2. INTRODUCTION
• Cholecystitis is inflammation in your gallbladder.
• Acute cholecystitis is swelling (inflammation) of the gallbladder. It is a potentially
serious condition that usually needs to be treated in hospital.
• The main symptom of acute cholecystitis is a sudden sharp pain in the upper right
side of your tummy (abdomen) that spreads towards your right shoulder.
• Cholecystitis usually develops when the bile gets trapped in your gallbladder and
becomes infected with bacteria. Bile gets trapped when gallstones block the flow of
bile out of your gallbladder.
3. What causes Acute Cholecystitis?
• Cholecystitis is commonly caused by gallstones that have blocked your cystic
duct, which prevents bile from exiting your gallbladder.
• Your gallbladder becomes swollen and may become infected with bacteria.
• Less common causes include blocked bile ducts due to scarring, reduced
blood flow to your gallbladder, tumors that block the flow of bile from your
gallbladder, or viral infections that inflame your gallbladder.
4.
5. Acute Cholecystitis
• Acute cholecystitis comes on suddenly and causes severe, ongoing pain.
• More than 95% of people with acute cholecystitis have gallstones.
• Pain begins in your mid to upper right abdomen and may spread to your
right shoulder blade or back.
• Pain is strongest 15 to 20 minutes after eating and it continues.
• Pain that remains severe is considered a medical emergency.
6. Symptoms
• Severe pain in your upper right or center abdomen
• Pain that spreads to your right shoulder or back
• Tenderness over your abdomen when it's touched
• Nausea
• Vomiting
• Fever
7.
8. Diagnosis
• Abdominal ultrasound: This test uses sound waves to examine the gallbladder and
the bile ducts. It helps identify signs of inflammation in your gallbladder, the
presence of gallstones, and thickening or swelling of the gallbladder wall.
• Hepatobiliary nuclear imaging (HIDA scan): This is an imaging test that
involves an injected radioactive substance. A gamma camera sees the radiation as it
moves through the different tracts of the digestive system. If that substance doesn’t
enter your gallbladder, then the healthcare provider knows the organ is blocked,
indicating cholecystitis. This test can also detect the function of the gallbladder and
its ability to eject the bile once stimulated. This is called the ejection fraction of the
gallbladder, which is considered normal when it is above 30-35%.
9. Diagnosis
• Magnetic Resonance Cholangiopancreatography (MRCP): This type of
MRI shows details of your liver, gallbladder, bile ducts, structures and ducts
of the pancreas as well. It can show gallstones, inflammation or blockage of
the bile ducts and gallbladder and if there is any inflammation of the
pancreas.
• Abdominal Computed Tomography (CT Scan): This X-ray test shows
details of your liver, gallbladder and bile ducts. It shows inflammation of the
gallbladder.
10.
11. Treatment
• Fasting. You may not be allowed to eat or drink at first in order to take
stress off your inflamed gallbladder.
• Fluids through a vein in your arm. This treatment helps prevent
dehydration.
• Antibiotics to fight infection. If your gallbladder is infected, your provider
likely will recommend antibiotics.
• Pain medications. These can help control pain until the inflammation in
your gallbladder is relieved.
12. Treatment
• Procedure to remove stones. You may have a procedure called an
endoscopic retrograde cholangiopancreatography (ERCP). During this
procedure that uses dye to highlight the bile ducts, instruments can be used
to remove stones blocking the bile ducts or cystic duct.
• Gallbladder drainage. In some cases, such as when surgery to remove the
gallbladder is not an option, gallbladder drainage (cholecystostomy) may be
done to remove infection. Drainage is done through the skin on the
abdomen (percutaneous) or by passing a scope through the mouth
(endoscopic).
13.
14. What complications can occur if
cholecystitis is not treated?
• Severely Infected gallbladder: A blocked gallbladder that is extremely
uncomfortable and painful. Without treatment, it could lead to an overwhelming
infection, or even gangrene of the gallbladder.
• Cholangitis: An acute infection of the main bile ducts and liver that can be
extremely life-threating if not promptly treated.
• Inflamed pancreas (Pancreatitis): Your common bile duct and the pancreatic
duct share the same “valve” into the duodenum. If a gallstone blocks that valve, the
potent pancreatic enzyme juice excreted by the pancreases gets backed up causing
pancreatitis, which can also be severe and life threatening.
15. How can cholecystitis be prevented?
• Eating a healthy diet: Choose to eat a healthy diet – one high in fruits,
vegetables whole grains and healthy fats – such as the Mediterranean diet.
Stay away from foods high in fat and cholesterol.
• Exercising: Exercise reduces cholesterol, and the lower the cholesterol level
the lower the chance of getting gallstones.
• Losing weight slowly: If you are making efforts to lose weight, don’t lose
more than one to two pounds a week. Rapid weight loss increases your risk
for developing gallstones.
