female 36 yr old with c/o episodic severe rt upper quadrant pain associated with vomiting on us showed cholelithiasis . suggest if surgery is necessary urgently. the pt is reluctant for surgery

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Acute calculus cholecystitis. Antibiotics and analgesics for 1 week Surgery after 6 weeks if condition improved Otherwise emergency surgery

If the pt is reluctant for Sx means pt is not counselled for best possible treatment if fit for general anaesthesia. Gold standard treatment for gall stones diseases is Lap cholecystectomy if fit.

Right now a case of acute calculus cholecystitis with cholelithiasis .with G.B wall oedema . Treatment conservatively with parenteral antibiotics, semi solid bland diet . As it is a 11 mm solitary calculus which is unlikely to pass in CBD and cause obstructive jaundice or Gall stone pancreatitis, surgery can be postponed. Meanwhile, patient can be operated at any time later as per the convenience of the patient

Thanx sir
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pain in rt hypochondrium and vomiting and pt is reluctant for surgery then start antibiotic and UDCA and wait for surgery till 1 month when symptoms are reduced.

Conservative management with IV antibiotics followed by elective cholesystectomy after 4 weeks.

Any pt with symptomatic stone disease will require surgical removal. Reason 1./Rec. attacks are common. 2. Empyema, perforation, gangrene. 3. CBD obstruction. Convince the pt

Should go for surgery within 72 hrs of attack or if it’s passed manage conservatively and operate after 6 weeks.... but ultimately cholecystectomy must be done

Lap choly or open cholecystectomy had to be done because the pt is repeatedly in distress As far as I know there's no medicine to dissolve hall stones though there are anectodes of ursodeoxycholic acid being used

Acute Calculus cholecystitis. If patient is reluctant for surgery now than put her on antibiotic and antiinflammatory. Tell her to come after a month for surgery.

Than you sir
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