| General Illness Information |
Common Name: |
Cholecystitis
and Cholangitis |
|
Medical Term:
|
None Specified. |
| Description: |
Infection or inflammation of
the gallbladder, which collects and concentrates bile from the
liver (Cholecystitis).
Infection or inflammation of
the ducts that drain bile from the liver to the gallbladder (cholangitis).
More common in women and some
ethnic groups (North American Indians). Incidence increases with
age. |
| Causes: |
Unknown.
Postulated to be caused by
inflammation or bacterial infection, with some degree of damage by
gallstones or previous infection. Cholecystitis is associated with
gallstones in 90% of cases. |
| Prevention: |
Avoid
risk factors when possible.
|
| Signs
& Symptoms |
 |
Severe cramping pain in
the upper right of the abdomen. Pain may also occur in the
chest (imitating a heart attack), in the upper back or the
right shoulder. These symptoms frequently follow a meal rich
in fats. |
|
Tenderness in the upper
abdomen. |
|
Nausea and vomiting. |
|
Slight fever. If high
fever and chills occur, a bacterial infection may be
present. |
|
Jaundice (sometimes). |
|
Pale stools (sometimes). |
|
Skin itching
(sometimes), from jaundice. |
|
| Risk Factors |
|
Gallstones. |
|
Family history of
gallbladder disease. |
|
Diet that is high in fat
and low in fiber. |
|
Chronic or acute
pancreatitis. |
|
Obesity. |
|
Rapid weight loss. |
|
Diabetes or cirrhosis. |
|
Oral contraceptives. |
|
Female, middle age
(40-50). |
|
Female with previous
gallstones who takes estrogen. |
|
| Diagnosis & Treatment |
| Diagnostic
test may include laboratory blood studies, X-rays of the
gallbladder, ultrasound of the gallbladder and bile ducts,
radioisotope studies of liver and pancreas |
| General
Measures: |
|
Hospital admission
usually necessary. Patient with acute Cholecystitis usually
needs to be hospitalized and is administered fluids and
electrolytes intravenously and is not allowed to take
anything by mouth. Sometimes a tube is inserted into the
stomach, so that suctioning can be performed to keep the
stomach empty and thus reduce stimulation of the
gallbladder. Usually antibiotics are also administered as
soon as acute Cholecystitis is suspected. |
|
Specific treatment will
depend on degree of severity, infection, size of stones, and
your general health. |
|
No surgical treatment
methods include: Medication to dissolve the stones or extra
corporeal shock wave lithotripsy that will shatter stones. |
|
Surgical treatment is
usually a cholecystectomy done by laparoscopic technique or
by laparotomy. |
|
| Medications: |
|
Intravenous fluids. |
|
Analgesics, including
narcotics, to relieve pain may be prescribed. |
|
Antibiotics may be
prescribed in acute cases. |
|
| Activity: |
|
Rest in bed until
symptoms disappear or recovery from surgery is complete.
While in bed, move your legs often to reduce the likelihood
of deep-vein blood clotting.
Other limits on activity
will be determined by treatment method. |
|
| Diet: |
|
Because of nausea and
vomiting, intravenous fluids are usually required during
severe attacks. Clear liquids are started when nausea
subsides. |
|
Begin a low-fat diet as
soon as you can tolerate solid foods. |
|
| Possible
Complications : |
|
Empyema and pus in
gallbladder.
|
|
Gallbladder rupture and
peritonitis, or abscess. |
|
Hepatitis. |
|
Choledocholithiasis
(stones pass from gallbladder into common bile duct
obstructing flow of bile). |
|
Fistula formation -
direct communication between gallbladder and stomach or
intestines. |
|
| Prognosis |
|
Most episodes require
hospitalization and treatment. Recurrences are common.
Attacks will cease with surgery to remove the
gallbladder. Symptoms of some mild attacks subside
spontaneously in 1 to 4 days, if no complications develop.
However complications are common. Severe or recurrent
Cholecystitis is a definite indication for surgery. |
|
| Other |
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