Acute cholecystitis, which refers to inflammation of the gall bladder, mainly occurs as a complication of gallstone disease. Natural history of asymptomatic and symptomatic gallstones. Am J Surg 1993.
Inflammatory mediators are released in response to gallbaldder inflammation and make that inflammation worse. Pathophysiology of acute obstructive cholecystitis: implications for non-operative management. Br J Surg 1987.
- Abdominal pain, commonly in the right upper quadrant or epigastrium.
- Pain may radiate to the right shoulder or back.
- Steady and severe pain.
- May include:
- Pain typically prolonged, greater than 4-6 hours.
- Appear ill
- Abdominal pain caused by local parietal inflammation aggravated by movement.
- Positive to Murphys sign- It is elicited by firmly placing a hand at the costal margin in the right upper abdominal quadrant and asking the patient to breathe deeply. If the gallbladder is inflamed, the patient will experience pain and catch their breath as the gallbladder descends and contacts the palpating hand. Correlation Among Clinical, Laboratory, and Hepatobiliary Scanning Findings in Patients With Suspected Acute Cholecystitis. Annals of Emergency Medicine 1994.
- Elevation in the serum total bilirubin and alkaline phosphatase concentrations are not common in uncomplicated acute cholecystitis since biliary obstruction is limited to the gallbladder
Confirmation of the diagnosis of cholecystitis requires abdominal ultrasound. Features on ultrasound will include gallbladder wall thickening or oedema
- Gangrene- Changing trends in surgery for acute cholecystitis. World J Surg 1990
- Perforation- Risk factors for gallbladder perforation. Am J Gastroenterol. 1987
- Gallstone Ileus- Gallstone Ileus. Br J Surg. 1990