Cholecystitis

Cholecystitis is a medical condition that involves inflammation of the gallbladder, a small organ near the liver, causing severe abdominal pain. The pain is felt more on the right side under the ribs and may also travel down to the back or the right shoulder. It usually worsens during a deep breath. Other symptoms of cholecystitis may include nausea, vomiting and fever. Women are more at risk for developing cholecystitis. Moreover, the risk increases with advancing age.

Causes

Most cases of cholecystitis are associated with presence of gallstones in the gall bladder. Usually gallstones do not cause any problem or symptoms, however, sometimes gallstones may get stuck in the cystic duct trapping the bile in the gallbladder. The chemicals in the trapped bile cause the inflammation of the walls of the gallbladder, causing swelling and pain. The inflamed gallbladder may also get infected.

In rare cases inflammation of the gallbladder may occur due to trauma, such as an injury from a car accident; or as a complication of another disease such as diabetes.

Diagnosis

Usually, an abdominal ultrasound is recommended to diagnose cholecystitis. An abdominal ultrasound can detect the gallstones and also show any thickening of the gallbladder wall. A nuclear scanning test called gallbladder scan may also be ordered, in some, to check for any blockage in the bile ducts carrying bile from liver and gallbladder to the small intestine.

Treatment

The patient is hospitalized and given fluids and painkillers directly into a vein through a ‘drip’. No food or drinks will be allowed to give rest to the inflamed gallbladder. Antibiotics may also be administered through the drip if infection of the gallbladder is suspected.

Doctors usually wait for a few days to a few weeks depending on the condition of the patient to let the inflammation settle, before the surgery is performed. Surgery to remove the gallbladder (cholecystectomy) is the main treatment for cholecystitis as the problem may re-occur in the future even when the inflammation has settled completely.

In the case of an infection, the cholecystectomy needs to be performed in a timely manner as delay in surgery may increase the risk of blood poisoning (septicaemia), a serious and life-threatening condition. Other complications may also occur that include formation of a channel (fistula) between the gallbladder and gut, pancreatitis, jaundice and rarely rupture of the gallbladder.