1. A nurse is assessing a patient who has been diagnosed with
cholecystitis, and is experiencing localized abdominal pain. When
assessing the characteristics of the patient’s pain, the nurse should
anticipate that it may radiate to what region?
A) Left upper
B) Inguinal region
C) Neck or jaw
D) Right shoulder
The patient may have biliary colic with
excruciating upper right abdominal pain that radiates to the back or
right shoulder. Pain from cholecystitis does not typically radiate to
the left upper chest, inguinal area, neck, or jaw.
2. A 55-year-old man has been newly diagnosed with acute pancreatitis
and admitted to the acute medical unit. How should the nurse most
likely explain the pathophysiology of this patient’s health
A) “Toxins have accumulated and inflamed your
B) “Bacteria likely migrated from your intestines and
became lodged in your pancreas.”
C) “A virus that was likely
already present in your body has begun to attack your pancreatic
D) “The enzymes that your pancreas produces have damaged
the pancreas itself.”
Although the mechanisms causing
pancreatitis are unknown, pancreatitis is commonly described as the
autodigestion of the pancreas. Less commonly, toxic substances and
microorganisms are implicated as the cause of pancreatitis.
3. A patient’s assessment and diagnostic testing are suggestive of
acute pancreatitis. When the nurse is performing the health interview,
what assessment questions address likely etiologic factors? Select all
A) “How many alcoholic drinks do you typically
consume in a week?”
B) “Have you ever been tested for
C) “Have you ever been diagnosed with
D) “Would you say that you eat a particularly
E) “Does anyone in your family have cystic fibrosis?”
Ans: A, C
Eighty percent of patients with acute
pancreatitis have biliary tract disease such as gallstones or a
history of long-term alcohol abuse. Diabetes, high-fat consumption,
and cystic fibrosis are not noted etiologic factors.
4. A patient’s abdominal ultrasound indicates cholelithiasis. When
the nurse is reviewing the patient’s laboratory studies, what finding
is most closely associated with this diagnosis?
B) Decreased serum cholesterol
C) Increased blood
urea nitrogen (BUN)
D) Decreased serum alkaline phosphatase level
If the flow of blood is impeded,
bilirubin, a pigment derived from the breakdown of red blood cells,
does not enter the intestines. As a result, bilirubin levels in the
blood increase. Cholesterol, BUN, and alkaline phosphatase levels are
not typically affected.
5. A nurse who provides care in a walk-in clinic assesses a wide
range of individuals. The nurse should identify which of the following
patients as having the highest risk for chronic pancreatitis?
A 45-year-old obese woman with a high-fat diet
B) An 18-year-old
man who is a weekend binge drinker
C) A 39-year-old man with
D) A 51-year-old woman who smokes
one-and-a-half packs of cigarettes per day
Excessive and prolonged consumption of
alcohol accounts for approximately 70% to 80% of all cases of chronic pancreatitis.
6. A 37-year-old male patient presents at the emergency department
(ED) complaining of nausea and vomiting and severe abdominal pain. The
patient’s abdomen is rigid, and there is bruising to the patient’s
flank. The patient’s wife states that he was on a drinking binge for
the past 2 days. The ED nurse should assist in assessing the patient
for what health problem?
A) Severe pancreatitis with possible
B) Acute cholecystitis
D) Acute appendicitis with possible perforation
Severe abdominal pain is the major
symptom of pancreatitis that causes the patient to seek medical care.
Pain in pancreatitis is accompanied by nausea and vomiting that does
not relieve the pain or nausea. Abdominal guarding is present and a
rigid or board-like abdomen may be a sign of peritonitis. Ecchymosis
(bruising) to the flank or around the umbilicus may indicate severe
peritonitis. Pain generally occurs 24 to 48 hours after a heavy meal
or alcohol ingestion. The link with alcohol intake makes pancreatitis
a more likely possibility than appendicitis or cholecystitis.
7. A patient has been scheduled for an ultrasound of the gallbladder
the following morning. What should the nurse do in preparation for
this diagnostic study?
A) Have the patient refrain from food and
fluids after midnight.
B) Administer the contrast agent orally 10
to 12 hours before the study.
C) Administer the radioactive agent
intravenously the evening before the study.
D) Encourage the
intake of 64 ounces of water 8 hours before the study.
