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Acute cholecystitis is a sudden swelling and irritation of the gallbladder. It causes severe belly pain.
See also: Chronic cholecystitis
Cholecystitis - acute
The gallbladder is an organ that sits below the liver. It stores bile, which your body uses to digest fats in the small intestine.
Acute cholecystitis occurs when bile becomes trapped in the gallbladder. This often happens because a gallstone blocks the cystic duct. This is the tube that bile travels into and out of the gallbladder. When a stone blocks this duct, bile builds up, causing irritation and pressure in the gallbladder. This can lead to swelling and infection.
Other causes include:
Some people are more at risk for gallstones. Risk factors include:
Sometimes the bile duct becomes blocked temporarily. When this occurs repeatedly, it can lead to chronic cholecystitis. This is swelling and irritation that continues over time. Eventually, the gallbladder becomes thick and hard. It also does not store and release bile as well.
The main symptom is pain in the upper right side or upper middle of your belly that usually lasts at least 30 minutes. You may feel:
Other symptoms that may occur include:
A physical exam will show that it hurts to touch your belly.
Your doctor may order the following blood tests:
Imaging tests can show gallstones or inflammation. You may have one of these tests:
If you have severe belly pain, seek medical attention right away.
In the emergency room, you'll be given fluids through a vein. You also may be given antibiotics to fight infection.
Cholecystitis may clear up on its own. However, if you have gallstones, you will probably need surgery to remove your gallbladder.
Nonsurgical treatment includes:
You may need emergency surgery if you have complications such as:
If you are very ill, a tube may be placed in your gallbladder and through your skin to drain it. Then, once you are feeling better, you may have surgery.
Most people who have surgery to remove their gallbladder recover completely.
Call your health care provider if:
Removing the gallbladder and gallstones will prevent further attacks.
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Jackson P, Evans S. Biliary system. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap. 55.
Siddiqui T. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials. Am J Surg. 2008;195:40-47.
Wang DQH, Afdhal NH. Gallstone disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 65.