Cholecystitis

CHOLECYSTITIS

Cholecystitis is infection or inflammation of the gallbladder. In most cases, gallstones blocking the tube leading out of your gallbladder cause cholecystitis. This results in a bile build up that can cause inflammation. Other causes of cholecystitis include bile duct problems, tumours, serious illness, and certain infections. If left untreated, cholecystitis can lead to serious, sometimes life-threatening complications, such as a gallbladder rupture. Treatment for cholecystitis often involves gallbladder removal.

Symptoms of cholecystitis

  • Severe pain in your upper right or center abdomen
  • Pain that spreads to your right shoulder or back
  • Tenderness over your abdomen when it’s touched
  • Nausea
  • Vomiting
  • Fever

Cholecystitis signs and symptoms often occur after a meal, particularly a large or fatty one.

Causes of cholecystitis

Cholecystitis occurs when your gallbladder becomes inflamed. Gallbladder inflammation can be caused by:

  • Gallstones. Most often, cholecystitis is the result of hard particles that develop in your gallbladder (gallstones). Gallstones can block the tube (cystic duct) through which bile flows when it leaves the gallbladder. Bile builds up, causing inflammation.
  • Tumor. A tumor may prevent bile from draining out of your gallbladder properly, causing bile buildup that can lead to cholecystitis.
  • Bile duct blockage. Kinking or scarring of the bile ducts can cause blockages that lead to cholecystitis.
  • Blood vessel problems. A very severe illness can damage blood vessels and decrease blood flow to the gallbladder, leading to cholecystitis.

Complications:

Cholecystitis can lead to many serious complications, including:

  • Empyema (pus) within the gallbladder
  • Gangrene of the gallbladder
  • Perforation (hole) in the gallbladder

Tests to diagnose cholecystitis

Blood tests

Imaging tests that show your gallbladder. Abdominal ultrasound, endoscopic ultrasound, or a computerized tomography (CT) scan can reveal signs of cholecystitis or stones in the bile ducts and gallbladder.

Treatment

Treatment for cholecystitis usually involves a hospital stay to control the inflammation in the gallbladder. Sometimes, surgery is needed.

Most people need surgery to remove the gallbladder.

Gallbladder removal surgery is called a cholecystectomy. Usually, this is a minimally invasive procedure, involving a few tiny incisions (laparoscopic cholecystectomy). Rarely, an open procedure, in which a long incision is made in your abdomen, is required.

The timing of surgery depends on the severity of symptoms and the overall risk of problems during and after surgery. If at low surgical risk, surgery may be performed within 48 hours or during hospital stay. Otherwise, the surgeon may advise waiting for six weeks before surgery to allow the inflammation to settle down.