Cholecystitis
What is cholecystitis?
Cholecystitis is inflammation (swelling) of your gallbladder. Your gallbladder is the sac just under your liver where your body stores bile. Bile is a digestive fluid that helps break down fats in food.
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If you have cholecystitis, you may have belly pain that lasts more than 6 hours, a fever, and feel sick to your stomach
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Doctors usually look for cholecystitis by doing an ultrasound of your gallbladder
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Doctors treat cholecystitis by doing surgery to take out your gallbladder
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Cholecystitis is acute if it starts suddenly and lasts a short time
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Cholecystitis becomes chronic after you've had several attacks of acute cholecystitis
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In chronic cholecystitis, the gallbladder becomes scarred and doesn't work as well as it did but still causes pain
What causes cholecystitis?
The most common cause of cholecystitis is gallstones. Gallstones are clumps of solid material that can form in your gallbladder. You can get an attack of cholecystitis when a gallstone blocks your cystic duct. The cystic duct is the tube that takes bile from the gallbladder to the intestine. When the duct is blocked, fluid can't leave your gallbladder. The fluid irritates your gallbladder and makes it swell up and hurt.
Sometimes the gallstone gets out of the way by passing into the intestines or going back into the gallbladder. This lets your gallbladder drain, and the pain goes away. However, another stone can block your gallbladder and give you another attack.
Cholecystitis can also be caused by infection or tumors in the gallbladder, but these are rare.
Acalculous cholecystitis
Cholecystitis without gallstones is called acalculous cholecystitis. Instead of gallstones, you have small bits of material in your gallbladder that form a kind of sludge. Attacks of acalculous cholecystitis can be triggered by:
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Major surgery
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Serious injuries, burns, or blood infection (sepsis)
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Being fed through a vein for a long time
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Not eating for a long time
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A problem with your immune system
What are symptoms of cholecystitis?
Cholecystitis can happen suddenly (acute) or repeatedly over time (chronic).
Symptoms of acute cholecystitis:
An attack usually lasts from about 30 minutes to 2 or 3 days. But attacks may be severe and last longer.
Older people (over age 55) may have different symptoms for acute cholecystitis. These may include:
Older people may not have a fever.
See a doctor if your symptoms last for more than a few hours or if you have any of these symptoms:
Symptoms of chronic cholecystitis:
How can doctors tell if I have cholecystitis?
Doctors check whether your symptoms are caused by cholecystitis by doing:
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Ultrasound of your gallbladder—a test that uses sound waves to create a moving picture
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Cholescintigraphy—a test in which a substance is injected into your vein and lets doctors see whether something is blocking your gallbladder
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Blood tests
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CT scan—a special x-ray test that creates a detailed picture of your organs
How do doctors treat cholecystitis?
Doctors usually do surgery to remove your gallbladder.
You'll stay in the hospital. You won’t be able to eat or drink. Doctors will also give you:
Doctors usually remove the gallbladder quickly (within 24 to 48 hours after symptoms start) if you:
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Have acute cholecystitis and the risk of surgery is small
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Are older
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Have diabetes
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May have a serious complication
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Have acalculous cholecystitis
Sometimes doctors will give you fluids by vein, antibiotics, and pain medicine and wait a few weeks or more before doing surgery. But in most cases, doing surgery earlier is better for you.
To do gallbladder surgery, doctors usually use laparoscopy. Doctors will make a small hole in your belly and insert a rigid viewing tube (laparoscope) to see inside your body. They make one or two other holes to insert tools that are needed to cut out your gallbladder. Your gallbladder is then removed through the small hole.
