Cholecystitis is the inflammation (or swelling) of the gallbladder. It occurs when a stone blocks the cystic duct, which carries bile from the gallbladder.
The gallbladder is located towards the upper right abdominal. It stores bile, which is responsible for breaking down the body’s fats. A normal functioning gallbladder stores bile (which is made in the liver) and pushes it into the small intestines to help digest food. The main bile duct, which is also called common bile duct, connects the liver with the intestine and carries the bile. The gallbladder is connected to this main bile duct through a little side duct, called the cystic duct.
Cholecystitis may occur when the cystic duct (the passage that connects the gallbladder to the bile duct) is blocked, typically by a gallstone, causing bile to become trapped leading to inflammation of the gallbladder.
Cholecystitis is caused by gallstones blocking the entrance of the gallbladder. This causes the bile to build up and the gallbladder to inflame. Cholecystitis can cause serious abdominal pain.
There are two different types of cholecystitis – acute and chronic.
- Acute cholecystitis is the sudden inflammation of the gallbladder that causes marked abdominal pain, often with nausea, vomiting, and fever.
- Chronic cholecystitis is a lower intensity inflammation of the gallbladder that lasts a long time. It may be caused by repeat attacks of acute cholecystitis. Chronic cholecystitis may cause intermittent mild abdominal pain, or no symptoms at all. Damage to the walls of the gallbladder leads to a thickened, scarred gallbladder. Ultimately, the gallbladder can shrink and lose its ability to store and release bile.
Cholecystitis is not uncommon. About 10% to 20% of Americans have gallstones, and about half of those will develop cholecystitis.
Causes
The gallbladder is an organ that sits below the liver. It stores bile, which your body uses to digest fats in the small intestine.
- Gallstones – in the majority of cases acute cholecystitis is caused by gallstones or biliary sludge getting trapped at the gallbladder’s opening.
- Injury – trauma to the abdomen, or surgery, can result in cholecystitis.
- Infection – if the infection is located within the bile, the gallbladder can become inflamed.
- Tumor – a tumor may stop the bile from draining out of the gallbladder properly, resulting in an accumulation of bile, which can lead to cholecystitis.
Other causes include:
- Serious illnesses such as HIV or diabetes
- Tumors of the gallbladder (rare)
Risk Factors
Some people are more at risk for gallstones. Risk factors include –
- Being female
- Pregnancy
- Hormone therapy
- Older age
- Being Native American or Hispanic
- Obesity
- Losing or gaining weight rapidly
- Diabetes
Sometimes the bile duct becomes blocked temporarily. When this occurs repeatedly, it can lead to chronic cholecystitis. This is swelling and irritation that continues over time. Eventually, the gallbladder becomes thick and hard. It also does not store and release bile as well.
Symptoms
A symptom is something the patient feels and reports, while a sign is something other people, including a doctor or a nurse may detect. For example, pain may be a symptom while a rash may be a sign.
Pain on the right-hand side of the upper abdomen – In cases of acute cholecystitis the pain comes on suddenly, does not go away, and is intense. If left untreated it will usually get worse, and feel more intense when breathing in deeply. The pain may radiate from the abdomen to the right shoulder or back.
Other symptoms may include –
- A slight fever
- Chills
- Abdominal bloating
- Tenderness on the upper-right hand side of the abdomen
- Very little or no appetite
- Nausea
- Vomiting
- Sweating
After a meal, especially one high in fat, symptoms will worsen.
Complications
- A fistula (a tube/channel is formed between the gallbladder and duodenum)
- Biliary peritonitis
- Gallbladder distention – if the gallbladder is inflamed because of bile accumulation, it may stretch and swell, causing pain. There is then a much greater risk of perforation (a tear) in the gallbladder, as well as infection and tissue death.
- Perforation of the gallbladder
- Pericholecystic abscess
- Tissue death – gallbladder tissue can die (gangrene), which can result in perforation, or the bursting of the bladder.
Treatment
For acute cholecystitis, initial (medical) treatment includes bowel rest, IV hydration, analgesia, and IV antibiotics. For mild cases of acute cholecystitis, antibiotic therapy with a single broad-spectrum antibiotic is adequate. Bacteria commonly associated with acute cholecystitis include E. Coli, B. Fragilis, Klebsiella, Enterococcus, and Pseudomonas species
Laparoscopic cholecystectomy is the standard of care for the surgical treatment of cholecystitis. Surgery is typically performed after symptoms have subsided, but during the hospitalization for acute illness.
Alternative Treatment
(Not Found)
Reference –
http://dictionary.reference.com/browse/cholecystitis
http://www.nejm.org/doi/full/10.1056/NEJMcp0800929
http://bestpractice.bmj.com/best-practice/monograph/78.html
http://www.belmarrahealth.com/cholecystitis-gallbladder-inflammation-causes-types-and-treatment/
https://rarediseases.org/rare-diseases/cholecystitis/
http://radiopaedia.org/articles/cholecystitis
https://my.clevelandclinic.org/health/diseases_conditions/hic-cholecystitis