Acute Cholecystitis

Cystic duct obstruction leads to gallbladder inflammation & distention.; often due to gallstones.

• If no stones are present, it is called acalculous cholecystitis.

Inflammation and edema can lead to necrosis of the gallbladder wall, with a risk of rupture. Review Gallstones. In contrast to the intermittent pain of simple cholelithiasis, cholecystitis is characterized by constant pain with possible fever and tachycardia. Positive Murphy's sign: palpate under the ribs in the right upper quadrant region and ask the patient to inhale - if the patient experiences pain and abrupt inspiratory arrest, we have a positive sign. In acute cholecystitis, white blood cell counts and liver enzymes may be elevated. CT scans or ultrasound imaging may show pericholecystic fluid with thickened gallbladder walls and gallstones. If acute cholecystitis resolves and recurs, it may become chronic, with fibrosis and contraction resulting in impaired bile concentration and emptying. Treatment for acute cholecystitis is usually laparoscopic cholecystectomy (gallbladder removal).