Conditions Basics What is cholecystitis? Cholecystitis is inflammation of the gallbladder, a small organ near the liver that plays a part in digesting food. Normally, fluid called bile passes out of the gallbladder on its way to the small intestine. If the flow of bile is blocked, it builds up inside the gallbladder, causing swelling, pain, and possible infection.
What causes it? A gallstone stuck in the cystic duct (Figure 1) , a tube that carries bile from the gallbladder, is most often the cause of sudden (acute) cholecystitis. The gallstone blocks fluid from passing out of the gallbladder. This results in an irritated and swollen gallbladder. Infection or trauma, such as an injury from a car crash, can also cause cholecystitis.
Acute acalculous cholecystitis, though rare, is most often seen in critically ill people in hospital intensive care units. In these cases, there are no gallstones. Problems from another severe illness, such as heart disease, diabetes, or an impaired immune system
Long-term (chronic) cholecystitis is another form of cholecystitis. It occurs when the gallbladder remains swollen over time, causing the walls of the gallbladder to become thick and hard.
What are the symptoms? The most common symptom of cholecystitis is pain in your upper right abdomen (Figure 2) that can sometimes move around to your back or right shoulder blade. Other symptoms include:
Nausea or vomiting. Tenderness in the right abdomen. Fever. Pain that gets worse during a deep breath. Pain for more than 6 hours, particularly after meals. Older people may not have fever or pain. Their only symptom may be a tender area in the abdomen.
How is it diagnosed? Your doctor will ask about your symptoms and do a physical exam. Your doctor will carefully feel your right upper abdomen to look for tenderness. You may have blood drawn and an ultrasound, a test that uses sound waves to create a picture of your gallbladder. Ultrasound may show gallstones, thickening of the gallbladder wall, extra fluid, and other signs of cholecystitis. This test also allows doctors to check the size and shape of your gallbladder.
You may also have other tests, such as a gallbladder scan. This is a nuclear scanning test that checks how well your gallbladder is working. It can also help find blockage in the tubes (bile ducts) that lead from the liver to the gallbladder and small intestine (duodenum).
How is cholecystitis treated? Treatment for cholecystitis will depend on your symptoms and your general health. People who have gallstones but don't have any symptoms may need no treatment. For mild cases, treatment includes bowel rest, fluids and antibiotics given through a vein, and pain medicine.
The main treatment for acute cholecystitis is surgery to remove the gallbladder (cholecystectomy). Often this surgery can be done through small incisions in the abdomen (laparoscopic cholecystectomy), but sometimes it requires a more extensive operation. Your doctor may try to reduce swelling and irritation in the gallbladder before removing it. Sometimes acute cholecystitis is caused by one or more gallstones getting stuck in the main tube leading to the intestine, called the common bile duct. Treatment may involve an endoscopic procedure
In rare cases of chronic cholecystitis, you may also receive medicine that dissolves gallstones over a period of time.
Figure 1 - Gallstones Gallstones develop when cholesterol and other substances in the bile form crystals that become hard stones in the gallbladder. The gallbladder is a small sac located just under the liver. Gallstones can form when too much cholesterol is in the bile or when the gallbladder does not empty properly.
Current as of: October 19, 2023
Author: Ignite Healthwise, LLC StaffClinical Review Board
Figure 2 - Abdominal pain Abdominal (or belly) pain can be felt in many different parts of the belly. If you see a doctor about belly pain, they will ask you questions to find out where you feel the pain the most. The location of your pain can help the doctor know what might be causing it.
One way to describe the location is to think about your belly as having four sections. With your belly button in the centre, the four sections are upper left, lower left, lower right, and upper right. You can describe the sections from your own point of view.
Current as of: October 19, 2023
Author: Ignite Healthwise, LLC StaffClinical Review Board
