Cholecystitis

Cholecystitis – General Information

Cholecystitis is the inflammation of the gall bladder (which is also known as cholecyst, which is an organ that has the shape of a pear and that stores approximately 50 ml of bile or gall, until the organism needs it for the digestion). Cholecystitis is usually caused by cholelithiasis (cholelithiasis is the presence of the choleliths in the cholecyst, which usually blocks the cystic duct).  The blocking of the cystic duct leads to the inspissation of the bile, bile statis and also at a secondary infection by the gut organisms (such as Escherichia Coli and Bacteroides species). The cholecyst’s wall becomes inflamed and the inflammation usually spreads to the cholecyst’s outer covering and it irritates the surrounding structures (like the diaphragm or the bowel for example). The extreme cases can lead to necrosis and rupture. In the rare cases such as those with trauma patients, the cholecyst can become infected and also inflamed, this medical condition is called Acalculous Cholecystitis.

In the case of the stones that may develop in the gallbladder, they can not cause the obstruction of it. The patients who suffer from this medical condition can develop a chronic low-level inflammation which usually leads to a chronic type of the disease. In this case the gallbladder is calcified and fibroitc. Other complications include: perforation, rupture and also ascending cholangitis. The ascending cholangitis is a cholangitis (which is the inflammation of the bile duct) caused by a bacterial infection. This medical condition may be very difficult for a doctor to diagnose, because its symptoms usually resemble those of other medical disorders. If the doctor suspects that the patient suffers from this disease after examining him physically, he will submit the patient to a series of other tests such as: abdominal ultrasound and blood tests.

Cholecystitis – Symptoms

It is well known the fact that any medical disorder (including Cholecystitis) can trigger a variety of symptoms. Therefore, some of this medical condition's most uncommon symptoms have not been listed (mentioned) here. This is why we strongly recommend you to contact your personal health care provider whenever you develop any unusual, bothersome or unpleasant symptoms. Your personal physician will be able to tell you if you are suffering from Cholecystitis or from any other medical disorder. Here is a list of the most common symptoms that a person who suffers from Cholecystitis, may experience, although each person experience them differently:

• Intense pain in the upper right part of the abdomen
• Sudden pain in the upper right part of the abdomen
• Recurrent pain attack that can least several hours and usually occur after meals
• Pain that usually worsens in deep breaths
• Crampy and episodic pain
• Nausea
• Vomiting
• Rigid abdominal muscles on the right side
• Chills
• Slight fever
• Abdominal bloating
• Itching – this appears in rare cases
• Loose, light-colored bowel movement
• Dark urine
• Jaundice – which is the yellowing of the eyes and skin- it may take several days until becoming obvious.
• Tenderness in the right part of the abdomen
• Biliary colic
• Severe abdominal pain
• Indigestion
• Loss of appetite
• Belching
• Cholangitis

 It is also true that many patients are asymptomatic or experience the symptoms after a long time after this medical condition has developed. The symptoms listed above are common to many other illnesses, this is why if a person suspects that she suffers from this medical disorder, she has to consult a doctor and make several tests in order for the doctor to establish a diagnosis.

Cholecystitis – Treatment

As, we said before, the symptoms of Cholecystitis are common to other medical disorders, this is why the doctor has to perform a series of tests in order to diagnose a patient. The diagnostic procedures in the case of the Cholecystitis may include:

• Abdominal ultrasound – is a diagnostic imagining technique. This technique uses high-frequency sound waves in order to create a picture of the internal organs. This test is usually used in order to see all the internal organs such as: liver, kidneys, spleen, etc.
• Hepatobiliary scintigraphy – it is also an imaging technique; by using it, the doctor can see the liver, gallbladder, the bile ducts and the upper part of the small intestine.
• Cholangiography – is an x-ray examination of the bile ducts.
• Percutaneous transhepatic cholangiography (also known as PTC) – in this test the doctor will introduce a needle through the abdomen in the patient’s liver in order to deposit the dye (also known as contrast); this is done in order for the bile conduct to be visible at the x-ray.
• Endoscopic retrograde cholangiopancreatography (also known as ERCP) – this technique gives the doctor the possibility to diagnose and also treat the problems which occur in the liver, gallbladder, bile ducts and pancreas.
• Computed tomography scan (also know as CT or CAT scan) – is also an imaging procedure (which allows the doctors to have a closer look to the sight of the problem, as it shows detailed images of any part of the body), which uses a combination between the x-rays and the computer technology.

The treatment of this medical disorder, called Cholecystitis, needs in most of the cases hospitalization. The patients are not allowed to drink or eat by mouth; this is why they are administered fluids, sugars, salts, and vitamins intravenously, through a perfusion. Usually the patients have excess fluid in the stomach, which are removed with the help of an NG tube (also know as nasogastric tube) which is introduced in the nose and down into the stomach. In the cases where infections develop, the patients are given antibiotics. In the advanced stages of the Cholecystitis there is no other solution, but the surgical one, during which the doctor performing it, will remove the gallbladder. This surgery is called cholecystectomy. In the patients also suffering from other medical conditions, the gallbladder will not be removed; instead the doctor will remove the obstructed gallstones and drain the infected bile. This surgery is called cholecystotomy.

Another way of treating it is an endoscopic procedure (also known as ERCP). This technique is used to remove the stones that form in the common bile duct and it is performed before the gallbladder is removed, meaning before the cholecystectomy. The best way to prevent the appearance and development of the Cholecystitis for the patients is to try to maintain an ideal weight. Patients should also have a diet rich in fiber, vegetables, and fruits, as it is protective for the liver.
Here is a list of the possible medication that a doctor may prescribe to a patient who is suffering from this medical condition:

• Ancef
• Cefazolin
• Cefotan
• Cefotetan
• Cefoxitin
• Kefzol
• Mefoxin