Chronic cholecystitis (patient information): Difference between revisions

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{{Cholecystitis (patient information)}}
{{Cholecystitis (patient information)}}
'''For the WikiDoc page for this topic, click [[Cholecystitis|here]]'''
'''For the WikiDoc page for this topic, [[Chronic cholecystitis|click here.]]'''


{{CMG}}; '''Assistant Editor-in-Chief:''' Meagan E. Doherty
{{CMG}}; '''Assistant Editor-in-Chief:''' Meagan E. Doherty, {{MMF}}


==Overview==
==Overview==
Cholecystitis is [[inflammation]] of the [[gall bladder]]. There are two distinct types of cholecystitis, acute and chronic. Acute cholecystitis is a sudden [[inflammation]] of the gallbladder that causes severe [[abdominal pain]]. Chronic cholecystitis is long-standing [[swelling]] and [[irritation]] of the [[gall bladder]].
Chronic cholecystitis is the chronic [[inflammation]] of the [[gallbladder]]. Chronic cholecystitis is causes [[abdominal pain]], [[nausea]], and [[vomiting]]. The abdominal pain is usually worsened after eating fatty or greasy food. Chronic cholecystitis is long-standing [[swelling]] and [[irritation]] of the [[gallbladder]]. The diagnosis is established by the combination of physical examination, laboratory, and imaging findings. The treatment of cholecystitis is mainly surgical removal of [[gallbladder]]. Possible complications of chronic cholecystitis are the [[gangrene]], [[perforation]], and malignancy of the gallbladder.  


==What are the symptoms of Cholecystitis?==
==What are the symptoms of Chronic Cholecystitis?==
===Acute Cholecystitis===
 
The main symptom is [[abdominal pain]] that is located on the upper right side or upper middle of the [[abdomen]]. The pain may:
===Chronic Cholecystitis===
* Be sharp, cramping, or dull
 
* Come and go
*Attacks of upper [[abdominal pain]], often with [[nausea]] or [[vomiting]]
* Spread to the back or below the right shoulder blade
*[[Abdominal pain]] that is located on the upper right side or upper middle of the [[abdomen]]
* Be worse after eating fatty or greasy foods
** The pain may:
* Occur within minutes of a meal
*** Spread to the back or below the right shoulder blade
*** Worsened by eating fatty or greasy foods


Other symptoms that may occur include:
Other symptoms that may occur include:
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* [[Nausea]] and [[vomiting]]
* [[Nausea]] and [[vomiting]]
* Yellowing of skin and whites of the eyes ([[jaundice]])
* Yellowing of skin and whites of the eyes ([[jaundice]])
===Chronic Cholecystitis===
Attacks of upper [[abdominal pain]], often with [[nausea]] or [[vomiting]].


==What causes Cholecystitis?==
==What causes Cholecystitis?==
===Acute Cholecystitis===
In 90% of cases, acute cholecystitis is caused by [[gallstones]] in the [[gall bladder]]. Severe illness, [[alcohol abuse]], and, rarely, [[tumors]] of the [[gall bladder]] may also cause cholecystitis.
Acute cholecystitis causes [[bile]] to become trapped in the [[gall bladder]]. The buildup of [[bile]] causes [[irritation]] and pressure in the [[gall bladder]]. This can lead to [[bacterial infection]] and perforation of the organ.


===Chronic Cholecystitis===
===Chronic Cholecystitis===
Chronic cholecystitis is usually caused by repeated attacks of acute cholecystitis. This leads to thickening of the [[gall bladder]] walls. The [[gall bladder]] begins to shrink and eventually loses the ability to perform its function, which is concentrating, storing, and releasing [[bile]].
* Chronic cholecystitis is usually caused by [[gallstones]] in the [[gallbladder]].
* It is usually preceded by repeated attacks of acute cholecystitis.  
* This leads to thickening of the [[gallbladder]] walls.  
* The [[gallbladder]] begins to shrink and eventually loses the ability to perform its function, which is concentrating, storing, and releasing [[bile]].


==Who is at highest risk?==
==Who is at highest risk?==
Risk Factors for Cholecystitis include:
Risk factors for chronic cholecystitis include:
*Gender: The disease occurs more often in women than in men
*Gender: The disease occurs more often in women than in men
*Age: The incidence increases after age 40
*Age: The incidence increases after age 40
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==Diagnosis==
==Diagnosis==
===Acute Cholecystitis===
A physical exam will show that your [[abdomen]] is tender to the touch.


