Soins infirmiers en médecine chirurgie 2 (1803DOCH)
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Cholélithiase
Définition
Formation de calculs dans la vésicule biliaire. Il est le trouble le plus commun des voies
biliaires.
Physiopathologie
Survient lorsque l’équilibre entre le cholestérol, les sels biliaires et le calcium en
solution est modifié créant la précipitation de ces substances. certains facteurs comme
l’infection ou les troubles du métabolisme du cholestérol perturbent l’équilibre. La bile
sécrétée par le foie lors de cholélithiases est sursaturée de cholestérol entraînant la
précipitation de celui-ci. Il est à noter que c’est le passage des calculs dans les canaux
qui cause la DLR. La stase biliaire peut donc entraîner une cholécystite.
Étiologie
La cause véritable de cette pathologie est inconnue.
Manifestations cliniques
Sbujectives
Parfois asymptomatique
DLR intense (+ spasmes si obstruction d’un canal)
Sensibilité QSD
Objectives
Tachycardie
Diaphorèse
Selles grises
Facteurs de risque
Sédentarité
Infection
Obésité
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