Symptom Ker and Ortner with cholecystitis. Manifestation of symptoms and location of their localization

The causes of the appearance of cholecystitis in a person can be various chronic diseases, or changes in the structure of certain vessels of bile ducts. Also, it can develop due to diseases of the stomach (only those that are accompanied by dyscholia). The main reference point in the definition of the disease is Kehra's symptom.

Common symptoms of cholecystitis

Depending on the localization of inflammation or changes in the structure of blood vessels and bile ducts, there are many symptoms of the disease:

• Dull pain in the region of the right hypochondrium, which spreads upwards - into the region of the right scapula, collarbone and shoulder; With the development of the disease, the pain becomes more acute and intense;
• Nausea and vomiting, which is provoked by pain;
• The taste of bitterness in the mouth;
• Presence of bile impurities in the emetic masses;
• The tongue is coated and dried;
• Possibly fever and chills;
• In the case of disease progression, tachycardia and increased blood pressure are detected;
• If the lumen of the bile ducts is blocked (if there are stones in it), then the person has pronounced jaundice;
• Pain during palpation in the right hypochondrium.

In addition to those listed, the main symptom of the disease is Kera's symptom. It is expressed in pain when palpated in the area where the diseased organ is located. With the development of the disease, pain has an increasing character and spreads less localized.

Specific symptoms of cholecystitis

The special manifestations of the disease include the symptoms of Kera and Ortner. Further examination occurs after confirmation of the presence of these manifestations. To detect the first symptom, it is enough to conduct a deep palpation of the right hypochondrium, in this case the patient will have a sharp sharp pain.

The symptom of Ortner is detected by tapping the costal arch from the right side with the palm rim. In the presence of the disease, all manipulations will be accompanied by painful sensations of varying degrees, depending on how badly the disease has developed, and what is the age and general state of human health.

In addition, they also distinguish:

• Symptom Obraztsova - when a person inhales with palpation and pain intensifies;
• A symptom of Murphy - the inability to breathe with deep palpation in the right hypochondrium;
• A symptom of Mussi-Georgievsky - when palpation of the sternocleidomastoid muscle (in the region of its legs), the patient exhibits painful sensations.

At the laboratory analysis of a blood neutrophilia, a leukocytosis and a lymphopenia can be found out.

When symptoms appear

Using the symptom of Kera, it is possible to determine the presence of an effeminate cholecystitis. In the presence of stones in the gallbladder or biliary tract distinguish other symptomatic manifestations.

Symptom Kera with acute cholecystitis consists in the appearance of soreness in the gallbladder area when carrying out deep palpation at the site of the diseased organ.

Differential disease

Acute cholecystitis can be differentiated with a duodenal ulcer or stomach, as well as with acute pancreatitis, appendicitis or renal colic. In order not to confuse these diseases, it is important to be able to distinguish them.

With peptic ulcers, the pain arises abruptly, besides it is sharp enough, whereas with cholecystitis in the region of the liver, the pain is blunt and increases with time. There is also a temperature around 38 degrees and vomiting with bile.

In acute pancreatitis, the pain is localized in the left hypochondrium, and can also be accompanied by continuous vomiting.

Acute appendicitis does not have pain in its symptoms , radiating to the shoulder and shoulder blade, and also does not appear as vomiting. With appendicitis, the patient does not have a symptom of Kera and Mussie.

With renal colic, there is no increase in temperature and the presence of leukocytosis in the blood. The pain is localized mainly in the lumbar region and extends to the hips and pelvic organs.

Treatment of cholecystitis

Treatment of cholecystitis should begin before hospitalization of the patient. Intravenous drugs are introduced that help reduce painful sensations (most often an injectable solution of "No-shpy"), and a decrease in pressure in the gallbladder, due to an improvement in the outflow of bile to the small intestine.

Kehr's symptom in cholecystitis is the cause of immediate hospitalization of the patient followed by prompt or conservative intervention by medical personnel.

The timely attention to the presence of the described symptoms and the ability to distinguish them from differential diseases increases the chance of a quick recovery without surgery.