An ultrasound of the gallbladder is most
accurate if the patient fasts overnight, so that the gallbladder is
distended. Contrast and radioactive agents are not used when
performing ultrasonography of the gallbladder, as an ultrasound is
based on reflected sound waves.
8. A patient who had surgery for gallbladder disease has just
returned to the postsurgical unit from postanesthetic recovery. The
nurse caring for this patient knows to immediately report what
assessment finding to the physician?
A) Decreased breath
B) Drainage of bile-colored fluid onto the abdominal
C) Rigidity of the abdomen
D) Acute pain with movement
The location of the subcostal incision
will likely cause the patient to take shallow breaths to prevent pain,
which may result in decreased breath sounds. The nurse should remind
patients to take deep breaths and cough to expand the lungs fully and
prevent atelectasis. Acute pain is an expected assessment finding
following surgery; analgesics should be administered for pain relief.
9. A patient with chronic pancreatitis had a pancreaticojejunostomy
created 3 months ago for relief of pain and to restore drainage of
pancreatic secretions. The patient has come to the office for a
routine postsurgical appointment. The patient is frustrated that the
pain has not decreased. What is the most appropriate initial response
by the nurse?
A) “The majority of patients who have a
pancreaticojejunostomy have their normal digestion restored but do not
achieve pain relief.”
B) “Pain relief occurs by 6 months in most
patients who undergo this procedure, but some people experience a
recurrence of their pain.”
C) “Your physician will likely want to
discuss the removal of your gallbladder to achieve pain
D) “You are probably not appropriately taking the
medications for your pancreatitis and pain, so we will need to discuss
your medication regimen in detail.”
Pain relief from a
pancreaticojejunostomy often occurs by 6 months in more than 85% of
the patients who undergo this procedure, but pain returns in a
substantial number of patients as the disease progresses. This patient
had surgery 3 months ago; the patient has 3 months before optimal
benefits of the procedure may be experienced. There is no obvious
indication for gallbladder removal and nonadherence is not the most
likely factor underlying the pain.
10. A nurse is caring for a patient who has been scheduled for
endoscopic retrograde cholangiopancreatography (ERCP) the following
day. When providing anticipatory guidance for this patient, the nurse
should describe what aspect of this diagnostic procedure?
need to protect the incision postprocedure
B) The use of moderate
C) The need to infuse 50% dextrose during the
D) The use of general anesthesia
Moderate sedation, not general
anesthesia, is used during ERCP. D50 is not administered and the
procedure does not involve the creation of an incision.
11. A patient has undergone a laparoscopic cholecystectomy and is
being prepared for discharge home. When providing health education,
the nurse should prioritize which of the following topics?
Management of fluid balance in the home setting
B) The need for
blood glucose monitoring for the next week
C) Signs and symptoms
of intra-abdominal complications
D) Appropriate use of prescribed
Because of the early discharge following
laparoscopic cholecystectomy, the patient needs thorough education in
the signs and symptoms of complications. Fluid balance is not
typically a problem in the recovery period after laparoscopic
cholecystectomy. There is no need for blood glucose monitoring or
12. A nurse is preparing a plan of care for a patient with pancreatic
cysts that have necessitated drainage through the abdominal wall. What
nursing diagnosis should the nurse prioritize?
A) Disturbed Body
B) Impaired Skin Integrity
D) Risk for
Deficient Fluid Volume
While each of the diagnoses may be
applicable to a patient with pancreatic drainage, the priority nursing
diagnosis is Impaired Skin Integrity. The drainage is often perfuse
and destructive to tissue because of the enzyme contents. Nursing
measures must focus on steps to protect the skin near the drainage
site from excoriation. The application of ointments or the use of a
suction apparatus protects the skin from excoriation.
13. A home health nurse is caring for a patient discharged home after
pancreatic surgery. The nurse documents the nursing diagnosis Risk for
Imbalanced Nutrition: Less than Body Requirements on the care plan
based on the potential complications that may occur after surgery.
What are the most likely complications for the patient who has had
A) Proteinuria and hyperkalemia
Hemorrhage and hypercalcemia
C) Weight loss and
D) Malabsorption and hyperglycemia
The nurse arrives at this diagnosis
based on the complications of malabsorption and hyperglycemia. These
complications often lead to the need for dietary modifications.
