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Abstract: 30-year-old Ms. Yang complained of always vomiting after eating fatty food, so she visited our hospital. After examination, she was found to have a mass in her groin and yellow skin staining, but no other adverse symptoms. She was diagnosed with gallstones with cholecystitis through abdominal CT examination and routine blood test. She was treated with diclofenac sodium extended-release tablets, amoxicillin potassium clavulanate dispersible tablets, and ursodeoxycholic acid tablets, which eventually led to improvement of her condition.
Basic information】Female, 30 years old
Disease Type】Gallstones
Hospital】Shandong Provincial Hospital
Date of consultation】March 2022
Treatment plan】Oral medication (diclofenac sodium extended-release tablets, amoxicillin potassium clavulanate dispersible tablets, ursodeoxycholic acid tablets)
Treatment Period】Inpatient treatment for 2 days, home medication for 5 days, return to hospital for review after 1 month of discharge
Treatment effect】The physical discomfort gradually disappeared, and the indexes of each examination returned to normal.
I. Initial consultation
Ms. Yang, 30 years old, complained of nausea after eating more fatty food, but no other somatic discomfort, physical examination showed that her body temperature, pulse and respiration were normal. A mass in both groins was found by palpation. The abdominal CT revealed stones in the gallbladder and common bile duct and inflammation at the gallbladder. The nausea after eating was considered to be mainly caused by abnormal bile excretion, resulting in symptoms of fat indigestion. Routine blood tests revealed that the levels of total bilirubin, direct bilirubin, indirect bilirubin, ghrelin, ghrelin and albumin were all high, and the preliminary diagnosis was “gallstones”.
Treatment history
After the diagnosis of gallstones, since Ms. Yang did not have any obvious physical discomfort, she first took conservative treatment by using diclofenac sodium extended-release tablets for anti-inflammatory treatment. At the same time, ursodeoxycholic acid tablets can be used to promote the discharge of stones and reduce the accumulation of bile in the body to improve the groin lumps and the symptoms of yellow skin staining. Ms. Yang was instructed to take the medication at home for 5 weeks and then come back for a review, with good results, she could stop the medication and was reminded to review again after 1 month of discontinuation.
III. Treatment effect
After 5 days of hospitalization, Ms. Yang’s yellow skin stain was reduced, and the frequency of nausea after eating was reduced. 2 weeks later, Ms. Yang returned to the hospital for a follow-up examination and complained that she had not experienced any nausea after eating, and the inguinal mass and yellow skin stain disappeared. indirect bilirubin, glutathione, and glutamic oxaloacetic transaminase levels have decreased and have returned to normal levels. The drug can be considered to be discontinued, and the patient returned to the hospital for a review 1 month after the discontinuation of the drug, and no recurrence of gallstones was found.
IV. Precautions
I was very happy that Ms. Yang had completely improved her gallstones as well as cholecystitis by receiving medication. On the occasion of her discharge, I reminded her to pay attention to good personal life and dietary care to avoid recurrence of gallstones.
1.After discharge from the hospital, she should pay attention to avoid over-eating cholesterol-rich foods, such as pig liver, lamb brain, goose liver, etc., so as to avoid excessive cholesterol intake leading to disorder of bile secretion and recurrence of gallstones.
2, pay attention to regular participation in outdoor activities, such as rope skipping, long jump, gymnastics, fast running, walking, etc., which can help to reduce body fat and control body weight, which is helpful to the prevention of gallstones.
3, after the gallstones are cured through medication, Ms. Yang should relax, pay attention to maintain a cheerful, relaxed and positive state of mind, do not be afraid of eating or fear of disease recurrence, after developing a good diet and living habits, gallstones are also less likely to recur.
V. Personal insight
Gallstones are diseases of hepatobiliary surgery, which can be triggered by various factors such as excessive consumption of high cholesterol food, congenital malformation of gallbladder, long-term inattention to exercise, etc. Ms. Yang’s condition has been improved through active treatment. If she continues to delay her condition, thinking that she is fine without symptoms, the stones are likely to become larger and larger, causing severe abdominal pain, fever and other uncomfortable symptoms, and eventually surgical procedures such as cholecystectomy may be needed to deal with the disease.