Acute cholecystitis
Definition
Acute cholecystitis is a sudden inflammation of the gallbladder that causes severe abdominal pain.
See also: Chronic cholecystitis
Causes
In 90% of cases, acute cholecystitis is caused by gallstones in the gallbladder. Severe illness and, rarely, tumors of the gallbladder may also cause cholecystitis.
Acute cholecystitis causes bile to become trapped in the gallbladder. The buildup 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.
Symptoms
The main symptom is abdominal pain that is located on the upper right side or upper middle of the abdomen. The pain may:
- Be sharp, cramping, or dull
- Come and go
- Spread to the back or below the right shoulder blade
- Occur within minutes of a meal
Other symptoms that may occur include:
- Abdominal fullness
- Clay-colored stools
- Fever
- Nausea and vomiting
- Yellowing of skin and whites of the eyes (jaundice)
Treatment
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.
Occasionally, in very ill patients, a tube may be placed through the skin to drain the gallbladder until the patient gets better and can have surgery.
Prognosis
Patients who have surgery to remove the gallbladder usually do very well.
Prevention
Removal of the gallbladder and gallstones will prevent further attacks. Follow a low-fat diet if you are prone to gallstone attacks.