Pancreatic enzyme replacement, a low-fat diet, and vitamin
supplementation often are also required to meet the patient’s
nutritional needs and restrictions. Electrolyte imbalances often
accompany pancreatic disorders and surgery, but the electrolyte levels
are more often deficient than excessive. Hemorrhage is a complication
related to surgery, but not specific to the nutritionally based
nursing diagnosis. Weight loss is a common complication, but
hypoglycemia is less likely.
14. A patient has had a laparoscopic cholecystectomy. The patient is
now complaining of right shoulder pain. What should the nurse suggest
to relieve the pain?
A) Aspirin every 4 to 6 hours as
B) Application of heat 15 to 20 minutes each hour
Application of an ice pack for no more than 15 minutes
Application of liniment rub to affected area
If pain occurs in the right shoulder or
scapular area (from migration of the CO2 used to insufflate the
abdominal cavity during the procedure), the nurse may recommend use of
a heating pad for 15 to 20 minutes hourly, walking, and sitting up
when in bed. Aspirin would constitute a risk for bleeding.
15. A patient returns to the floor after a laparoscopic
cholecystectomy. The nurse should assess the patient for signs and
symptoms of what serious potential complication of this
A) Diabetic coma
B) Decubitus ulcer
D) Bile duct injury
The most serious complication after
laparoscopic cholecystectomy is a bile duct injury. Patients do not
face a risk of diabetic coma. A decubitus ulcer is unlikely because
immobility is not expected. Evisceration is highly unlikely, due to
the laparoscopic approach.
16. A patient has been treated in the hospital for an episode of
acute pancreatitis. The patient has acknowledged the role that his
alcohol use played in the development of his health problem, but has
not expressed specific plans for lifestyle changes after discharge.
What is the nurse’s most appropriate response?
A) Educate the
patient about the link between alcohol use and pancreatitis.
Ensure that the patient knows the importance of attending follow-up
C) Refer the patient to social work or spiritual
D) Encourage the patient to connect with a community-based
After the acute attack has subsided,
some patients may be inclined to return to their previous drinking
habits. The nurse provides specific information about resources and
support groups that may be of assistance in avoiding alcohol in the
future. Referral to Alcoholics Anonymous as appropriate or other
support groups is essential. The patient already has an understanding
of the effects of alcohol, and follow-up appointments will not
necessarily result in lifestyle changes. Social work and spiritual
care may or may not be beneficial.
17. A patient is being treated on the acute medical unit for acute
pancreatitis. The nurse has identified a diagnosis of Ineffective
Breathing Pattern Related to Pain. What intervention should the nurse
perform in order to best address this diagnosis?
A) Position the
patient supine to facilitate diaphragm movement.
corticosteroids by nebulizer as ordered.
C) Perform oral
suctioning as needed to remove secretions.
D) Maintain the
patient in a semi-Fowler’s position whenever possible.
The nurse maintains the patient in a
semi-Fowler’s position to decrease pressure on the diaphragm by a
distended abdomen and to increase respiratory expansion. A supine
position will result in increased pressure on the diaphragm and
potentially decreased respiratory expansion. Steroids and oral
suctioning are not indicated.
18. A patient with gallstones has been prescribed ursodeoxycholic
acid (UDCA). The nurse understands that additional teaching is needed
regarding this medication when the patient states:
A) “It is
important that I see my physician for scheduled follow-up appointments
while taking this medication.”
B) “I will take this medication
for 2 weeks and then gradually stop taking it.”
C) “If I lose
weight, the dose of the medication may need to be changed.”
“This medication will help dissolve small gallstones made of cholesterol.”
Ursodeoxycholic acid (UDCA) has been
used to dissolve small, radiolucent gallstones composed primarily of
cholesterol. This drug can reduce the size of existing stones,
dissolve small stones, and prevent new stones from forming. Six to 12
months of therapy is required in many patients to dissolve stones, and
monitoring of the patient is required during this time. The effective
dose of medication depends on body weight.
19. A nurse is assisting with serving dinner trays on the unit. Upon
receiving the dinner tray for a patient admitted with acute
gallbladder inflammation, the nurse will question which of the
following foods on the tray?
A) Fried chicken
C) Dinner roll
D) Tapioca pudding
The diet immediately after an episode of
acute cholecystitis is initially limited to low-fat liquids. Cooked
fruits, rice or tapioca, lean meats, mashed potatoes, bread, and
coffee or tea may be added as tolerated. The patient should avoid
fried foods such as fried chicken, as fatty foods may bring on an
episode of cholecystitis.
