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When the gallbladder is inflamed, it is called cholecystitis. The gallbladder is a small pouch, pear-shaped organ located beneath the liver on the right side of the abdomen that contains bile, a digestive fluid, before released into the small intestine.
In most cases, the gallstone blocks the cystic duct (the tube that connect gallbladder to bile duct) resulting in inflammation and infection of the gallbladder. Additionally, bile duct problem, tumors, major illnesses, and specific infections are causes of cholecystitis.
Untreated cholecystitis can cause serious, life-threatening complications, such a ruptured gallbladder. The recommended treatment for acute cholecystitis is a surgical removal of the gallbladder (cholecystectomy).
Symptoms
The following symptoms may be manifested when you have cholecystitis:
- Nausea or vomiting
- Fever
- Abdominal pain radiating to the back or right shoulder
- Intense pain on the upper right side or center of the abdomen
- Abdominal pain after eating around 15 to 20 minutes and it continues
- Jaundice (skin, whites of the eyes, and mucous membranes turn yellow)
If you have any of these symptoms, it is important to consult your doctor immediately.
Causes
When your gallbladder is inflamed, it leads to cholecystitis. Inflammation of the gallbladder may result from:
- Gallstones. The most common cause of cholecystitis is gallstones. The duct (cystic duct) by which bile exits the gallbladder can become blocked by gallstones. Inflammation results from the gallbladder’s bile accumulation.
- Bile duct blockage. Cholecystitis can be caused by bile duct blockage brought on by stones, thickened bile, or small particles (sludge). A blockage may also result from the bile ducts becoming scarred.
- Tumor. Inadequate drainage of bile from your gallbladder such as having a tumor could cause cholecystitis.
- Severe illness. Cholecystitis can result from severe illness that damages blood vessels and reduces blood supply to the gallbladder.
- Infection. Patient with AIDS, who have not received HIV treatment, are at risk for cholecystitis.
Risk factors
The risk factor for cholecystitis is having gallstones as well as the following factors:
- Under birth control pills or treatment to replace estrogen levels
- Native Hispanic descent, American, or Scandinavian
- Pregnant or have had multiple pregnancies
- Consuming a high fat and cholesterol food
- Your family has a history of gallstones
- 60 years old or older (male or female)
- 50 years old or older woman
- Eat a diet high in fat and cholesterol
- Rapid weight loss
- Obesity or overweight
- Diabetes
Diagnosis
Your doctor will perform a physical examination to identify cholecystis in addition to talking with you about your symptoms and medical background. The following tests and techniques are used to identify cholecystitis:
- Blood tests. Blood tests may be requested by your doctor in order to evaluate for infections or gallbladder issues.
- Imaging tests. Images of your gallbladder and bile ducts can be produced using abdominal ultrasound, endoscopic ultrasound, Computerized Tomography (CT) scan, or Magnetic Resonance Cholangiopancreatography (MRCP). These images can demonstrate symptoms of gallbladder and bile duct stones or cholecystitis.
- A scan that shows the movement of bile through your body. A hepatobiliary iminodiacetic acid (HIDA) scan of the liver and bile ducts monitors the generation and movement of bile from the liver to the small intestine. An intravenous injection of a radioactive tracer that adheres to bile-producing cells is required for a HIDA scan. The dye can be seen during the scan as it moves through the bile ducts with the bile. This can reveal any obstructions.
Treatment
Cholecystitis usually needs to be treated in hospital as well as intravenous antibiotic to control infection. Sometime, surgery may be required Your healthcare professional will work up to plan for further management while you’re in the hospital. Treatments could consist of:
- Fasting. Initially, you might not be allowed to eat or drink anything to relieve the pressure on your inflamed gallbladder.
- Intravenous fluids. Dehydration will be addressed through this intervention.
- Antibiotics. In the event that your gallbladder is infected, your doctor will suggest antibiotics.
- Pain medications. These can aid in pain management while your gallbladder is still inflamed.
- Procedure to remove stones. An Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed on you. Instruments can be used to remove stones obstructing the bile ducts or cystic duct during this operation that highlights the bile ducts with dye.
- Gallbladder drainage. Gallbladder drainage (cholecystostomy) may be performed in some circumstances, such as when surgery to remove the gallbladder is not an option, to clear infection. Drainage is carried out either by putting a scope via the mouth (endoscopic) or through the skin of the belly (percutaneous).
Your symptoms should become better in two to three days. The doctor may recommend surgery to remove the gallbladder if the cholecystitis keeps recurring.
Gallbladder removal surgery
Cholecystectomy refers to the surgical surgery used to remove the gallbladder. Typically, this is a minimally invasive surgery that only requires a few small abdominal incisions (laparoscopic cholecystectomy). An open operation may be necessary, which involves making a lengthy incision in your abdomen.
Your symptom severity and total risk of complications during and after surgery will determine whether you should have surgery or not. If your risk for surgery is low, surgery might be done while you are admitted in the hospital.
After your gallbladder is removed, bile no longer needs to be stored in your gallbladder and instead flows directly from your liver into your small intestine which helps in food digestion even when the gallbladder is not functioning.
