GB Sludge + GB wall Thickened

Three months back when USG W/A report revealed GB sludge with GB wall thickened patient was started on - Tab. UDCA 300mg BD, Tab. Liv 52 OD, Cap. Pantop DSR OD BBF Tab. Voveron 75mg SR SOS After three months of intensive therapy, patient is now shifted on maintenance therpay Tab. UDCA 150mg BD Tab Liv 52 OD Investigations His LFT was very mildly raised, just two points above the upper limit of normal Management Kindly give your opinion on GB wall thickness? Does GB needs to be removed?? As GB wall thickness has remained the same in last 3 months, I am wondering whether GB needs removal or not?

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Hyperplesia of gall bladder wall will remain same as regression is not observed usually it is sign of cholecystitis and needs antibiotics

Thanx dr Kute Ankush
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Gall bladder wall thickness of 4 mm with gall bladder sludge No treatment required unless patient is symptomatic In symptomatic patients laparoscopic cholecystectomy is indicated

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NEED'S.. TO..TREAT AS A..CASE OF.. CHOLECYSTITIS.. BS..ANTIBIOTICS AS PER REQUIREMENT AND.. DOSE.. SURGEONS OPINION..

Tnx &wc Dr Ajeet Singh
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Pt having reactive cholecystitis. No definite indication of cholecystectomy at this stage. Interval usg and regular lft study is appropriate at this stage

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Looks like chronic cholsystitis, I would suggest a hepatologis't opinion if possible

My gdness all big big drs entered in ur case man. chalo i thought lets see what i can give different in this case. ur case i gone thru..Confusing point was u didnt mentioned abt symptoms and signs prior to starting treatment and after three months any reductionof post treatment symptoms and signs seen. that will help us to understand the progress of case. second point was i could not figure out thickness measurement from second sono but considering as same as previous thru conclusion status,it shows still there is no improvement. in points to say.. 1] i dont think thickness of GB will regress..but sludge formation in lumen shows ki there is hypomotility of gb.. means contractions of gb has reduced. 2]UDCA isnt drug of choice in this case i feels, would help u in any way.neither regress nor reduce sludge formation.its gd only in case of calculous cholecystitis. 3]increased transaminase {2+] and lft physician suggestion by sono could be reason this liver has got exposure to this bile acids,so this transient increase of bile in hepatocytes could have caused reversible elevation of transaminases.. so my personal assessment would be he may go into cholecystectomy [lap] in future.. another guessing lets see even if his symptoms improved,but still u may require to go for usg bcz even asymptomatic gall stones can happen.. at the end wish u happy new year dr ajeetji.

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Sir Just great

In my opinion if symptoms arise then indicated cholecystectomy

Plvrulevout pancreatitis also

POSSIBLY CHOLECYSTITIS NEEDS .SYMPTOMATIC MANAGEMENT

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