cholecystitis
🧠 Definition:
Cholecystitis is an inflammation of the gallbladder, usually caused by obstruction of the cystic duct due to gallstones (cholelithiasis), leading to bile accumulation and infection.
⚠️ Causes
1. Gallstones (most common cause) – block cystic duct and trap bile.
2. Acalculous cholecystitis – without stones, often seen in critically ill patients (sepsis, trauma, burns).
3. Infections – E. coli, Klebsiella, Enterococcus.
4. Tumors – that block bile flow.
5. Prolonged fasting or parenteral nutrition (no gallbladder stimulation).
🧍♀️ Risk Factor
Female (especially >40 years)
Obesity
Rapid weight loss
High-fat diet
Pregnancy
Diabetes mellitus
😖 Symptoms:
* Severe pain in the right upper quadrant (RUQ) or epigastric region
* Pain radiating to right shoulder or back
* Nausea and vomiting
* Fever and chills
* Tenderness over RUQ (Murphy’s sign positive)
* Jaundice (in some cases)
🔬 Complications:
* Empyema of the gallbladder (pus collection)
* Gangrene or perforation of the gallbladder
* Peritonitis
* Chronic cholecystitis (fibrosis and shrunken gallbladder)
* Choledocholithiasis (stones in common bile duct)
🧪 Diagnosis:
* Ultrasound – shows thickened gallbladder wall, stones, fluid.
* HIDA scan (hepatobiliary iminodiacetic acid) – assesses bile flow.
Blood tests:
↑ WBC (infection)
↑ Bilirubin, AST, ALT (if bile duct obstruction)
↑ Alkaline phosphatase
💊 Treatment:
Medical Management:
* NPO (nothing by mouth) – rest the gallbladder
* IV fluids – prevent dehydration
* Analgesics – pain relief
* Antibiotics – to treat infection
* Nasogastric suction (if vomiting severe)
Surgical Management:
* Cholecystectomy – removal of the gallbladder (laparoscopic or open)
Percutaneous cholecystostomy – drainage in critically ill patients
🍎 Dietary Management
* After acute phase / Post-surgery:
* Low-fat diet
* Avoid fried and greasy foods
* Small frequent meals
* Increase fiber intake (to prevent constipation)
* Avoid gas-producing foods (cabbage, beans, carbonated drinks)