Merck Manual

Please confirm that you are a health care professional

honeypot link

Chronic Cholecystitis


Christina C. Lindenmeyer

, MD, Cleveland Clinic

Reviewed/Revised Sep 2021 | Modified Sep 2022
View Patient Education
Topic Resources

Chronic cholecystitis is long-standing gallbladder inflammation almost always due to gallstones.

Chronic cholecystitis almost always results from gallstones and prior episodes of acute cholecystitis Acute Cholecystitis Acute cholecystitis is inflammation of the gallbladder that develops over hours, usually because a gallstone obstructs the cystic duct. Symptoms include right upper quadrant pain and tenderness... read more (even if mild). Damage ranges from a modest infiltrate of chronic inflammatory cells to a fibrotic, shrunken gallbladder. Extensive calcification due to fibrosis is called porcelain gallbladder.

Overview of Chronic Cholecystitis

Symptoms and Signs of Chronic Cholecystitis

Gallstones intermittently obstruct the cystic duct and so cause recurrent biliary colic. Such episodes of pain are not necessarily accompanied by overt gallbladder inflammation; the extent of inflammation does not correlate with the intensity or frequency of biliary colic. Upper abdominal tenderness may be present, but usually fever is not. Fever suggests acute cholecystitis. Once episodes begin, they are likely to recur.

Diagnosis of Chronic Cholecystitis

  • Ultrasonography

Chronic cholecystitis is suspected in patients with recurrent biliary colic plus gallstones. Ultrasonography or another imaging test usually shows gallstones and sometimes a shrunken, fibrotic gallbladder. The diagnosis is made in patients with a history of recurrent biliary colic and ultrasonographic evidence of gallstones. Cholescintigraphy may show nonvisualization of the gallbladder but is less accurate.

Treatment of Chronic Cholecystitis

View Patient Education
NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
quiz link

Test your knowledge

Take a Quiz!