20. A nurse is assessing an elderly patient with gallstones. The
nurse is aware that the patient may not exhibit typical symptoms, and
that particular symptoms that may be exhibited in the elderly patient
may include what?
A) Fever and pain
B) Chills and
C) Nausea and vomiting
D) Signs and symptoms of
The elderly patient may not exhibit the
typical symptoms of fever, pain, chills jaundice, and nausea and
vomiting. Symptoms of biliary tract disease in the elderly may be
accompanied or preceded by those of septic shock, which include
oliguria, hypotension, change in mental status, tachycardia, and tachypnea.
21. A nurse is creating a care plan for a patient with acute
pancreatitis. The care plan includes reduced activity. What rationale
for this intervention should be cited in the care plan?
rest reduces the patient’s metabolism and reduces the risk of
B) Reduced activity protects the physical
integrity of pancreatic cells.
C) Bed rest lowers the metabolic
rate and reduces enzyme production.
D) Inactivity reduces caloric
need and gastrointestinal motility.
The acutely ill patient is maintained on
bed rest to decrease the metabolic rate and reduce the secretion of
pancreatic and gastric enzymes. Staying in bed does not release energy
from the body to fight the disease.
22. The nurse is caring for a patient who has just returned from the
ERCP removal of gallstones. The nurse should monitor the patient for
signs of what complications?
A) Pain and peritonitis
Bleeding and perforation
C) Acidosis and hypoglycemia
Gangrene of the gallbladder and hyperglycemia
Following ERCP removal of gallstones,
the patient is observed closely for bleeding, perforation, and the
development of pancreatitis or sepsis. Blood sugar alterations,
gangrene, peritonitis, and acidosis are less likely complications.
23. A patient with pancreatic cancer has been scheduled for a
pancreaticoduodenectomy (Whipple procedure). During health education,
the patient should be informed that this procedure will involve the
removal of which of the following? Select all that apply.
B) Part of the stomach
of the common bile duct
E) Part of the rectum
Ans: A, B, C, D
(Whipple procedure or resection) is used for potentially resectable
cancer of the head of the pancreas (Fig. 50-7). This procedure
involves removal of the gallbladder, a portion of the stomach,
duodenum, proximal jejunum, head of the pancreas, and distal common
bile duct. The rectum is not affected.
24. An adult patient has been admitted to the medical unit for the
treatment of acute pancreatitis. What nursing action should be
included in this patient’s plan of care?
A) Measure the patient’s
abdominal girth daily.
B) Limit the use of opioid
C) Monitor the patient for signs of
D) Encourage activity as tolerated.
Due to the risk of ascites, the nurse
should monitor the patient’s abdominal girth. There is no specific
need to avoid the use of opioids or to monitor for dysphagia, and
activity is usually limited.
25. A community health nurse is caring for a patient whose multiple
health problems include chronic pancreatitis. During the most recent
visit, the nurse notes that the patient is experiencing severe
abdominal pain and has vomited 3 times in the past several hours. What
is the nurse’s most appropriate action?
A) Administer a PRN dose
of pancreatic enzymes as ordered.
B) Teach the patient about the
importance of abstaining from alcohol.
C) Arrange for the patient
to be transported to the hospital.
D) Insert an NG tube, if
available, and stay with the patient.
Chronic pancreatitis is characterized by
recurring attacks of severe upper abdominal and back pain, accompanied
by vomiting. The onset of these acute symptoms warrants hospital
treatment. Pancreatic enzymes are not indicated and an NG tube would
not be inserted in the home setting. Patient education is a later
priority that may or may not be relevant.
26. A student nurse is caring for a patient who has a diagnosis of
acute pancreatitis and who is receiving parenteral nutrition. The
student should prioritize which of the following assessments?
B) Oral intake
C) Blood glucose levels
BUN and creatinine levels
In addition to administering enteral or
parenteral nutrition, the nurse monitors serum glucose levels every 4
to 6 hours. Output should be monitored but in most cases it is not
more important than serum glucose levels. A patient on parenteral
nutrition would have no oral intake to monitor. Blood sugar levels are
more likely to be unstable than indicators of renal function.
27. A patient has a recent diagnosis of chronic pancreatitis and is
undergoing diagnostic testing to determine pancreatic islet cell
function. The nurse should anticipate what diagnostic test?
