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Acute cholecystitis

Cholecystitis - acute; Gallstones - acute cholecystitis

Acute cholecystitis is sudden swelling and irritation of the gallbladder. It causes severe belly pain.

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Digestive system
Cholecystitis, CT scan
Cholecystitis - cholangiogram
Cholecystolithiasis
Gallstones, cholangiogram

Presentation

Gallbladder removal - Series

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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.

Acute cholecystitis occurs when bile becomes trapped in the gallbladder. This often happens because a gallstone blocks the cystic duct, the tube through which bile travels into and out of the gallbladder. When a stone blocks this duct, bile builds up, causing irritation and pressure in the gallbladder. This can lead to swelling and infection.

Other causes include:

Some people are more at risk for gallstones. Risk factors include:

Sometimes, the bile duct becomes blocked temporarily. When this occurs repeatedly, it can lead to long-term (chronic) cholecystitis. This is swelling and irritation that continues over time. Eventually, the gallbladder becomes thick and hard. It does not store and release bile as well as it did.

Symptoms

The main symptom is pain in the upper right side or upper middle of your belly that usually lasts at least 30 minutes. You may feel:

Other symptoms that may occur include:

Exams and Tests

Your health care provider will perform a physical exam and ask about your symptoms. During the physical exam, you will likely have pain when the provider touches your belly.

Your provider may order the following blood tests:

Imaging tests can show gallstones or inflammation. You may have one or more of these tests:

Treatment

If you have severe belly pain, seek medical attention right away.

In the emergency room, you'll be given fluids through a vein. You also may be given antibiotics to fight infection.

Cholecystitis may clear up on its own. However, if you have gallstones, you will probably need surgery to remove your gallbladder.

Nonsurgical treatment includes:

You may need emergency surgery if you have complications such as:

If you are very ill, a tube may be placed through your belly into your gallbladder to drain it. Once you feel better, your provider may recommend that you have surgery.

Outlook (Prognosis)

Most people who have surgery to remove their gallbladder recover completely.

Possible Complications

Untreated, cholecystitis may lead to any of the following health problems:

When to Contact a Medical Professional

Call your provider if:

Prevention

Removing the gallbladder and gallstones will prevent further attacks.

Related Information

Abdominal pain
Gallstones
Bile
Empyema
Peritonitis
Gallbladder removal - laparoscopic
Gallstones - discharge
Gallbladder removal - laparoscopic - discharge
Gallbladder removal - open - discharge

References

Glasgow RE, Mulvihill SJ. Treatment of gallstone disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 66.

Jackson PG, Evans SRT. Biliary system. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 54.

Wang DQ-H, Afdhal NH. Gallstone disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 65.

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Review Date: 7/10/2017  

Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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