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Acute cholecystitis Causes and Risks:
In 90% of cases, acute cholecystitis is caused by the presence of gallstones obstructing the duct leading from the gallbladder. Trauma or previous surgery may be other causes. The trapped bile becomes concentrated and causes irritation and pressure build-up in the gallbladder. This can lead to bacterial infection and perforation. The attack often follows a large or fatty meal. Gallstones occur more frequently in women than men, and the incidence increases with age in both sexes. Native Americans and diabetics have a higher incidence of gallstones. The incidence is 2 out of 10,000 people.
Prevention:
Treatment (removal) of gallstones may prevent further attacks of
cholecystitis. Reduce fat in the diet if prone to attacks of
cholecytitis.
Symptoms:
Signs and Tests:
Examination of the abdomen by touch ( palpation ) reveals tenderness.
Tests that detect the presence of gallstones or inflammation include: This disease may also alter the results of the following tests:
Treatment:
Although most cases of cholecystitis resolve on their own, surgery to remove the gallbladder ( cholecystectomy ) is the usual treatment because inflammation frequently recurs.
Emergency surgery is done when gangrene (tissue death), perforation, pancreatitis , or inflammation of the common bile duct occurs.
Nonsurgical treatment consists of pain control, decompression of the pressure in the abdomen by a tube placed in the stomach, antibiotics to eliminate the infection, and a low fat diet when food is tolerated after the acute attack.
Prognosis:
Acute cholecystitis resolves by itself in 90% of cases. However, the other 10% of those affected will develop complications.
Complications:
- empyema (pus in the gallbladder)
- peritonitis (inflammation of the lining of the abdomen)
- gangrene (tissue death) of the gallbladder
Call Your Healthcare Provider:
Call your health care provider if severe abdominal pain persists.
Call for an appointment with your health care provider if symptoms of cholecystitis recur after an acute episode.
Picture:
P0109.pctCholecystitis, cholangiogram
P0110.pctCholecystitis, CT scan
P0219.pctGallstones, cholangiogram
This illustration shows the major organs of the digestive system. Their relative sizes and positioning in the body are also demonstrated.
This is a CT scan of the upper abdomen showing cholecystitis (gall stones).
Cholecystitis can be seen on a cholangiogram. Radio-opaque dye is used to enhance the X-ray. Multiple stones are present in the gallbladder (PTCA).
Cholecystolithiasis. CT scan of the upper abdomen showing multiple gallstones.
A cholecystogram in a patient with gallstones.
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