Cholecystitis: what it is and why gallbladder inflammation occurs

Doctors call inflammation of the gallbladder cholecystitis. The diagnosis sounds serious, and for good reason: without help, the disease can lead to complications. Below is what happens to the organ, where the inflammation comes from, and which signs should not be ignored.

Cholecystitis: what kind of disease it is

The gallbladder is a small organ under the liver. It stores bile produced by the liver and helps digest fats. Cholecystitis is inflammation of the wall of the gallbladder. Most often it occurs acutely, with severe pain, and the person is hospitalized. There is also a chronic form: inflammation lasts a long time, the gallbladder wall thickens and hardens, and the organ stores and releases bile less well.

Causes of cholecystitis

The main cause is a stone in the cystic duct. The duct becomes blocked, bile stagnates, pressure inside the gallbladder rises, and the wall becomes inflamed. Sometimes a bacterial infection is added. This variant, calculous cholecystitis, accounts for about 95% of all cases. Less common is acalculous cholecystitis — inflammation without stones. It is less widespread but usually more severe and develops as a complication of a serious illness, infection, or injury. Among the factors are damage to the gallbladder during major surgery, burns, sepsis, severe wasting, and dehydration.

Gallstones are found in more than 1 in 10 adults. In most people they cause no symptoms. The risk is higher in women, during pregnancy and hormone therapy, at an older age, with obesity, with rapid weight loss or gain, and with diabetes.

How gallbladder inflammation manifests

The main sign is sudden sharp pain in the upper right abdomen. It radiates to the right shoulder, the abdomen is tender in that area, and a deep breath intensifies the sensations. It differs from other abdominal pain in that it does not go away within a few hours. The minimum duration is about 30 minutes. The pain may radiate to the back or under the right shoulder blade and appear after eating, more often after fatty food.

• high fever;
• nausea and vomiting;
• sweating and loss of appetite;
• yellowing of the skin and whites of the eyes;
• pale, almost discolored stool.

How cholecystitis is detected: tests and ultrasound

The examination begins with the abdomen. The doctor checks Murphy's sign: presses with a hand under the costal arch and asks the patient to take a deep breath. The inflamed gallbladder moves downward and causes sudden pain. Next, blood tests are ordered: a complete blood count, liver function tests, bilirubin, amylase, and lipase. Stones and signs of inflammation are shown by ultrasound of the abdominal organs, CT or MRI, X-ray, and radioisotope scanning of the gallbladder. The sooner the diagnosis is made, the lower the risk of complications.

Why cholecystitis is dangerous: possible complications

Without treatment, inflammation can result in death of the wall tissue — gangrenous cholecystitis — and spread of infection throughout the body. The gallbladder can rupture: then the infection spreads into the abdominal cavity and peritonitis develops, or an abscess forms. Other complications include accumulation of pus in the gallbladder, pancreatitis, and cholangitis. In about 2–3 out of 10 cases of acute cholecystitis, complications require emergency surgery.

When urgent medical help is needed

With severe abdominal pain, see a doctor as soon as possible, especially if the pain lasts longer than several hours or is accompanied by yellowing and high fever. If acute cholecystitis is suspected, the doctor refers the patient to a hospital, where tests and ultrasound are performed. Without treatment, complications are possible.

Cholecystitis by itself is not a reason to call an ambulance. 103 or 112 — if severe abdominal pain is accompanied by yellowing of the skin and whites of the eyes and high fever, and the condition is rapidly worsening.

This material is for reference. It explains what happens in cholecystitis but does not replace a doctor's consultation: the decision about examination is made based on your situation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer