Published: 18 Jun 2025

ICD9: 575.10      ICD10: K81.9      ICD11: DC12

Cholecystitis is the inflammation of the gallbladder.


Here's a more detailed breakdown:

Gallbladder: A small, pear-shaped organ located under the liver. It stores and concentrates bile, a digestive fluid produced by the liver. Bile helps digest fats.
Inflammation: The body's response to injury or infection. In cholecystitis, this inflammation affects the walls of the gallbladder.

Causes:

The most common cause is gallstones (cholelithiasis) blocking the cystic duct (the tube that carries bile out of the gallbladder). When the duct is blocked, bile builds up in the gallbladder, causing pressure and inflammation. Other less common causes include:

Tumors: Can obstruct the flow of bile.
Bile duct problems: Strictures or other issues.
Severe illness: Serious infections or prolonged fasting can sometimes lead to acalculous cholecystitis (cholecystitis without gallstones).

Types:

Acute Cholecystitis: Sudden onset of symptoms, usually due to a blocked cystic duct by gallstones.
Chronic Cholecystitis: Long-term inflammation of the gallbladder, often following repeated acute attacks. It can cause the gallbladder to become thickened and scarred.
Acalculous Cholecystitis: Inflammation of the gallbladder without gallstones. More common in critically ill patients.

Symptoms:

Severe pain in the upper right abdomen: This is often the main symptom, and it may radiate to the back or right shoulder.
Nausea and vomiting
Fever
Tenderness to the touch in the upper right abdomen
Jaundice (yellowing of the skin and eyes) - less common, but can occur if the bile duct is blocked

Diagnosis:

Physical Exam: A doctor will examine your abdomen for tenderness.
Blood Tests: To check for signs of infection and liver function.
Imaging Tests:
Ultrasound: Often the first test used to look for gallstones.
HIDA scan (hepatobiliary iminodiacetic acid scan): A nuclear medicine scan that can assess the function of the gallbladder and bile ducts.
CT Scan: Can help identify complications or other problems.
MRI: Sometimes used for a more detailed view.

Treatment:

Hospitalization: Usually required for acute cholecystitis.
NPO (nothing by mouth): To rest the gallbladder.
IV fluids: To prevent dehydration.
Pain medication: To manage pain.
Antibiotics: To treat infection.
Cholecystectomy (gallbladder removal surgery): This is often the definitive treatment. It can be done laparoscopically (through small incisions) or with open surgery. Laparoscopic surgery is generally preferred.
Percutaneous cholecystostomy: A procedure where a drainage tube is inserted into the gallbladder to drain it. This may be used for patients who are too ill to undergo surgery.

Complications:

If left untreated, cholecystitis can lead to serious complications, including:

Gallbladder rupture (perforation)
Infection of the gallbladder (empyema)
Sepsis (blood infection)
Pancreatitis (inflammation of the pancreas)

In summary, cholecystitis is a painful and potentially serious condition. If you experience symptoms, seek medical attention promptly for diagnosis and treatment.