Calculus of Gallbladder with Acute Cholecystitis

Written by Raihan Khalid | Published on July 16, 2012
Medically Reviewed by George Krucik, MD

What Is Acute Cholecystitis?

Acute Cholecystitis is an inflammation of the gallbladder, a green pear-shaped hollow organ located beneath your liver.

 

The gallbladder acts as a reservoir for bile, a dark-green fluid that helps in the digestion and absorption of food. After you eat, bile is released from the gallbladder into the cystic duct. From there, it makes its way down the common bile duct to enter the small intestine (specifically, the duodenum). Sometimes this process is inhibited, leading to a build-up of bile inside the gallbladder. As a result, the gallbladder becomes larger and inflamed.

Causes of Acute Cholecystitis

Acute cholecystitis is caused by a blockage of the cystic duct by gallstones in 90 percent of the cases. The remaining 10 percent may be due to tumors or other bile duct problems such as inflammation, strictures, cysts, trauma, surgery, parasites, or infection. In most cases, however, the infection is a result of cholecystitis, not the cause.

Who Is at Risk of Developing Acute Cholecystitis?

The risk factors for acute cholecystitis include:

  • gallstones
  • high-fat diet
  • high-cholesterol diet
  • low-fiber diet
  • old age
  • being female
  • obesity
  • rapid weight loss
  • certain drugs
  • pregnancy
  • certain ethnic groups (Native Americans, Mexican Americans)
  • diabetes

Symptoms of Acute Cholecystitis

If you have acute cholecystitis, you may experience some of the following symptoms:

  • pain
  • abdominal tenderness
  • nausea
  • vomiting
  • fever
  • chills
  • sweating

Pain is one of the most distinctive factors for acute cholecystitis. It is usually in the upper right area of the abdomen. Pain may also occur between your shoulder blades or radiate to your right shoulder. The onset of the pain is often sudden and may be very intense. More often than not, it is a constant pain lasting for a few minutes or hours. It may become worst after you eat a meal.

Diagnosis

The following tests may be helpful in diagnosing acute cholecystitis:

Blood Tests

Blood tests will provide your physician with a complete blood count (CBC) and assess liver function. The results can be helpful in indicating an obstruction.

Ultrasonography

This is usually the first step to reaching an acute cholecystitis diagnosis. It employs sound waves to create an image of your gallbladder and bile ducts.

X-ray

X-rays are often performed to exclude other conditions.

Oral Cholecystogram (OCG)

Pills containing a dye are swallowed before being X-rayed. The dye helps to detect any problems with your gallbladder including gallstones.

Hepatobiliary Iminodiacetic Acid (HIDA) Scan

This scan is helpful in tracking and indicating an obstruction in bile flow. Your physician will inject a solution into your system that will then be viewed with a special camera.

Computed Tomography (CT)

CTs create cross-section images of your abdomen. These images allow your physician to detect gallstones.

Magnetic Resonance Imaging (MRI)

MRIs use a magnetic field and radio waves to create an image of your abdomen.

Treatment

The first step of treatment is to control the inflammation. This may be achieved through:

  • Antibiotics to prevent or treat the infection.
  • Medications to temporarily control your pain.
  • Fasting to relieve the gallbladder from any stress.

After your condition has stabilized, your physician may recommend surgery to remove the gallbladder. This is the only guaranteed way to prevent cholecystitis from recurring. This procedure is known as a cholecystectomy. A cholecystectomy may be performed laparoscopically or via open surgery.

 

Laparoscopic surgery is performed by making small incisions in your abdomen. A small camera and some surgical instruments are then inserted through the incision. The camera displays the inside of your abdomen on a monitor. The doctor can then guide the instruments to remove the gallbladder. Laparoscopic surgery is preferred over classic open surgery because and it can be done with small incisions. The small incision results in faster recovery times. Patients prefer it as well because it doesn’t leave an unpleasant scar.

In the Long Term

You don’t need your gallbladder to stay alive. Once your gallbladder has been removed, you may resume a normal life.

Prevention

The majority of cholecystitis cases are a result of gallstones. You may reduce your chances of developing gallstones by:

  • losing weight slowly if you are overweight or obese
  • maintain a healthy diet rich in fiber, low it fats
  • eat more fruits and vegetables
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