifestations of t disease.

During the attack of pain the face is moist with cc perspiration, the skin is pale, the tongue and lips are fit liven a slight palpation reveals severe tenderness, it being due to irritation of the peritoneum. Approximately in 50% of cases there is slight jaundice of sclerae. The chemical blood analysis is known to reveal some changes, they resulting from the effect of toxic substances in the liver.

Purulent form of cholecystitis is highly dangerous to life and requires an emergency operation. An even more severe course is observed in gangrenous cholecystitis. Recov­ery is achieved by surgical treatment, it being followed by prolonged antibiotic therapy and chemotherapy.

Exercise 5. Use the verbs in brackets in the appropriate tense of the Indefinite group. Translate the sentences:

1. Products of protein, fat, and carbohydrate digestion (to be absorbed) from the gastrointestinal tract by the liver in which they (to undergo) furthur chemical processes.

2. The liver (to destroy) toxic substances which usually (to be formed) in the intestinal tract as well as some poisons which (to enter) the body from without.

3. Jaundice (to be known) to be the disease which (to be due to) the presence of a large amount of bilirubin in the blood and tissues.

Exercise 6. Choose the appropriate form of the Infinitive. Translate the sentences:

1. The patient was known... stool retention accompa­nied by nausea a month before his present admission to the hospital. (a) to have; b) to have had; c) to be having)

2. Sensitivity to antibiotics was reported... not only in this patient but in all the other members of the family as well since their early age. (a) to be present; b) to have been present)

3. Prophylactic vaccination was found... since no cases of hepatitis were diagnosed after its admin­istration. (a) to be effective; b) to have been effective)

4. Skin irritation was revealed... after each parenteral administration of this preparation. (a) to occur; b) to have occurred; c) to be occurring)

Exercise 7. Translate the sentences paying attention to the construction Complex subject:

1. This diet seems to be good for the patients and should be recommended.

2. The basic mode of action is thought to be the same.

3. An ECG-based diagnosis may prove to be extremely difficult in patients with re-infarction.

4. A new imaging system is expected to give radiology additional information to guide biopsy recommendation.

5. Coronary patients are established to be at an increased risk of cardiac infarction.

6. Environmental factors are known to of significance.

7. Additional studies are required to determine the precise role of protein.

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