cholecystitis

Cholecystitis: Inflammation of the Gallbladder

Cholecystitis is a medical condition characterized by inflammation of the gallbladder, a small organ located beneath the liver that stores bile. The gallbladder plays a crucial role in digesting fats and fat-soluble vitamins.

• Causes: Cholecystitis can be caused by various factors, including:
  • Gallstones: Small, hard deposits that form in the gallbladder and can cause inflammation [2].
  • Infection: Bacterial or viral infections can lead to cholecystitis [4].
  • Trauma: Physical injury to the gallbladder can cause inflammation [5].
• Symptoms: The main symptom of acute cholecystitis is a sudden, sharp pain in the upper right side of the abdomen that spreads towards the right shoulder [3]. Other symptoms may include:
  • Fever
  • Nausea and vomiting
  • Abdominal tenderness
  • Jaundice (yellowing of the skin and eyes)
• Types: Cholecystitis can be classified into two types:
  • Acute cholecystitis: Sudden onset of inflammation [5].
  • Chronic cholecystitis: Ongoing inflammation that persists over time [9].

References

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Common Signs and Symptoms of Cholecystitis

Cholecystitis, an inflammation of the gallbladder, can manifest in various ways. The symptoms can range from mild to severe and may include:

• Abdominal pain: A sharp, cramping, or dull pain in the upper right or upper middle of the belly is a common symptom [4][6].
• Fever: An elevated body temperature is often present due to inflammation [3][5].
• Nausea and vomiting: Many people experience nausea and vomiting, especially after eating a meal [1][2].
• Abdominal distension (bloating): The abdomen may feel bloated or swollen due to the accumulation of fluid [2].
• Right upper quadrant pain: Pain in this area is often a sign of gallbladder inflammation [7].

In some cases, cholecystitis can lead to more severe complications, such as:

• Jaundice: Yellowing of the skin and whites of the eyes due to liver dysfunction [3][5].
• Abdominal muscle stiffness: The abdominal muscles may become stiff or rigid on the right side [2].

It's essential to seek medical attention if you experience any of these symptoms, as prompt treatment can help prevent further complications.

References:

[1] - Oct 23, 2024 — Tenderness over the belly area when it's touched. Nausea. Vomiting. Fever. Cholecystitis symptoms often come on after a meal. [2] - What are the signs and symptoms of cholecystitis? · Abdominal distension (bloating) and tenderness. · Abdominal muscle stiffness on the right side. · Weakness and ... [3] - Symptoms of acute cholecystitis · a high temperature · feeling sick · being sick · sweating · loss of appetite · yellowing of the skin and the whites of the eyes ( ... [4] - May 29, 2023 — The main symptom of acute cholecystitis is a sudden sharp pain in the upper right side of your tummy (abdomen) that spreads towards your right ... [5] - Cholecystitis · Typically, people have abdominal pain, fever, and nausea. · Ultrasonography can usually detect signs of gallbladder inflammation. · The gallbladder ... [6] - Symptoms · Sharp, cramping, or dull pain in upper right or upper middle of your belly · Steady pain lasting about 30 minutes · Pain that spreads to your back or ... [7] - May 3, 2022 — The signs and symptoms of cholecystitis include right upper quadrant pain, fever, and a high white blood cell count. Pain generally occurs ...

Diagnostic Tests for Cholecystitis

Cholecystitis, an inflammation of the gallbladder, can be diagnosed using various tests. Here are some of the common diagnostic tests used to diagnose cholecystitis:

• Complete Blood Count (CBC): A CBC measures your white blood cell count, which may be high if you have an infection [1].
• Liver Function Tests: These tests assess liver function and can help identify any abnormalities in liver enzymes [1].
• Abdominal Ultrasound: This is often the first test done to evaluate for cholecystitis. An ultrasound uses sound waves to produce pictures of the gallbladder and surrounding tissues, which can show signs of inflammation or gallstones [6][8].
• Endoscopic Ultrasound: This test combines endoscopy and ultrasound to provide detailed images of the gallbladder and surrounding tissues [3].
• CT Scan (Computed Tomography): A CT scan uses X-rays and computer technology to produce cross-sectional images of the body, which can help identify signs of inflammation or infection in the gallbladder [4][7].
• Hepatobiliary Scintigraphy (HIDA Scan): This test is considered the most sensitive and specific for diagnosing cholecystitis. It involves injecting a small amount of radioactive material into your bloodstream, which accumulates in the gallbladder and can show signs of inflammation or blockage [5].

These diagnostic tests can help healthcare professionals determine if you have cholecystitis and rule out other conditions that may be causing your symptoms.

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Treatment Options for Cholecystitis

Cholecystitis, an inflammation of the gallbladder, can be treated with a combination of antibiotics and supportive care.

• Antibiotics: Antibiotics are typically the first-line treatment for acute cholecystitis. Examples include penicillins, cephalosporins, and quinolones [5].
• Empirical Therapy: For moderate (grade II) acute cholecystitis, wider-spectrum penicillins, second-generation cephalosporins, and oxacephems are recommended empirically as the initial antibiotic therapy [4].
• Specific Antibiotics:
  • Imipenem/cilastatin or meropenem can be used in life-threatening cases [1].
  • Metronidazole plus a third-generation cephalosporin is an alternative option for enterococcus coverage [2].
  • Vancomycin can be added to cefepime for enterococcus coverage [2].

Additional Treatment Considerations

• Gallbladder Drainage: In some cases, gallbladder drainage may be necessary, which can be done percutaneously or endoscopically [6].
• Surgery: Surgery, such as laparoscopic cholecystectomy, may be required in severe cases of cholecystitis [3].

It's essential to consult a healthcare professional for proper diagnosis and treatment planning.

Differential Diagnosis of Cholecystitis

Cholecystitis, an inflammation of the gallbladder, can be challenging to diagnose due to its similarity in symptoms with other conditions. The differential diagnosis of cholecystitis involves identifying and ruling out other possible causes of right upper quadrant abdominal pain and nausea/vomiting.

Common Differential Diagnoses:

• Acute Cholangitis: An infection of the bile duct, which can cause similar symptoms to cholecystitis [1].
• Chronic Cholecystitis: A long-standing inflammation of the gallbladder that may not always present with acute symptoms [2].
• Peptic Ulcer Disease: A condition where stomach acid damages the lining of the stomach or duodenum, causing abdominal pain and nausea/vomiting [3].
• Acute Pancreatitis: Inflammation of the pancreas, which can cause severe abdominal pain and nausea/vomiting [4].
• Sickle Cell Crises: A complication of sickle cell disease that can cause abdominal pain and other systemic symptoms [5].

Key Factors in Differential Diagnosis:

• The ability to distinguish between cholecystitis and other diagnoses is crucial for providing quick and effective treatment [6].
• The differential diagnosis of cholecystitis is based on the presenting symptom of right upper quadrant abdominal pain [7].

References:

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