Cholecystitis occurs when the gallbladder wall and nearby abdominal lining becomes inflamed. In 90% of cases, cholecystitis is caused by a gallstone in the cystic duct, the duct that connects the gallbladder to the hepatic duct. Gallstones are frequently the cause of inflammation.
* Be sharp, cramping, or dull * Come and go * Spread to the back or below the right shoulder blade * Be worse after eating fatty or greasy foods * Occur within minutes of a meal
In 90% of cases, acute cholecystitis is caused by gallstones in the gallbladder. Severe illness, alcohol abuse and, rarely, tumors of the gallbladder may also cause cholecystitis. Acute cholecystitis causes bile to become trapped in the gallbladder. The build up of bile causes irritation and pressure in the gallbladder. This can lead to bacterial infection and perforation of the organ. Gallstones occur more frequently in women than men. Gallstones become more common with age in both sexes. Native Americans have a higher rate of gallstones.
Removal of the gallbladder and gallstones will prevent further attacks. Follow a low-fat diet if you are prone to gallstone attacks.
Acute cholecystitis is suspected from the characteristics of the pain and from the examination. A history of acute attacks, their symptoms, and the patient’s examination will suggest chronic cholecystitis. Investigations like Ultrasound scanning and X-rays are used to confirm the diagnosis and for ruling out other possible causes. Blood tests may be used to look for signs of infection, obstruction, pancreatitis, or jaundice.
Patients who have surgery to remove the gallbladder usually do very well.
Seek immediate medical attention for severe abdominal pain. In the emergency room, patients with acute cholecystitis are given fluids through a vein and antibiotics to fight infection. Although cholecystitis may clear up on its own, surgery to remove the gallbladder (cholecystectomy) is usually needed when inflammation continues or recurs. Surgery is usually done as soon as possible, however some patients will not need surgery right away. Nonsurgical treatment includes pain medicines, antibiotics to fight infection, and a low-fat diet (when food can be tolerated). Emergency surgery may be necessary if gangrene (tissue death), perforation, pancreatitis, or inflammation of the common bile duct occurs.