Glucose tolerance test
C) Pancreatic biopsy
A glucose tolerance test evaluates
pancreatic islet cell function and provides necessary information for
making decisions about surgical resection of the pancreas. This
specific clinical information is not provided by ERCP, biopsy, or ultrasound.
28. A patient has been admitted to the hospital for the treatment of
chronic pancreatitis. The patient has been stabilized and the nurse is
now planning health promotion and educational interventions. Which of
the following should the nurse prioritize?
A) Educating the
patient about expectations and care following surgery
Educating the patient about the management of blood glucose after
C) Educating the patient about postdischarge lifestyle
D) Educating the patient about the potential
benefits of pancreatic transplantation
The patient’s lifestyle (especially
regarding alcohol use) is a major determinant of the course of chronic
pancreatitis. The disease is not often managed by surgery and blood
sugar monitoring is not necessarily indicated for every patient after
hospital treatment. Transplantation is not an option.
29. The family of a patient in the ICU diagnosed with acute
pancreatitis asks the nurse why the patient has been moved to an air
bed. What would be the nurse’s best response?
A) “Air beds allow
the care team to reposition her more easily while she’s on bed
B) “Air beds are far more comfortable than regular beds
and she’ll likely have to be on bed rest a long time.”
bed automatically moves, so she’s less likely to develop pressure
sores while she’s in bed.”
D) “The bed automatically moves, so
she is likely to have less pain.”
It is important to turn the patient
every 2 hours; use of specialty beds may be indicated to prevent skin
breakdown. The rationale for a specialty bed is not related to
repositioning, comfort, or ease of movement.
30. A patient is receiving care in the intensive care unit for acute
pancreatitis. The nurse is aware that pancreatic necrosis is a major
cause of morbidity and mortality in patients with acute pancreatitis.
Consequently, the nurse should assess for what signs or symptoms of
A) Sudden increase in random blood glucose
B) Increased abdominal girth accompanied by decreased
level of consciousness
C) Fever, increased heart rate and
decreased blood pressure
D) Abdominal pain unresponsive to analgesics
Pancreatic necrosis is a major cause of
morbidity and mortality in patients with acute pancreatitis because of
resulting hemorrhage, septic shock, and multiple organ dysfunction
syndrome (MODS). Signs of shock would include hypotension, tachycardia
and fever. Each of the other listed changes in status warrants
intervention, but none is clearly suggestive of an onset of pancreatic necrosis.
31. A patient has been diagnosed with acute pancreatitis. The nurse
is addressing the diagnosis of Acute Pain Related to Pancreatitis.
What pharmacologic intervention is most likely to be ordered for this
A) Oral oxycodone
B) IV hydromorphone
C) IM meperidine (Demerol)
D) Oral naproxen (Aleve)
The pain of acute pancreatitis is often
very severe and pain relief may require parenteral opioids such as
morphine, fentanyl (Sublimaze), or hydromorphone (Dilaudid). There is
no clinical evidence to support the use of meperidine for pain relief
in pancreatitis. Opioids are preferred over NSAIDs.
32. A patient has just been diagnosed with chronic pancreatitis. The
patient is underweight and in severe pain and diagnostic testing
indicates that over 80% of the patient’s pancreas has been destroyed.
The patient asks the nurse why the diagnosis was not made earlier in
the disease process. What would be the nurse’s best response?
“The symptoms of pancreatitis mimic those of much less serious
B) “Your body doesn’t require pancreatic function
until it is under great stress, so it is easy to go
C) “Chronic pancreatitis often goes undetected until
a large majority of pancreatic function is lost.”
D) “It’s likely
that your other organs were compensating for your decreased pancreatic function.”
By the time symptoms occur in chronic
pancreatitis, approximately 90% of normal acinar cell function
(exocrine function) has been lost. Late detection is not usually
attributable to the vagueness of symptoms. The pancreas contributes
continually to homeostasis and other organs are unable to perform its
33. A patient has been diagnosed with pancreatic cancer and has been
admitted for care. Following initial treatment, the nurse should be
aware that the patient is most likely to require which of the
A) Inpatient rehabilitation
B) Rehabilitation in
the home setting
C) Intensive physical therapy
D) Hospice care
Pancreatic carcinoma has only a 5%
survival rate at 5 years regardless of the stage of disease at
diagnosis or treatment. As a result, there is a higher likelihood that
the patient will require hospice care than physical therapy and rehabilitation.
