Acute cholecystitis is an inflammation of the gallbladder. The gallbladder is a green pear-shaped hollow organ located beneath your liver. Bile — a dark green fluid that helps your body digest and absorb food — is stored there.
After you eat, bile is released from your gallbladder into your cystic duct. From there, it makes its way down the common bile duct to enter your small intestine (specifically, the duodenum). Sometimes this process is inhibited, leading to a buildup of bile inside your gallbladder. As a result, your gallbladder becomes larger and inflamed.
If you have acute cholecystitis, you may experience some of the following symptoms:
- abdominal tenderness
Pain is one of the most distinctive features of acute cholecystitis. You will usually feel it in the upper right area of your abdomen. Pain may also occur between your shoulder blades or radiate from the abdominal area 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 worse after you eat a meal.
In about 90 percent of cases, acute cholecystitis is caused by gallstones blocking your cystic duct. In other cases, it may be caused by tumors or other problems with your bile duct, such as inflammation, strictures, cysts, trauma, surgery, parasites, or infection. In most cases, however, the infection is a result of cholecystitis, not the cause.
The risk factors for acute cholecystitis include:
- high-fat diet
- high-cholesterol diet
- low-fiber diet
- old age
- being female
- rapid weight loss
- certain drugs
- certain ethnicities (e.g., Native American, Mexican-American)
The following tests may be helpful in diagnosing acute cholecystitis:
Blood tests will provide your doctor with a complete blood count (CBC) and liver enzymes levels help them assess your liver function. The results can help them learn if your bile flow is blocked.
This test 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-rays are often performed to rule out other conditions.
Oral Cholecystogram (OCG)
In this test, you will be asked to swallow pills containing a dye before you are X-rayed. The dye will help your doctor detect any problems with your gallbladder, including gallstones.
Hepatobiliary Iminodiacetic Acid (HIDA) Scan
This scan can help your doctor track and identify an obstruction in your bile flow. They will inject a solution into your body and use a special camera to view it.
Computed Tomography (CT)
CT scans can be used to create cross-sectional images of your abdomen. These images allow your doctor to detect gallstones.
Magnetic Resonance Imaging (MRI)
MRI scans use a magnetic field and radio waves to create an image of your abdomen.
The first step of treatment is to control inflammation. Your doctor may prescribe:
- antibiotics to prevent or treat infection
- medications to temporarily control your pain
- fasting to relieve the gallbladder from stress
After your condition has been stabilized, your doctor may recommend surgery to remove your gallbladder. This is the only guaranteed way to prevent cholecystitis from happening again. This procedure is known as a cholecystectomy. A cholecystectomy may be performed laparoscopically or through 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. Your 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.
You don’t need your gallbladder for your body to function properly. If your gallbladder is removed, you can still lead a normal life.
The majority of cholecystitis cases are caused by gallstones. You may reduce your chances of developing gallstones by:
- losing weight slowly if you are overweight or obese
- maintaining a healthy diet that is rich in fiber and low in fat
- eating more fruits and vegetables