Once you have determined that the patient has acute cholecystitis, admit the patient with IV fluids and analgesic therapy. Do not allow oral intake and use NG suction if there is vomiting or an ileus. The antibiotic choices used most often empirically are ceftriaxone plus metronidazole or piperacillin/tazobactam. Surgery is curative and should be done early if there is a low surgical risk, a high risk of complications, or evidence of perforation, gangrene, empyema, or acalculous cholecystitis.
DIVERTICULITIS Diverticulitis involves infection or inflammation of a diverticulum in the colon. Because these often obstruct the lumen of the diverticulum, these can lead to a bowel wall phlegmon, perforation, abscess, fistula formation, or peritonitis. Most people have multiple diverticula but rarely have true diverticulitis of more than one of these at a time. Figure 3 shows what diverticulitis looks like:
Figure 3.
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