What is cholecystitis?
Cholecystitis is a medical term for inflammation of the gallbladder. The gallbladder is a small organ that lies beneath the liver. It collects the bile produced in the liver and delivers it into the small intestine after the meals and thus helps to digest fats.
The word cholecystitis comes from cholecyst (gallbladder) + -itis (inflammation).
- Gallstones (cholelithiasis) are the cause of cholecystitis in about 90% cases .
- Other causes include trauma or other severe acute condition, infections, parasites and chronic diseases, such as diabetes mellitus.
Symptoms and Signs
Typical symptoms of acute cholecystitis are :
- Right or central upper abdominal pain
- Nausea or vomiting
Chronic cholecystitis can be without any symptoms.
During a physical examination, a doctor may or may not detect a tender lump below the right rib cage.
- Ultrasonography can detect cholecystitis in most cases.
- Scintigraphy (HIDA scan) can help to distinguish between acute and chronic cholecystitis and between the inflammation of the gallbladder and bile ducts.
- An X-ray or computed tomography (CT) can reveal gallbladder calcification.
Types of Gallbladder Inflammation
Acute gallbladder inflammation with gallstones (acute calculous cholecystitis) develops when a gallstone blocks the flow of the bile out of the gallbladder.
Chronic gallbladder inflammation with gallstones (chronic calculous cholecystitis) probably develops due to recurrent episodes of acute cholecystitis.
- Porcelain gallbladder is chronic gallbladder inflammation with a calcified wall.
Acalculous cholecystitis is gallbladder inflammation without gallstones.
- Acute acalculous cholecystitis usually develops as a complication of trauma or critical illness in emergency care units in hospitals.
- Chronic acalculous cholecystitis can develop as a complication of a chronic disease, such as diabetes mellitus.
When acute cholecystitis is not treated promptly it may develop into life-threatening complications :
- Gallbladder infection (suppurative cholecystitis or empyema), sometimes associated with the accumulation of air in the gallbladder (emphysematous cholecystitis)
- Gallbladder perforation and subsequent inflammation of the abdominal membrane (peritonitis) or passage of a gallstone into the intestine and its blockage (gallstone ileus)
- Death of the gallbladder wall (necrotizing cholecystitis)
- Blood infection (sepsis)
Chronic cholecystitis increases the risk of gallbladder cancer.
The most commonly recommended treatment of cholecystitis is surgical gallbladder removal.