Acute Cholecystitis: Guide to Symptoms, Causes, and Treatment


Acute Cholecystitis: A Comprehensive Guide to Symptoms, Causes, and Treatment


Acute cholecystitis is a condition characterized by inflammation of the gallbladder. It occurs when a gallstone blocks the cystic duct, which is the main opening of the gallbladder. This condition is potentially serious and requires prompt medical attention to prevent complications. In this comprehensive guide, we will explore the symptoms, causes, diagnosis, and treatment options for acute cholecystitis.

Understanding Acute Cholecystitis

Acute cholecystitis is commonly caused by gallstones, which are small stones, usually made of cholesterol, that form in the gallbladder. These stones can block the cystic duct, leading to the inflammation of the gallbladder. While gallstones often do not cause symptoms, they can occasionally result in episodes of pain known as biliary colic or acute cholecystitis. It is estimated that more than 1 in 10 adults in the UK are affected by gallstones.

Symptoms of Acute Cholecystitis

The primary symptom of acute cholecystitis is a sudden, sharp pain in the upper right-hand side of the abdomen. This pain may radiate towards the right shoulder. The affected area of the abdomen is usually tender, and deep breathing can exacerbate the pain. Unlike other types of abdominal pain, the pain associated with acute cholecystitis is persistent and does not subside within a few hours.

Additional symptoms that may accompany acute cholecystitis include:

  • High temperature
  • Nausea
  • Vomiting
  • Sweating
  • Loss of appetite
  • Jaundice (yellowing of the skin and eyes)
  • Bulge in the abdomen

Seeking Medical Advice for Acute Cholecystitis

If you experience sudden and severe abdominal pain, particularly if it lasts longer than a few hours or is accompanied by other symptoms such as jaundice and a high temperature, it is important to seek medical advice promptly. Contact your general practitioner (GP) or utilize your local out-of-hours service for immediate assistance. Alternatively, you can call NHS 111 for advice. Early diagnosis of acute cholecystitis is crucial to prevent serious complications.

Causes of Acute Cholecystitis

Acute cholecystitis can be categorized into two main types: calculous cholecystitis and acalculous cholecystitis.

Calculous Cholecystitis

Calculous cholecystitis is the most common form of acute cholecystitis, accounting for approximately 95% of cases. It occurs when the cystic duct is obstructed by a gallstone or a substance called biliary sludge. Biliary sludge is a mixture of bile, which is produced by the liver to aid in fat digestion, and small cholesterol and salt crystals. The blockage of the cystic duct causes bile to accumulate in the gallbladder, leading to increased pressure and inflammation. In some cases, the inflamed gallbladder can become infected by bacteria.

Acalculous Cholecystitis

Acalculous cholecystitis is a less common but more severe form of gallbladder inflammation that occurs without the presence of gallstones. The exact cause of acalculous cholecystitis is not fully understood, but it is often associated with serious illnesses, infections, or injuries that damage the gallbladder. Factors such as accidental gallbladder damage during major surgery, severe injuries or burns, sepsis, severe malnutrition, or dehydration can contribute to the development of acalculous cholecystitis.

Diagnosing Acute Cholecystitis

If you present with severe abdominal pain, your GP may perform a simple test called Murphy's sign. During this test, you will be asked to take a deep breath while the GP's hand is pressed on your abdomen, just below the rib cage. As you inhale deeply, your gallbladder will move downwards. If you have acute cholecystitis, you will experience sudden pain as your gallbladder reaches the GP's hand.

If your symptoms suggest acute cholecystitis, your GP will refer you to a hospital for further tests and treatment. These tests may include blood tests to check for signs of inflammation and an ultrasound scan of the abdomen to identify gallstones or other abnormalities in the gallbladder.

Treatment Options for Acute Cholecystitis

If diagnosed with acute cholecystitis, you will likely need to be admitted to the hospital for treatment. The initial treatment approach includes fasting to relieve strain on the gallbladder, intravenous fluids to prevent dehydration, and pain medication. Antibiotics may also be prescribed if there is an accompanying infection.

Surgery may be recommended after the initial treatment to prevent the recurrence of acute cholecystitis and reduce the risk of complications. The surgical procedure, known as cholecystectomy, involves the removal of the gallbladder. There are two main types of cholecystectomy: open cholecystectomy and laparoscopic cholecystectomy. Open cholecystectomy involves making a single incision in the abdomen to remove the gallbladder, while laparoscopic cholecystectomy is a minimally invasive procedure performed through small incisions using specialized surgical instruments.

In some cases, a percutaneous cholecystostomy may be performed as an alternative to surgery. This procedure involves inserting a needle through the abdomen to drain the fluid accumulated in the gallbladder.

Potential Complications of Acute Cholecystitis

Without appropriate treatment, acute cholecystitis can lead to potentially life-threatening complications. The main complications include the death of gallbladder tissue (gangrenous cholecystitis) and the splitting of the gallbladder (perforated gallbladder). Gangrenous cholecystitis can cause a serious infection that may spread throughout the body, while a perforated gallbladder can lead to peritonitis or the formation of abscesses. Emergency surgery is often required to treat these complications.

Preventing Acute Cholecystitis

While it may not always be possible to prevent acute cholecystitis, certain measures can reduce the risk of developing this condition. One of the primary preventive strategies is to adopt a healthy, balanced diet and reduce the consumption of high-cholesterol foods. Cholesterol is believed to contribute to the formation of gallstones. Maintaining a healthy weight through a nutritious diet and regular exercise is also important, as obesity increases the risk of gallstone formation. It is advisable to avoid rapid weight loss diets, as they can disrupt bile chemistry and potentially increase the risk of gallstones.


Acute cholecystitis is a condition characterized by the inflammation of the gallbladder, often caused by gallstones. Recognizing the symptoms and seeking prompt medical attention is crucial to prevent complications. Treatment options may include medication, fasting, and surgery to remove the gallbladder. By adopting a healthy lifestyle and managing weight, the risk of developing acute cholecystitis can be reduced. If you experience symptoms suggestive of acute cholecystitis, consult your healthcare provider for an accurate diagnosis and appropriate treatment.

Post a Comment


Post a Comment (0)