Cholecystitis

Cholecystitis is inflammation of the gallbladder, a small organ near the liver that plays a part in digesting food. Normally, fluid called bile passes out of the gallbladder on its way to the small intestine. If the flow of bile is blocked, it builds up inside the gallbladder, causing swelling, pain, and possible infection.

Cholecystitis is classified as acute or chronic.

Acute cholecystitis begins suddenly, resulting in severe, steady pain in the upper abdomen. At least 95% of people with acute cholecystitis have gallstones. The inflammation almost always begins without infection, although infection may follow later. Inflammation may cause the gallbladder to fill with fluid and its walls to thicken.

Rarely, a form of acute cholecystitis without gallstones (acalculous cholecystitis) occurs. Acalculous cholecystitis is more serious than other types of cholecystitis. It tends to occur after the following:
-Major surgery
-Critical illnesses such as serious injuries, major burns, and bodywide infections (sepsis)
-Intravenous feedings for a long time
-Fasting for a prolonged time
-A deficiency in the immune system

It can occur in young children, perhaps developing from a viral or another infection.



Chronic cholecystitis is gallbladder inflammation that has lasted a long time. It almost always results from gallstones. It is characterized by repeated attacks of pain (biliary colic). In chronic cholecystitis, the gallbladder is damaged by repeated attacks of acute inflammation, usually due to gallstones, and may become thick-walled, scarred, and small. The gallbladder usually contains sludge (microscopic particles of materials similar to those in gallstones), or gallstones that either block its opening into the cystic duct or reside in the cystic duct itself.

Symptoms.

The most common symptom of cholecystitis is pain in your upper right abdomen that can sometimes move around to your back or right shoulder blade. Other symptoms include:

- Nausea or vomiting.
- Tenderness in the right abdomen.
- Fever.
- Pain that gets worse during a deep breath.
- Pain for more than 6 hours, particularly after meals (a fatty meal).

Older people may not have fever or pain. Their only symptom may be a tender area in the abdomen.

Diagnose.

A doctor's examination of the abdomen by touch (palpation) may reveal tenderness.

Tests that detect the presence of gallstones or inflammation include:

- Abdominal ultrasound
- Abdominal CT scan
- Abdominal x-ray
- Oral cholecystogram
- Gallbladder radionuclide scan
- A CBC shows infection by an elevated white blood cell count.

Treatment.

Treatment for cholecystitis will depend on your symptoms and your general health. People who have gallstones but don't have any symptoms may need no treatment. For mild cases, treatment includes bowel rest, fluids and antibiotics given through a vein, and pain medicine.

The main treatment for acute cholecystitis is surgery to remove the gallbladder (cholecystectomy). Often this surgery can be done through small incisions in the abdomen (laparoscopic cholecystectomy), though sometimes it requires a more extensive operation. Your doctor may try to reduce swelling and irritation in the gallbladder before removing it. Occasionally acute cholecystitis is caused by one or more gallstones becoming stuck in the main tube leading to the intestine, called the common bile duct. Treatment may involve an endoscopic procedure (endoscopic retrograde cholangiopancreatography, or ERCP) to remove the stones in the common bile duct before the gallbladder is removed.

In rare cases of chronic cholecystitis, you may also receive medicine that dissolves gallstones over a period of time.

References:
1.http://www.webmd.com/digestive-disorders/tc/cholecystitis-overview
2.http://www.merck.com/mmhe/sec10/ch140/ch140c.html
3.http://www.nlm.nih.gov/medlineplus/ency/article/000264.htm

Image Taken From:
http://www.nlm.nih.gov/medlineplus/ency/imagepages/1090.htm