April 9, 2009

Gall Bladder Cholecystitis

Posted in Category : Gall Bladder

Cholecystitis is an inflammation of the Gall Bladder. This usually occurs when the cystic duct of the bladder gets blocked by a gallstone. The cystic duct conveys the bile from the gall bladder where it is stored, to the intestines for digesting fatty foods. The blockage caused by the gall stone prevents free flow of bile, causing a surplus in the liver.

While cholecystitis is typically accompanied by severe abdominal pain and followed by fever, there are two types of cholecystitis – chronic or acute, and a rare form called acalculous cholecystitis.

  • Chronic Cholecystitis: This is an inflammation of the gall bladder which has carried on for a long period of time, with the individual experiencing repeated painful attacks.
  • Acute Cholecystitis: This starts off suddenly, is more acute and is mostly caused by gallstones.
  • Acalculous cholecystitis: this is a rare form of acute cholecystitis, which occurs without gallstones. It can happen after a major surgery, a viral infection, a long period of fasting, serious illness such as major burns or injuries and bodywide sepsis (infections) and can also be caused by an immune system deficiency.Acalculous cholecystitis is usually the most serious form of cholecystitis.
  • Symptoms: Most cholecystitis attacks start with pain. The pain is similar to biliary colic, but it is more severe and last longer, sometimes as long as 6 to 12 hours. The pain increase within a period of 15 to 60 minutes, and thereafter it remains constant. The pain starts from the right side of the upper abdomen. It then gradually spreads to the back, right shoulder and between the shoulder blades. After some time, the abdomen may also feel rigid to the touch. This is accompanied by high fever (over 100.8 F degrees) followed by chills, Due to the severity of the pain, the patient may experience difficulty in breathing. Nausea and vomiting may also occur. The patient gradually becomes weaker and feels exhausted.
  • An attack usually last for 2 to 3 days, with other symptoms too disappearing within a week. After the first attack, there may be a gap with no pain. But repeated episodes occur, with greater severity, each time.

    The repeated attacks damage the gall bladder, scarring the walls and making them thick, resulting in the gall bladder becoming smaller. The white blood cell count may also rise. Sometimes the normal contractions of the intestines may stop. This indicates gangrene, or abscess (formation of pus) or a perforated gall bladder, all of which are life-threatening conditions.

    Diagnosis and Treatment: Ultrasonography and Cholescintigraphy are useful in diagnosing the problem, along with laparoscope probes.

    Patients with Cholecystitis need to be hospitalized. In some cases, treatment with antibiotics suffices, but usually the gall bladder is removed by laparoscopic surgery.