Description

Acute cholecystitis is a condition characterized by inflammation of the gallbladder, usually caused by the obstruction of the cystic duct, which is the tube that carries bile out of the gallbladder. The obstruction is typically due to the presence of gallstones, although it can also be caused by other factors such as tumors, strictures, or infection. When the cystic duct becomes blocked, bile becomes trapped in the gallbladder, leading to an accumulation of bile and an increase in pressure within the organ. This buildup of pressure, along with the inflammation caused by the trapped bile, results in the characteristic symptoms of acute cholecystitis. Causes of acute cholecystitis Acute cholecystitis is primarily caused by the blockage or obstruction of the cystic duct, which is a tube that carries bile out of the gallbladder. The most common cause of this blockage is the presence of gallstones, which are solid deposits formed from substances found in bile. When a gallstone gets stuck in the cystic duct, it prevents the flow of bile, leading to inflammation and infection of the gallbladder. Other less common causes of acute cholecystitis include tumors, strictures (narrowing of the duct), or infection. These conditions can also obstruct the cystic duct, causing inflammation in the gallbladder. Symptoms of acute cholecystitis The symptoms of acute cholecystitis can vary but commonly include: 1. Severe abdominal pain: The pain is typically located in the right upper quadrant of the abdomen and may be constant or intermittent. It can be described as a sharp, cramping, or pressure-like pain. The pain may radiate to the back or shoulder. 2. Tenderness and sensitivity: The abdomen may be tender to touch, particularly in the area over the gallbladder. 3. Fever and chills: Inflammation and infection of the gallbladder can lead to an elevated body temperature, resulting in fever. Chills and shaking may also occur. 4. Nausea and vomiting: Many people with acute cholecystitis experience episodes of nausea and may vomit. This can contribute to a loss of appetite. 5. Jaundice (yellowing of the skin and eyes): In some cases, if the inflammation spreads to the common bile duct, it can cause bile to accumulate in the bloodstream, resulting in jaundice. Jaundice is characterized by yellowing of the skin and eyes, dark urine, and pale stools. 6. Bloating and indigestion: Some individuals may experience bloating, gas, and indigestion-like symptoms, such as belching or a feeling of fullness after meals. It's important to note that the severity and presentation of symptoms can vary from person to person. If you experience persistent or severe abdominal pain or other symptoms suggestive of acute cholecystitis, it is recommended to seek medical attention promptly for proper evaluation and diagnosis. Diagnosis of acute cholecystitis The diagnosis of acute cholecystitis typically involves a combination of medical history evaluation, physical examination, and diagnostic tests. Here are the common methods used for diagnosing acute cholecystitis: 1. Medical history and physical examination: The healthcare provider will ask about your symptoms, including the nature and location of the abdominal pain, and any associated symptoms. They will also perform a physical examination to assess tenderness, abdominal rigidity, and signs of inflammation. 2. Blood tests: Blood tests are conducted to assess the levels of certain markers and enzymes that may indicate gallbladder inflammation or infection. These tests may include a complete blood count (CBC), liver function tests, and inflammatory markers such as C-reactive protein (CRP). 3. Imaging tests: • Ultrasound: Ultrasound is usually the initial imaging test of choice for diagnosing acute cholecystitis. It helps visualize the gallbladder and detect any gallstones, thickening of the gallbladder wall, or signs of inflammation. • CT scan: In some cases, a computed tomography (CT) scan may be performed to provide more detailed images of the gallbladder and surrounding structures. • HIDA scan: A hepatobiliary iminodiacetic acid (HIDA) scan is a nuclear medicine test that can evaluate the function and obstruction of the bile ducts. 4. Other diagnostic procedures: • Cholecystogram: This is a specialized X-ray procedure in which a contrast dye is injected into the bloodstream, highlighting the gallbladder and bile ducts. • Endoscopic retrograde cholangiopancreatography (ERCP): ERCP involves passing a flexible tube with a camera through the mouth and into the small intestine to examine the bile ducts and perform interventions if necessary.