Cholecystitis
Gallbladder Inflammation — Acute & Chronic
Overview
Cholecystitis is inflammation of the gallbladder, most commonly caused by gallstones blocking the cystic duct. It can be acute (sudden onset) or chronic (recurring over time). Acute cholecystitis is a medical emergency requiring prompt treatment.
Symptoms
- Sudden, severe pain in the upper right abdomen
- Pain that worsens with deep breathing
- Fever (38–39°C)
- Nausea and vomiting
- Tenderness when pressing the right upper abdomen
- Murphy's sign positive on examination
Causes & Risk Factors
- Gallstones blocking the cystic duct (90% of cases)
- Bacterial infection
- Trauma or major surgery
- Prolonged fasting
- Acalculous cholecystitis (without stones) in critically ill patients
Diagnosis
- Ultrasound (thickened gallbladder wall, stones)
- Blood tests (elevated WBC, CRP)
- CT scan for complications
- HIDA scan for gallbladder function
Treatment Options
- IV antibiotics and pain management
- Emergency laparoscopic cholecystectomy
- Elective surgery after acute episode resolves
- Percutaneous cholecystostomy for high-risk patients
⚠️ When to Seek Immediate Treatment
- Severe right upper abdominal pain
- Fever above 38.5°C
- Pain lasting more than 6 hours
- Vomiting that won't stop
Frequently Asked Questions
Is cholecystitis an emergency?
Acute cholecystitis requires urgent medical attention. Most cases need hospitalization and surgery within 24–72 hours to prevent serious complications.
Can cholecystitis be treated without surgery?
Mild cases may be managed with antibiotics initially, but surgery is the definitive treatment. Delaying surgery increases complication risk.