Acute Cholecystitis

Acute cholecystitis is a sudden inflammation of the gallbladder, typically caused by gallstones blocking the cystic duct, which connects the gallbladder to the common bile duct. This blockage leads to the accumulation of bile in the gallbladder, causing inflammation and potentially leading to infection.

Causes and Risk Factors

The primary cause of acute cholecystitis is the obstruction of the cystic duct by a gallstone. Other risk factors include:

• Gallstones: The presence of gallstones is the most significant risk factor for developing acute cholecystitis.
• Female gender: Women are more likely to develop gallstones and acute cholecystitis due to hormonal influences.
• Obesity: Being overweight or obese increases the risk of developing gallstones and acute cholecystitis.
• Age: The risk of developing gallstones and acute cholecystitis increases with age, especially after the age of 40.
• Family history: Having a family history of gallstones or acute cholecystitis increases an individual's risk.

Symptoms

The symptoms of acute cholecystitis may include:

• Sudden and severe pain in the upper right abdomen, which may radiate to the back or right shoulder.
• Nausea and vomiting.
• Fever.
• Abdominal tenderness, especially in the upper right quadrant.
• Guarding (muscle tension) of the abdominal muscles.

Diagnosis

The diagnosis of acute cholecystitis is typically made based on a combination of:

• Medical history and physical examination.
• Imaging studies, such as ultrasound or computed tomography (CT) scans, to visualize the gallbladder and bile ducts.
• Laboratory tests, including complete blood counts, liver function tests, and blood cultures, to evaluate for signs of infection or inflammation.

Treatment

The treatment of acute cholecystitis typically involves:

• Supportive care, such as hydration, pain management, and bowel rest.
• Antibiotics to treat any underlying infection.
• Surgical removal of the gallbladder (cholecystectomy), which may be performed laparoscopically or through an open incision.

Complications

If left untreated, acute cholecystitis can lead to complications such as:

• Gangrene of the gallbladder.
• Perforation of the gallbladder, leading to peritonitis (inflammation of the lining of the abdominal cavity).
• Sepsis, a life-threatening condition that occurs when bacteria enter the bloodstream.

Prevention

While it is not possible to completely prevent acute cholecystitis, maintaining a healthy weight, eating a balanced diet, and managing underlying medical conditions can help reduce the risk of developing gallstones and acute cholecystitis.