2024-03-06 19:50:25
March 7, 2024
Mandy (pseudonym), a 56-year-old designer who likes to eat delicious food in her spare time, cooks complex dishes by herself every weekend and holiday: shark’s fin, dongpo pork, homemade roast pork, all of which are beyond her reach. Due to her love of eating and lack of exercise, Mandy’s pounds have been increasing in recent years, but she doesn’t pay much attention to it and only eats it.
One day, following eating a hairy crab feast, Mandy felt abdominal pain, which did not improve even following taking some patent medicines. She also had a fever that alternated between cold and hot. Upon seeing this, her family immediately sent her to the hospital. When she arrived at the hospital, she was confused and had low blood pressure. She had to be immediately admitted to the intensive care unit. Blood tests showed that her white blood cells and inflammation index were very high, and her liver function was abnormal: bilirubin was high and bile duct enzymes also increased significantly. An abdominal computer scan showed that Mandy had gallstones that blocked the bile duct, causing acute bile duct inflammation.
At the same time, E. coli was found in Mandy’s blood. It is believed that cholangitis caused sepsis. In addition to the use of cardiac injections, antibiotics were also needed to kill the bacteria. More importantly, bile duct endoscopy is required to remove gallstones blocking the bile ducts in order to control inflammation and infection. The next morning, Mandy underwent cholangioscopic surgery and the gallstones were successfully removed, and her liver function gradually returned to normal. Moreover, the antibiotic treatment following the operation was more effective, and she was soon out of danger and left the intensive care unit and moved to the general ward.
When I was in medical school, I learned that there are four F’s in the high-risk group for gallstones: female, 40 years old, fat, and fertile. Although Mandy is not perfect, obese women are more likely to have gallstones. After eating a high-fat dinner, there is a chance that the constantly contracting gallbladder will push gallstones into the bile ducts, causing obstruction and inflammation. After dealing with this acute cholangitis, the surgeon arranged for Mandy to undergo a cholecystectomy to remove the gallstones hidden in the gallbladder to reduce the chance of cholangitis occurring once more in the future. From then on, Mandy called herself a fearless “fat girl”.
The author is a specialist in clinical microbiology and infectious diseases
[信健康] A brief discussion on people at high risk of gallstones, please pay attention to doctor’s information
