Cholecystitis
What is it?
Cholecycstitis is a painful
inflammation of the gallbladder, the
small, pear-shaped sac under the liver
that stores bile. Bile is a liquid in the
liver that helps to digest food in the
intestine.
Who gets it?
Cholecystitis strikes twice as many
women than men, particularly those between
the ages of twenty and sixty. Pregnant
women, or those on birth control pills or
estrogen replacement therapy have a
greater risk of developing cholecystitis.
People who are overweight, or who lose a
large amount of weight quickly are also at
greater risk for developing the condition.
What causes it?
In about ninety-five percent of all
cases of cholecystitis, the gallbladder
contains gallstones. Gallstones are solid
accumulations of the components of bile,
which occur when the components of bile
are not in correct proportion to each
other. A gallstone blocking the outlet
from the gallbladder usually causes acute
cholecystitis, so that bile cannot get
out. The bile can become concentrated and
infected, causing the condition.
Chronic (reoccurring) cholecystitis
occurs when the gallbladder walls have
become permanently damaged by repeated
attacks of acute cholecystitis.
Rare causes of cholecystitis include
severe burns or injury, massive systemic
infection, severe illness, diabetes,
obstruction by a tumor of the duct leaving
the gallbladder, and certain uncommon
infections of the gallbladder (including
bacteria and worms).
What are the symptoms?
Symptoms of cholecystitis include
constant pain in the right upper abdomen.
It is usually made worse by moving. The
patient may have a fever and sometimes
jaundiced skin. Other symptoms include
indigestions and nausea. Eating fatty
foods will often make the symptoms worse.
When the bacterial infection sets in, many
patients experience a higher fever and
shaking chills.
How is it diagnosed?
Cholecystitis can be difficult for a
doctor to diagnose because its symptoms
resemble those of other illnesses. If a
doctor suspects cholecystitis after a
physical exam of the patient, the doctor
may perform an abdominal ultrasound to
create an image of the internal organs and
measure the thickness of the gallbladder
wall (a maker of inflammation and
scarring). Other imaging tests may also be
performed to see the liver, bile ducts,
gallbladder and upper part of the small
intestine. In addition, a blood test will
reveal an increase in the white blood
count, as well as an increase in
bilirubuin.
What is the treatment?
To treat cholecystitis, the doctor will
usually hospitalize the patient and remove
the gallbladder, either immediately after
diagnosis or after the patient has
improved. Occasionally, patients with
complications require surgery immediately
after diagnosis. Patients who have
cholecystitis with no gallstones have
about a fifty percent chance of death if
the gallbladder is not quickly removed.
Called a cholecystectomy, the procedure
can be performed using a laparoscope (a
tube inserted through small incisions) or
by conventional surgery.
If the patient has other serious
medical problems that may increase the
risks of gallbladder removal surgery, the
surgeon may decide to leave the
gallbladder in place. In this case,
an operation called a cholecystotomy may
be performed to remove obstructing
gallstones and drain infected bile.
Self-care tips
To help prevent cholecystitis, the
patient should maintain an ideal weight
and follow a diet high in fiber,
vegetables and fruit.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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