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Cholecystitis

DEFINITION

Cholecystitis is the inflammation of the gallbladder. The gallbladder is a small organ which sits underneath the liver in the right upper abdomen. The normal job of the gallbladder is to store bile, which is made in the liver then passed down the bile duct system to the gallbladder. This bile is used to help break down the fats that we eat. When something fatty enters the stomach, bile is released from the gallbladder to help break down fats to be used by the body. Most often, the cause of the inflammation of the gallbladder is a gallstone blocking the bile duct system through which the bile passes to the digestive tract. Cholecystitis can also be caused by tumors, infection, or other injury. If left untreated, cholecystitis can lead to serious infections and inury. Risk factor for getting cholecystitis include: diabetes, prolonged labor, traumatic injury, and having gallstones.

SYMPTOMS
Abdominal pain (especially in the right upper part of the abdomen), yellowing of the skin, pain in the back or shoulder blades, nausea and vomiting, bloating, gas, indigestion, fever, chills, sweating, loss of appetite

DIAGNOSIS
The diagnosis of cholescystitis is made after a careful history and physical exam by your doctor. You will likely have blood drawn for lab tests including liver functions test which show the activity of your gallbladder as well as your white blood cell count to see if you have an infection. You will likely also have an ultrasound (sonogram) of your right upper abdomen which will show if you have gallstones in your gallbladder. A CT scan (which provides pictures of your abdomen taken from the outside) can also be used to test for the presence of gallstones. You may also have a Hepatobiliary iminodiacetic acid (HIDA) scan done which shows the movement of bile fluid in the liver, gallbladder and small intestine.

TREATMENT
The treatment of cholecystitis requires hospitalization. You will likely be given antibiotics for your symptoms as well as medicine to treat your pain. Initially, you will not be allowed to eat anything to rest the gallbladder. After treatment with antibiotics for a little bit, other treatment options can be considered. Once you have cholecystitis, you will likely have surgery to remove your gallbladder (cholecystectomy). If signs of spreading infection are present, your gallbladder will be removed right away. If not, surgery may wait for days or weeks while you take antibiotics to decrease your infection. Cholecystectomy can either be done with an open abdominal surgery (laparotomy) or can be done by inserting a small camera and tools in small incisions in the abdomen (laparoscopy). Most people do not have problems living without a gallbladder, but some can have diarrhea.

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