34. A patient is admitted to the ICU with acute pancreatitis. The
patient’s family asks what causes acute pancreatitis. The critical
care nurse knows that a majority of patients with acute pancreatitis
A) Type 1 diabetes
B) An impaired immune
C) Undiagnosed chronic pancreatitis
D) An amylase deficiency
Eighty percent of patients with acute
pancreatitis have biliary tract disease or a history of long-term
alcohol abuse. These patients usually have had undiagnosed chronic
pancreatitis before their first episode of acute pancreatitis.
Diabetes, an impaired immune function, and amylase deficiency are not
specific precursors to acute pancreatitis.
35. A patient is admitted to the unit with acute cholecystitis. The
physician has noted that surgery will be scheduled in 4 days. The
patient asks why the surgery is being put off for a week when he has a
“sick gallbladder.” What rationale would underlie the nurse’s
A) Surgery is delayed until the patient can eat a
regular diet without vomiting.
B) Surgery is delayed until the
acute symptoms subside.
C) The patient requires aggressive
nutritional support prior to surgery.
D) Time is needed to
determine whether a laparoscopic procedure can be used.
Unless the patient’s condition
deteriorates, surgical intervention is delayed just until the acute
symptoms subside (usually within a few days). There is no need to
delay surgery pending an improvement in nutritional status, and
deciding on a laparoscopic approach is not a lengthy process.
36. A patient with a cholelithiasis has been scheduled for a
laparoscopic cholecystectomy. Why is laparoscopic cholecystectomy
preferred by surgeons over an open procedure?
cholecystectomy poses fewer surgical risks than an open
B) Laparoscopic cholecystectomy can be performed in a
clinic setting, while an open procedure requires an OR.
laparoscopic approach allows for the removal of the entire
D) A laparoscopic approach can be performed under
Open surgery has largely been replaced
by laparoscopic cholecystectomy (removal of the gallbladder through a
small incision through the umbilicus). As a result, surgical risks
have decreased, along with the length of hospital stay and the long
recovery period required after standard surgical cholecystectomy. Both
approaches allow for removal of the entire gallbladder and must be
performed under general anesthetic in an operating theater.
37. A patient with ongoing back pain, nausea, and abdominal bloating
has been diagnosed with cholecystitis secondary to gallstones. The
nurse should anticipate that the patient will undergo what
A) Laparoscopic cholecystectomy
tertiary butyl ether (MTBE) infusion
D) Extracorporeal shock wave therapy (ESWL)
Most of the nonsurgical approaches,
including lithotripsy and dissolution of gallstones, provide only
temporary solutions to gallstone problems and are infrequently used in
the United States. Cholecystectomy is the preferred treatment.
38. A nurse is caring for a patient with gallstones who has been
prescribed ursodeoxycholic acid (UDCA). The patient askshow this
medicine is going to help his symptoms. The nurse should be aware of
what aspect of this drug’s pharmacodynamics?
A) It inhibits the
synthesis of bile.
B) It inhibits the synthesis and secretion of
C) It inhibits the secretion of bile.
inhibits the synthesis and secretion of amylase.
UDCA acts by inhibiting the synthesis
and secretion of cholesterol, thereby desaturating bile. UDCA does not
directly inhibit either the synthesis or secretion of bile or amylase.
39. A nurse is providing discharge education to a patient who has
undergone a laparoscopic cholecystectomy. During the immediate
recovery period, the nurse should recommend what foods?
B) Low-purine, nutrient-dense foods
Low-fat foods high in proteins and carbohydrates
D) Foods that
are low-residue and low in fat
The nurse encourages the patient to eat
a diet that is low in fats and high in carbohydrates and proteins
immediately after surgery. There is no specific need to increase fiber
or avoid purines. A low-residue diet is not indicated.
40. A patient presents to the emergency department (ED) complaining
of severe right upper quadrant pain. The patient states that his
family doctor told him he had gallstones. The ED nurse should
recognize what possible complication of gallstones?
B) Atrophy of the gallbladder
D) Gangrene of the gallbladder
In calculous cholecystitis, a
gallbladder stone obstructs bile outflow. Bile remaining in the
gallbladder initiates a chemical reaction; autolysis and edema occur;
and the blood vessels in the gallbladder are compressed, compromising
its vascular supply. Gangrene of the gallbladder with perforation may
result. Pancreatitis, atrophy, and cancer of the gallbladder are not