Back التهاب المرارة Arabic Öd kisəsinin iltihabı Azerbaijani Халецыстыт Byelorussian Holecistitis BS Colecistitis Catalan Cholezystitis German ފިތް ދުޅަވުން DV Χολοκυστίτιδα Greek Colecistitis Spanish Koletsüstiit Estonian

Cholecystitis

Cholecystitis
Acute cholecystitis as seen on CT. Note the fat stranding around the enlarged gallbladder.
SpecialtyGeneral surgery, gastroenterology
SymptomsIntense right upper abdominal pain, nausea, vomiting, fever[1]
DurationShort term or long term[2]
CausesGallstones, severe illness[1][3]
Risk factorsBirth control pills, pregnancy, family history, obesity, diabetes, liver disease, rapid weight loss[4]
Diagnostic methodAbdominal ultrasound[5]
Differential diagnosisHepatitis, peptic ulcer disease, pancreatitis, pneumonia, angina[6]
TreatmentGallbladder removal surgery, gallbladder drainage[7][5]
PrognosisGenerally good with treatment[4]

Cholecystitis is inflammation of the gallbladder.[8] Symptoms include right upper abdominal pain, pain in the right shoulder, nausea, vomiting, and occasionally fever.[1] Often gallbladder attacks (biliary colic) precede acute cholecystitis.[1] The pain lasts longer in cholecystitis than in a typical gallbladder attack.[1] Without appropriate treatment, recurrent episodes of cholecystitis are common.[1] Complications of acute cholecystitis include gallstone pancreatitis, common bile duct stones, or inflammation of the common bile duct.[1][8]

More than 90% of the time acute cholecystitis is caused from blockage of the cystic duct by a gallstone.[1] Risk factors for gallstones include birth control pills, pregnancy, a family history of gallstones, obesity, diabetes, liver disease, or rapid weight loss.[4] Occasionally, acute cholecystitis occurs as a result of vasculitis or chemotherapy, or during recovery from major trauma or burns.[9] Cholecystitis is suspected based on symptoms and laboratory testing.[5] Abdominal ultrasound is then typically used to confirm the diagnosis.[5]

Treatment is usually with laparoscopic gallbladder removal, within 24 hours if possible.[7][10] Taking pictures of the bile ducts during the surgery is recommended.[7] The routine use of antibiotics is controversial.[5][11] They are recommended if surgery cannot occur in a timely manner or if the case is complicated.[5] Stones in the common bile duct can be removed before surgery by endoscopic retrograde cholangiopancreatography (ERCP) or during surgery.[7] Complications from surgery are rare.[4] In people unable to have surgery, gallbladder drainage may be tried.[5]

About 10–15% of adults in the developed world have gallstones.[5] Women more commonly have stones than men and they occur more commonly after age 40.[4] Certain ethnic groups are more often affected; for example, 48% of American Indians have gallstones.[4] Of all people with stones, 1–4% have biliary colic each year.[5] If untreated, about 20% of people with biliary colic develop acute cholecystitis.[5] Once the gallbladder is removed outcomes are generally good.[4] Without treatment, chronic cholecystitis may occur.[2] The word is from Greek, cholecyst- meaning "gallbladder" and -itis meaning "inflammation".[12]

  1. ^ a b c d e f g h Strasberg, SM (26 June 2008). "Clinical practice. Acute calculous cholecystitis". The New England Journal of Medicine. 358 (26): 2804–11. doi:10.1056/nejmcp0800929. PMID 18579815.
  2. ^ a b Feldman, Mark (2010). Sleisenger & Fordtran's Gastrointestinal and liver disease pathophysiology, diagnosis, management (9 ed.). [S.l.]: MD Consult. p. 1065. ISBN 9781437727678. Archived from the original on 2017-09-08.
  3. ^ Levy, Angela D.; Mortele, Koenraad J.; Yeh, Benjamin M. (2015). Gastrointestinal Imaging. Oxford University Press. p. 456. ISBN 9780199392148. Archived from the original on 2017-09-08.
  4. ^ a b c d e f g "Gallstones". NIDDK. November 2013. Archived from the original on 28 July 2016. Retrieved 27 July 2016.
  5. ^ a b c d e f g h i j Ansaloni, L (2016). "2016 WSES guidelines on acute calculous cholecystitis". World Journal of Emergency Surgery. 11: 25. doi:10.1186/s13017-016-0082-5. PMC 4908702. PMID 27307785.
  6. ^ Ferri, Fred F. (2010). Ferri's differential diagnosis : a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders (2nd ed.). Philadelphia, PA: Elsevier/Mosby. p. Chapter C. ISBN 978-0323076999.
  7. ^ a b c d Patel, PP; Daly, SC; Velasco, JM (18 October 2015). "Training vs practice: A tale of opposition in acute cholecystitis". World Journal of Hepatology. 7 (23): 2470–3. doi:10.4254/wjh.v7.i23.2470. PMC 4606202. PMID 26483868.
  8. ^ a b Internal Clinical Guidelines Team (October 2014). Gallstone Disease: Diagnosis and Management of Cholelithiasis, Cholecystitis and Choledocholithiasis. Clinical Guideline 188 (Report). p. 101. PMID 25473723.
  9. ^ "Section VIII". Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management (10 ed.). Elsevier Health Sciences. 2015. p. 1154. ISBN 9781455749898. Archived from the original on 2017-09-08.
  10. ^ Schuld, J; Glanemann, M (June 2015). "Acute Cholecystitis". Viszeralmedizin. 31 (3): 163–5. doi:10.1159/000431275. PMC 4569253. PMID 26468309.
  11. ^ van Dijk, AH; de Reuver, PR; Tasma, TN; van Dieren, S; Hugh, TJ; Boermeester, MA (June 2016). "Systematic review of antibiotic treatment for acute calculous cholecystitis". The British Journal of Surgery. 103 (7): 797–811. doi:10.1002/bjs.10146. PMID 27027851. S2CID 205507793.
  12. ^ Collins, Edwards (2013). A Short Course in Medical Terminology. Lippincott Williams & Wilkins. p. 246. ISBN 9781469835785. Archived from the original on 2017-09-08.

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