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Cholecystitis can be divided into chronic cholecystitis and acute cholecystitis. In either chase there is an inflammation of the gallbladder or infection of the gallbladder that causes abdominal pain and other symptoms.

The causes of acute cholecystitis in ninety percent of cases are gallstones in the gallbladder that back up bile and cause inflammation and infection of the lining of the gallbladder. You can also get acute cholecystitis with tumors of the gallbladder and with severe illness. Bile becomes trapped in the gallbladder and causes an increase in the pressure of the gallbladder and inflammation or irritation of the gallbladder. This can secondarily lead to bacterial infection and ultimate perforation of the gallbladder.

Gall stones increase with age and are more common in women. Native Americans get more gallstones than others and therefore get more cholecystitis.

The main symptom of acute cholecystitis is abdominal pain in the right upper quadrant abdominal pain. The pain can be dull or sharp and cramping; it may come and go and it may have spread to the back or to the right shoulder blade. It can occur within minutes of having a meal. Related symptoms include abdominal fullness, clay coloured stools, fever, nausea and vomiting and yellowing of the whites of the eyes and the skin. This is called jaundice and is a sign that the cholecystitis has been going on for a while.

Doctors can do a physical examination of the abdomen and can find tenderness to the touch of the right upper quadrant. Blood tests for lipase and amylase are done to see if the pancreas is inflamed and a bilirubin test can tell if the liver is involved. Other liver function tests can be done as well. A CBC can show a high white blood cell count. To image the gallbladder, an abdominal ultrasound, CT scan of the abdomen, abdominal x-ray and oral cholecystogram can be done. There is a specialized test called a gallbladder radionuclide scan that can use radioactive particles to outline the gallbladder on a film.

Treatment of acute cholecystitis involves seeking immediate medical attention if the pain is prolonged or severe. Fluids are given by IV along with antibiotics to fight off infection. Surgery to remove the gallbladder is the preferred treatment, unless the cholecystitis gets better on its own. Surgery can be delayed if antibiotics settle the inflammation down. Pain medications can be given and a low fat diet is recommended until the gallbladder can be removed. You may need emergency cholecystitis surgery if there is gangrene of the gallbladder, pancreatitis or perforation of the gall bladder. If the bile ducts become inflamed, too, you need to have emergency surgery. Sometimes, a tube might be placed through the skin so that the gallbladder is drained before surgery can be safely performed.

The prognosis of cholecystitis is excellent as long as the gallbladder is removed. Most people have their gallbladder removed via a laparoscope so that the incisions are small and heal very fast.

Chronic cholecystitis involves a longer period of irritation and swelling of the gallbladder. It usually occurs after repeated bouts with acute cholecystitis. This thickens the walls of the gallbladder and the gallbladder begins to shrink. It eventually fails to work and cannot store bile. Women get this disease more commonly than men and it is of a greater incidence in women over the age of forty. Risk factors for the disease include having gallstones and having them block the exit to the gallbladder.

Symptoms include having attacks of right upper quadrant abdominal pain associated with nausea or vomiting.

Tests for chronic cholecystitis are the same as for acute cholecystitis and include an abdominal ultrasound, a CT scan of the abdomen, a HIDA scan or radioactive scan of the gallbladder and an oral cholecystogram.

The treatment of chronic cholecystitis involves doing surgery to remove the gallbladder. This is called a cholecystectomy. Laparoscopic surgery is what is usually performed but open abdominal surgery is also possible.

Complications of chronic cholecystitis include a rare case of gallbladder cancer, jaundice, pancreatitis or worsened cholecystitis.

HELPLINE: ☎ 1800 633 634

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