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Acute Cholecystitis

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Acute Cholecystitis
Acute Cholecystitis

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kulasekar

Definition
Cholecystitis is inflammation of the gallbladder, usually resulting from a gallstone blocking the cystic duct.

• Gallbladder inflammation usually results from a gallstone blocking the flow of bile.
• Typically, people have abdominal pain that lasts more than 6 hours, fever, and nausea.
• Ultrasonography can usually detect signs of gallbladder inflammation.
• The gallbladder is removed, often using a laparoscope.
Cholecystitis is the most common problem resulting from gallbladder stones. It occurs when a stone blocks the cystic duct, which carries bile from the gallbladder

Causes
In 90% of cases, acute cholecystitis is caused by gallstones in the gallbladder. Severe illness, alcohol abuse and, rarely, tumors of the gallbladder may also cause cholecystitis.
Acute cholecystitis causes bile to become trapped in the gallbladder. The build up of bile causes irritation and pressure in the gallbladder. This can lead to bacterial infection and perforation of the organ.
Gallstones occur more frequently in women than men. Gallstones become more common with age in both sexes. Native Americans have a higher rate of gallstones.
Symptoms
The main symptom is abdominal pain -- particularly after a fatty meal -- that is located on the upper right side of the abdomen. Occasionally, nausea and vomiting or fever may occur.
Exams and Tests
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
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Outlook (Prognosis)
Patients who have cholecystectomy usually do very well.

Possible Complications • Empyema (pus in the gallbladder) • Peritonitis



References: 1. Claesson B, Holmlund D, Mätzsch T. Biliary microflora in acute cholecystitis and the clinical implications. Acta Chir Scand. 1984;150(3):229-37. [Medline]. 6. Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M. Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):15-26. [Medline].

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