Acute cholecystitis is inflammation of the gallbladder without gallstones. It is usually diagnosed in individuals with existing chronic conditions. Symptoms include right-sided abdominal pain, fever, vomiting, and nausea. Treatment depends on symptom severity and may include antibiotics, pain relievers, or surgical removal of the gallbladder.
Acute cholecystitis is a form of gallbladder inflammation that occurs in the absence of gallstones. The term acalculus is used to qualify that cholecystitis is in no way associated with the presence of gallstones. Acute acute cholecystitis is usually diagnosed in individuals with an existing chronic condition, such as diabetes, that causes swelling and inflammation of the gallbladder. Treatment for this painful condition depends entirely on the presentation of symptoms and the individual’s overall health.
Usually, gallbladder inflammation is associated with the presence of gallstones that block the bile ducts and prevent acidic fluid from passing into the small intestine. Cholecystitis occurs when inflammation and swelling alone impede the natural flow of bile through the gallbladder into the upper digestive tract. Rare in presentation, acute chronic cholecystitis can contribute to adverse physiological changes within the gallbladder, including tissue atrophy and hardening. When the gallbladder shrinks and thickens, it loses its elasticity, affecting its ability to contract and secrete bile. In the absence of proper function, the acidic composition of the accumulated bile promotes tissue inflammation.
A preliminary diagnosis of cholecystitis, or inflammation of the gallbladder, is usually made during a physical exam in which a doctor performs a palpatory evaluation of the abdominal area to check for signs of distension and tenderness. Imaging tests, including an ultrasound, are usually ordered to evaluate the condition and size of the gallbladder and upper gastrointestinal (GI) function. Further testing may involve the administration of a blood panel and an oral cholecystogram, which is used to confirm or rule out the presence of gallstones.
There are a variety of signs and symptoms associated with the bile buildup that occurs with cholecystitis. After eating, symptomatic individuals may develop moderate to severe right-sided abdominal pain that persists for several hours. In some cases, abdominal discomfort can get progressively worse and impair the ability to breathe deeply. Additional signs of acute cholecystitis can include fever, vomiting, and nausea. It is also possible for some individuals to remain asymptomatic, meaning they experience no symptoms at all or experience only mild abdominal discomfort.
Treatment for acute cholecystitis generally depends on the severity of your symptoms and your health. Individuals with mild symptoms may experience relief with the administration of antibiotics and pain relievers. More serious presentations may require hospitalization and surgical removal of the gallbladder, a procedure known as a cholecystectomy. Often done laparoscopically, a cholecystectomy carries some risks of complications, including excessive bleeding and infection.
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