Cholecystitis: Risk factors, Diagnosis & treatment!

Cholecystitis is the condition of the inflammation of the gallbladder that causes severe pain.

SIGNS & SYMPTOMS

  • Severe upper right abdominal pain
  • Right shoulder pain
  • Back pain
  • Nausea
  • Vomiting
  • Fever
  • Tenderness in the area where gallbladder is present.
  • Yellowing of the skin due to mild jaundice.

COMPLICATIONS ARISING FROM CHOLECYSTITIS

  • High fever over 102 degrees Celsius.
  • Shock due to insufficient blood
  • Severe jaundice
  • Gangrene/necrosis
  • Rupture of the gallbladder
  • Inflammation of the lining of the stomach & abdomen
  • Infected bile
  • Collection of pus in the gallbladder
  • Fistula formation between the gallbladder & abdomen.
  • Formation of gallstone in the small intestine & obstruction.
  • Adenomyomatosis.

CAUSES

  • Acute calculous cholecystitis
    a) Gallstones are present which block the gallbladder duct, preventing drainage of the bile.
    b) This bile builds up & thickens in the gallbladder causing reddening & enlargement of the gallbladder.
    c) Infection of the gallbladder by various bacteria.
  • Acalculous cholecystitis:
    a) Is not linked to presence of gallstones.
    b) Seen in people who are hospitalized or critically ill.
    c) More likely to occur in males who have undergone surgery.
    d) Associated with vasculitis, chemotherapy, trauma, tumors that block the flow of bile drainage & burns.
  • Chronic cholecystitis: Is presented after repeated cases of acute cholecystitis. Can lead to severe complications.

RISK FACTORS

  • Obesity
  • Diabetes
  • Birth control pills
  • Pregnancy
  • Liver disease
  • Genetic factors
  • Rapid weight loss.

DIAGNOSIS OF CHOLECYSTITIS

  1. Blood Test:
    a) Complete blood count shows an increased level of WBCs (12000-15000/mcL).
    b) C-reactive protein levels
    c) Elevated bilirubin levels (1-4 mg/dL)
    d) Blood aminotransferase levels.
  2. Imaging:
    a) Ultrasonography of the gallbladder is performed for detection of gallstones, pericholecystic fluid (fluid surrounding the gallbladder), gallbladder wall thickening, & assessment of enlargement of gallbladder.
    b) HIDA scan which utilizes radioactive markers for visualization & image production of the gall bladder, bile ducts, liver & checking for any abnormalities.
    c) X-ray & CT scan for checking of dilation of bile ducts, presence of tumors, & other complications like gangrene.
  3. Biopsy of the gallbladder & abdomen.
  4. Endoscopy, which views for presence of tumors, gallstones, inflammation or any other abnormalities in the intestines due to cholecystitis.

TREATMENT

  • Medications
  1. Cephalosporin antibiotics
  2. Quinolone antibacterials
  3. Pain management by opioid medications
  4. Immunosuppressant drugs for decreasing inflammation
  5. Antihistamines
  • Various types of surgeries are undertaken for removal of gallstones
  • Gallbladder removal/laparoscopic cholecystectomy

PREVENTION & MANAGEMENT FOR CHOLECYSTITIS

  • Decreasing caffeine intake
  • Low fat/cholesterol diet
  • Low carb/sugar diet
  • Staying hydrated
  • Moderate exercise
  • High fiber diet.