top of page

Acute Cholecystitis

Acute cholecystitis is a medical condition affecting the gallbladder, a small, pear-shaped organ beneath the liver. The gallbladder plays a crucial role in storing bile, a fluid the liver produces that aids in digesting fats. Acute cholecystitis occurs when the gallbladder becomes inflamed, often due to the presence of gallstones or other underlying factors.

Causes of Acute Cholecystitis
The most common cause of acute cholecystitis is the formation of gallstones within the gallbladder. Gallstones are small, hardened deposits that can vary in size and may be composed of cholesterol, bilirubin, or a combination of both. When gallstones block the cystic or common bile duct, bile cannot properly flow out of the gallbladder. This leads to pressure buildup and inflammation within the gallbladder, resulting in acute cholecystitis.

Recognizing the Symptoms
The symptoms of acute cholecystitis can manifest suddenly and intensely. Common signs and symptoms include:

1. Severe Abdominal Pain: The hallmark symptom of acute cholecystitis is intense pain in the upper right abdomen. The pain may radiate to the back or right shoulder and is usually persistent.
2. Nausea and Vomiting: As the inflammation affects the digestive system, patients may experience nausea and vomiting.
3. Fever and Chills: Inflammation in the gallbladder can lead to an infection, resulting in fever and chills.
4. Tenderness and Rigidity: The abdomen may feel tender to the touch, and the abdominal muscles may become rigid.
5. Jaundice: In some cases, the skin and whites of the eyes may turn yellow (jaundice) if a gallstone blocks the common bile duct.

It's important to note that symptoms can vary from person to person, and some individuals may experience a milder form of acute cholecystitis with less pronounced symptoms.

Diagnosing Acute Cholecystitis
If you experience symptoms suggestive of acute cholecystitis, it is essential to seek medical attention promptly. A healthcare provider will conduct a comprehensive evaluation, starting with a physical examination. During the examination, the doctor will check for signs of tenderness in the abdomen and any other associated symptoms.

To confirm the diagnosis and rule out other potential causes, the following diagnostic tests may be recommended:
1. Ultrasound: This non-invasive imaging test is often the first step in diagnosing acute cholecystitis. It allows the doctor to visualize the gallbladder, detect gallstones, and assess signs of inflammation.
2. Blood Tests: Blood tests may be performed to check for elevated levels of white blood cells, indicating inflammation or infection, and elevated liver enzyme levels.
3. HIDA Scan: A hepatobiliary iminodiacetic acid (HIDA) scan evaluates the gallbladder's function and can identify any blockages in the bile duct.
4. CT Scan or MRI: In some cases, a computed tomography (CT) scan or magnetic resonance imaging (MRI) may be performed to provide detailed images of the gallbladder and surrounding structures.

Complications of Acute Cholecystitis: When left untreated or if the condition becomes severe, acute cholecystitis can lead to several serious complications, including:
1. Gangrene: The inflammation can lead to the death of gallbladder tissues (gangrene), which can be life-threatening if not promptly addressed.
2. Abscess Formation: Pus-filled pockets (abscesses) can develop within the gallbladder due to the presence of infection.
3. Perforation: In severe cases, the gallbladder may rupture (perforate), spreading the infection to the abdominal cavity.
4. Bile Duct Obstruction: In some instances, gallstones or inflammation can cause a blockage in the common bile duct, leading to complications such as pancreatitis or obstructive jaundice.

Treatment Options: Managing acute cholecystitis involves addressing symptoms, treating the underlying cause, and preventing complications. Treatment options may include:
1. NPO (Nil per os): In the early stages of acute cholecystitis, patients may be asked to avoid eating or drinking to rest the gallbladder and reduce inflammation.

2. Pain Management: Medications such as acetaminophen or nonsteroidal antiinflammatory drugs (NSAIDs) may be prescribed to alleviate pain and discomfort.
3. Antibiotics: If an infection is present or suspected, antibiotics will be administered to combat it and prevent its spread.
4. Cholecystectomy: In most cases, the definitive treatment for acute cholecystitis is the surgical removal of the gallbladder (cholecystectomy). This can be performed using traditional open surgery or minimally invasive laparoscopic surgery.

Laparoscopic Cholecystectomy: Laparoscopic cholecystectomy is a less invasive procedure involving small incisions in the abdomen, through which a tiny camera and surgical instruments are inserted. This approach offers quicker recovery and reduced post-operative pain compared to open surgery.

Open Cholecystectomy: In some cases, an open cholecystectomy may be necessary, especially if there are complications or previous abdominal surgeries. The surgeon makes a larger incision in the abdomen to remove the gallbladder.

Recovery and Post-Surgery Care: Patients can usually resume their normal activities within a few weeks after cholecystectomy. The length of the recovery period may vary depending on the surgical approach used. During the recovery phase, it is crucial to follow the surgeon's postoperative care instructions, which may include:
1. Dietary Changes: The patient may be advised to start with a liquid diet and gradually introduce solid foods as tolerated.
2. Pain Management: Over-the-counter pain relievers or medications may be recommended to manage post-operative discomfort.
3. Activity and Rest: It's essential to balance rest and light physical activity during recovery to aid healing.
4. Incision Care: Keeping surgical incisions clean and dry is essential to preventing infection.

Conclusion: Acute cholecystitis is a condition that demands timely medical attention to prevent serious complications. Understanding its causes, symptoms, diagnosis, and treatment options can empower patients to take appropriate action and make informed decisions about their healthcare. If you suspect you have acute cholecystitis or experience symptoms suggestive of this condition, do not hesitate to seek medical advice from a healthcare professional. Early intervention can help prevent complications and promote a smoother recovery, allowing you to return to your daily activities with improved health and well-being.

You can download the pdf here :

If you need a PDF reader, this one is free to download: 

Center For Digestive Health & Nutrition

725 Cherrington Parkway • Moon Township, PA 15108 412.262.1000 • • IG: @thedigestivetract

The Center for Digestive Health & Nutrition is a private medical practice comprised of experienced Gastroenterologists, Nurse Practitioners, and staff members dedicated to preventing and treating digestive disorders. Our physicians have been serving the needs of those in Western Pennsylvania and surrounding areas since 1977, having cared for tens of thousands of individuals with digestive problems. Our mission is to deliver high-quality gastroenterology services efficiently and cost-consciously. We realize the very sensitive nature of GI illness and understand the necessity to provide our services in an environment that stresses patient privacy and confidentiality and where patient satisfaction is the goal. Appointments can be conveniently scheduled online via our website above. Learn more about digestive issues on Instagram @thedigestivetract

DISCLAIMER : The information on this website is to provide general information. The information on this website does NOT reflect definitive medical advice, and self-diagnoses should not be made based on information obtained online. It is important to consult a physician for a consultation and examination regarding ANY and ALL symptoms or signs as they may signify a serious illness or condition. An accurate diagnosis and treatment plan should only be made by a qualified doctor to exclude a serious condition.

bottom of page