Acute Cholecystitis - Critical Care Practitioner

Acute Cholecystitis

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:
    • fever
    • nausea
    • vomiting
    • anorexia.
  • Pain typically prolonged, greater than 4-6 hours.

Physical Examination

  •  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


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