Cholecystitis is inflammation of the gallbladder.

The gallbladder is a small, pear-shaped organ on the right

side of the belly (abdomen), beneath the liver. The gallbladder holds a digestive fluid (bile) that's released
into the small intestine.

Gallbladder inflammation can be caused by:

Gallstones. Most often, cholecystitis is the result of hard particles that develop in your gallbladder
(gallstones). Gallstones can block the tube (cystic duct) through which bile flows when it leaves the
gallbladder. Bile builds up in the gallbladder, causing inflammation.

Tumor. A tumor may prevent bile from draining out of your gallbladder properly. This causes bile buildup
that can lead to cholecystitis.

Bile duct blockage. Stones or thickened bile and tiny particles (sludge) can block the bile duct and lead to
cholecystitis. Kinking or scarring of the bile ducts can also cause blockage.

Infection. AIDS and certain viral infections can trigger gallbladder inflammation.

Severe illness. Very severe illness can damage blood vessels and decrease blood flow to the gallbladder,
leading to cholecystitis.

What are the different types of cholecystitis?

Gallbladder inflammation can be:

Acute (sudden and urgent).

Chronic (slow and longstanding).

Calculous (related to gallstones).

Acalculous (not related to gallstones).

An inflamed gallbladder can be an immediate response to an urgent problem, or a slow response to a long-
term problem. This is the difference between acute cholecystitis and chronic cholecystitis.

Gallstones are usually the cause of both chronic and acute cholecystitis. So, most cases are “calculous”.
Healthcare providers use “acalculous” to distinguish cholecystitis that’s not related to gallstones.

Symptoms of cholecystitis may include:

Severe pain in your upper right or center abdomen

Pain that spreads to your right shoulder or back

Tenderness over your abdomen when it's touched

Nausea

Vomiting

Fever

Cholecystitis symptoms often occur after a meal, particularly a large or fatty one.

Diagnostic tests:

Tests to diagnose cholecystitis may include:

Complete blood count (CBC).

Liver function tests.

Abdominal ultrasound.

Endoscopic ultrasound.

CT scan (computed tomography scan).

HIDA scan (hepatobiliary iminodiacetic acid scan).

Treatment begins with supportive care, including:

Intravenous (IV) fluids while your digestive system rests.

IV antibiotics to treat or prevent infections.

IV pain relief, which most people need.

The definitive treatment for cholecystitis is surgery to remove your gallbladder. Most causes of cholecystitis,
including gallstones, originate in your gallbladder itself. In rare cases, surgery might not be necessary if your
cholecystitis was caused by something that’s separately treatable, like an infection unrelated to gallstones.
You may also need to delay or forego surgery based on other health conditions.

Fluid drained from your gallbladder to relieve pressure. A healthcare provider might install a drainage tube
into your gallbladder through a small incision in your abdomen. Alternatively, they might install a drainage
tube from your gallbladder into your digestive tract via an endoscopic ultrasound. This nonsurgical
procedure accesses your organs through your mouth.

Endoscopic gallstone removal. Endoscopic retrograde cholangiopancreatography (ERCP) is another

nonsurgical procedure that combines an upper endoscopy with X-ray technology to visualize your biliary
system. An endoscopist can pass small tools through the endoscope to remove gallstones stuck in your bile
ducts. This can help relieve your immediate symptoms.

Complications

If untreated, cholecystitis can lead to a number of serious complications, including:

Infection within the gallbladder. If bile builds up within your gallbladder, causing cholecystitis, the bile may
become infected.

Death of gallbladder tissue. Untreated cholecystitis can cause tissue in the gallbladder to die (gangrene). It's
the most common complication, especially among older people, those who wait to get treatment and those
with diabetes. This can lead to a tear in the gallbladder, or it may cause your gallbladder to burst.

Torn gallbladder. A tear (perforation) in your gallbladder may result from gallbladder swelling, infection or
death of tissue.

Prevention

You can reduce your risk of cholecystitis by taking the following steps to prevent gallstones:

Lose weight slowly. Rapid weight loss can increase the risk of gallstones.

Maintain a healthy weight. Being overweight makes you more likely to develop gallstones. To achieve a
healthy weight, reduce calories and increase your physical activity. Maintain a healthy weight by continuing
to eat well and exercise.

Choose a healthy diet. Diets high in fat and low in fiber may increase the risk of gallstones. To lower your
risk, choose a diet high in fruits, vegetables and whole grains.