Acute cholecystitis as the name suggests is sudden and acute inflammation of the gallbladder. Gallbladder is a pear shaped small sac located beneath liver. It is a storehouse for bile, a type of enzyme that is utilized for digestion of fat. Bile is released in the intestine from gallbladder. In majority of cases acute cholecystitis occurs due to presence of gallstones. Gallstone can block the bile flow. Hence there is accumulation of bile which irritates the gallbladder wall to cause inflammation.
Patient complains of severe pain in upper right and middle aspect of abdomen. Nausea and vomiting are common accompanying symptoms. The disease is diagnosed with the help of ultrasound and CT scan of abdomen. Acute cholecystitis needs immediate medical attention. Patient may require admission in a hospital. Patient is treated conservatively or may require surgery to remove gallbladder.
Symptoms Of Acute Cholecystitis
The symptoms of acute cholecystitis mostly develop as a result of obstruction caused by the stones present in gallbladder. The accumulated bile irritates the wall of gallbladder leading to inflammation. Often it is associated with infection and pus. Most notable symptom of acute cholecystitis is severe and sudden pain in upper right side of abdomen. Pain may migrate to back under the shoulder blade.
Vomiting, nausea, are other common features along with mild to severe rise in body temperature. Breathing tends to become shallow since deep breathing aggravates pain. There is severe tenderness over the right upper abdomen. Muscle guarding is present in some patients. Clay-colored stool, jaundice, and pain after meals especially fatty meals is commonly associated with this condition.
Common Causes Of Acute Cholecystitis
In 80 percent of patients, acute cholecystitis is caused by presence of gallstones in gallbladder. Inflammation of gallbladder can also occur due to other causes but the incidence is rare. Here are some important causes:
- Gallstones: Gallstones in the gallbladder can cause obstruction in bile duct or cystic duct. Due to obstruction, bile does not flow into the intestine and it builds up in the gallbladder leading to inflammation.
- Infection: Certain illnesses can cause cholecystitis. HIV infection, diabetes, viral hepatitis, all can cause acute cholecystitis.
- Tumor: Presence of tumor in liver can put pressure on the gallbladder or the bile duct. It may not allow proper flow of bile from the gallbladder leading to cholecystitis.
- Kinking of the bile duct may not allow easy flow of bile. This may give rise of cholecystitis.
Cholecystitis is more common in women as compared to men. Women also have higher risk of developing gallstones and acute cholecystitis. The incidence increases with growing age.
Diagnosis And Treatment Of Acute Cholecystitis
Acute cholecystitis is diagnosed with the help of symptoms, medical history and certain tests. Tests include ultrasound examination of abdomen, CT scan of liver and gallbladder. Complete blood count and liver function test may also show some type of infection.
Acute cholecystitis presents with severe pain in upper abdomen. Patient needs immediate medical treatment to reduce and prevent complications. Patient is not given any food or liquid for few hours so that gallbladder will get some rest. Intravenous fluids are administered to maintain proper electrolyte balance.
Patient is also given antibiotic medicines and medicines to alleviate pain and fight infection. In case if cholecystitis is recurring or the symptoms are worsening the doctor may recommend for surgical removal of gallbladder.
If patient is better by conservative treatment, he may reduce the risk of recurrent attacks by avoiding foods such as red meat, alcohol, fried foods, sweets and smoothies.