Part 1: Choose a condition from the following case studies (Week 7 Case Study Details). Length: A minimum of 250 words, not including references Citations: At least one high-level scholarly reference in APA from within the last 5 years A 32 year-old-female who recently delivered twins presents with colicky-type pain, URQ pain radiating to the shoulder. After workup, she is diagnosed with cholecystitis. What is the role of the gallbladder? Would you expect her to have nausea and vomiting? Defend your answer. Why does the patient have referred pain? How do gallstones form?

The gallbladder plays a crucial role in storing and concentrating bile produced by the liver. Bile is essential for the digestion of fats. During digestion, the gallbladder contracts and releases bile into the small intestine, where it emulsifies fats, aiding in their absorption (Jones et al., 2022). In cholecystitis, the gallbladder becomes inflamed, which can impair its ability to store and release bile effectively.

Nausea and Vomiting in Cholecystitis

It is worth mentioning that not everyone with cholecystitis will have nausea and vomiting. Gallbladder inflammation can cause nausea and, in certain instances, vomiting.   Nevertheless, the intensity of these symptoms may differ among individuals. Nausea can be caused by the inflammation and blockage caused by gallstones in the cystic duct, which can lead to a backup of bile (Jones et al., 2023). In more severe instances, extended inflammation can cause the release of digestive enzymes and toxins into the bloodstream, leading to more noticeable symptoms like nausea and vomiting.

Why the Patient Has Referred Pain

A 32-year-old woman who recently had twins is diagnosed with cholecystitis, the inflammation of the gallbladder that can cause specific symptoms. These symptoms may involve colicky pain, typically described as sudden, intense, and intermittent pain in the upper right quadrant (URQ) of the abdomen. Pain can spread to the shoulder, especially the right, because of referred pain (Jones et al., 2023). Referred pain happens when the nerves that carry pain signals from the inflamed gallbladder can communicate with nearby nerves that serve the diaphragm and right shoulder. This cross-talk leads to the perception of pain in areas other than where the inflammation originates, making the diagnosis more complex.

Formation of Gallstones

In order to grasp the formation of gallstones, it is crucial to consider the makeup and movement of bile. Gallstones usually develop due to an imbalance in the components of bile, such as cholesterol or bilirubin. In specific individuals, cholesterol can become supersaturated in the body, resulting in the formation of small particles through crystallization. These particles can contribute to the formation of gallstones. Various factors, including bile stasis, changes in composition, and gallbladder inflammation, can lead to the formation of gallstones through particle aggregation and growth. Several factors, such as a diet high in fat, obesity, quick weight loss, and specific medical conditions, can raise the chances of developing gallstones (Sun et al., 2022). Nevertheless, the development of gallstones can be a complex process, and it is essential to note that not everyone with these risk factors will develop them.

References

Jones, M. W., Genova, R., & O’Rourke, M. C. (2023). Acute Cholecystitis. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459171/

Jones, M. W., Hannoodee, S., & Young, M. (2022, October 31). Anatomy, Abdomen and Pelvis, Gallbladder. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459288/

Sun, H., Warren, J., Yip, J., Ji, Y., Hao, S., Han, W., & Ding, Y. (2022). Factors Influencing Gallstone Formation: A Review of the Literature. Biomolecules, 12(4), 550. https://doi.org/10.3390/biom12040550