[Chronic cholecystitis and its clinical masks: diagnosis and differential diagnosis].
The author adduces modern data on the ethiology and pathogenesis of chronic cholecystitis and the stages of the development of biliary pathology (motorotonic disturbances of the gall bladder and the sphincter apparatus of the extrahepatic biliary tract - chronic acalculous cholecystitis - chronic calculous cholecystitis). He considers in detail the methods of diagnostics of chronic cholecystitis paying special attention to clinical (non-instrumental) methods. The author offers an original classification of physical symptoms of chronic cholecystitis, distinguishing three groups of symptoms according to their pathogenesis and clinical significance: segmentary reflectory symptoms ("exacerbation symptoms"); reflectory symptoms, localized in the right half of the body outside the segments of hepatobiliary system innervation ("severity symptoms"); irritative symptoms, observed during all the periods of chronic cholecystitis. The article contains a description of various clinical "masks" of chronic cholecystitis, which make the diagnosis more difficult: cardial, duodenal (gastrointestinal), rheumatic, solaralgic, allergic, pre-menstrual tension, and other masks, as well as a description of their differential diagnostic methods.
Tsimmerman
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D002764:Cholecystitis / Q000175:diagnosis*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D006801:Humans