Cholecystitis

Cholecystitis
Acute cholecystitis as seen on CT. Note the fat stranding around the enlarged gallbladder.
Specialty	general surgery, gastroenterology
Symptoms	right upper abdominal pain, nausea, vomiting, fever
Duration	short term or long term
Causes	gallstones, tumor, bile duct scarring
Treatment	gallbladder removal surgery
[]

Cholecystitis is inflammation of the gallbladder. Symptoms include right upper abdominal pain, nausea, vomiting, and occasionally fever. Often gallbladder attacks (biliary colic) precede acute cholecystitis. The pain lasts longer in cholecystitis than in a typical gallbladder attack. Without appropriate treatment, recurrent episodes of cholecystitis are common. Complications of acute cholecystitis include gallstone pancreatitis, common bile duct stones, or inflammation of the common bile duct.

More than 90% of the time acute cholecystitis is from blockage of the bile duct by a gallstone. Risk factors for gallstones include birth control pills, pregnancy, a family history of gallstones, obesity, diabetes, liver disease, or rapid weight loss. Occasionally acute cholecystitis occur as a result of vasculitis, chemotherapy, or during recovery from major trauma or burns. Cholecystitis is suspected based on symptoms and laboratory testing. Abdominal ultrasound is then typically used to confirm the diagnosis.

Treatment is usually with laparoscopic gallbladder removal, within 24 hours if possible. Taking pictures of the bile ducts during the surgery is recommended. The routine use of antibiotics is controversial. They are recommended if surgery cannot occur in a timely manner or if the case is complicated.Stones in the common bile duct can be removed before surgery by ERCP or during surgery. Complications from surgery are rare. In people unable to have surgery, gallbladder drainage may be tried.