===Chronic Cholecystitis===
Your doctor may order the following blood tests:
Your doctor may order the following blood tests:
* [[Amylase]] and [[lipase]]
* [[Amylase]] and [[lipase]]
* [[Bilirubin]]
* [[Bilirubin]]
* [[Complete blood count]] (CBC): may show a higher than normal [[white blood cell]] count
* [[Complete blood count]] (CBC):  
* Liver function tests
** May show a higher than normal [[white blood cell]] count
* [[Liver function tests]]


Imaging tests that can show [[gallstones]] or [[inflammation]] include:
Imaging tests that can show [[gallstones]] or [[inflammation]] include:
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* Abdominal [[CT scan]]
* Abdominal [[CT scan]]
* Abdominal [[x-ray]]
* Abdominal [[x-ray]]
* [[Oral cholecystogram]]
* Oral cholecystogram
* [[Gallbladder radionuclide scan]]
* Gallbladder radionuclide scan


===Chronic Cholecystitis===
Tests that reveal [[gallstones]] or [[inflammation]] in the [[gallbladder]]:
* Abdominal [[CT scan]]
* Abdominal [[ultrasound]]
* [[Gallbladder scan]] ([[HIDA scan]])
* [[Oral cholecystogram]]
==Diseases with similar symptoms==
==Diseases with similar symptoms==
===Acute Cholecystitis===
===Acute Cholecystitis===
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===Chronic Cholecystitis===
===Chronic Cholecystitis===
*[[Biliary colic|Billiary colic]]
*[[Peptic ulcer]]
*[[Peptic ulcer]]
*[[Hiatus hernia]]
*[[Hiatus hernia]]
*[[Colitis]]
*[[Colitis]]
*Functional bowel syndrome
*Functional bowel syndrome
==When to seek urgent medical care?==
==When to seek urgent medical care?==
===Acute Cholecystitis===
Call your health care provider if severe [[abdominal pain]] persists.
Call for an appointment with your health care provider if symptoms of cholecystitis recur after an acute episode.
===Chronic Cholecystitis===
===Chronic Cholecystitis===
Call for an appointment with your health care provider if you develop any symptoms of cholecystitis.
Call for an appointment with your healthcare provider if you develop any symptoms of cholecystitis.


==Treatment options==
==Treatment options==
===Acute Cholecystitis===
===Chronic Cholecystitis===
Seek immediate medical attention for severe [[abdominal pain]].
[[Surgery]] is the usual treatment. Surgery to remove the [[gallbladder]] ([[cholecystectomy]]) can be performed as an open or [[laparoscopic procedure]]. The open procedure requires a large cut in the upper-right part of the [[abdomen]]. [[Laparoscopic surgery]] uses instruments and a small camera inserted through a cluster of a few small cuts.


In the emergency room, patients with acute cholecystitis are given fluids through a [[vein]] and [[antibiotics]] to fight [[infection]].
In patients who are poor candidates for surgery because of other diseases or conditions, the [[gallstones]] may be dissolved with medication taken by mouth.


Although cholecystitis may clear up on its own, surgery to remove the [[gall bladder]] ([[cholecystectomy]]) is usually needed when [[inflammation]] continues or recurs. [[Surgery]] is usually done as soon as possible, however some patients will not need surgery right away.
===Medications to avoid===
{{MedCondContrPI


Nonsurgical treatment includes [[pain medicines]], [[antibiotics]] to fight [[infection]], and a low-fat diet (when food can be tolerated).
|MedCond =Cholecystitis|Fenofibrate|Gemfibrozil}}
 
Emergency surgery may be necessary if [[gangrene]] (tissue death), [[perforation]], [[pancreatitis]], or [[inflammation]] of the [[common bile duct]] occurs.
 
Occasionally, in very ill patients, a tube may be placed through the skin to drain the [[gallbladder]] until the patient gets better and can have surgery.
 
===Chronic Cholecystitis===
[[Surgery]] is the usual treatment. Surgery to remove the [[gall bladder]] ([[cholecystectomy]]) can be performed as an open or [[laparoscopic procedure]]. The open procedure requires a large cut in the upper-right part of the [[abdomen]]. [[Laparoscopic surgery]] uses instruments and a small camera inserted through a cluster of a few small cuts.
 
In patients who are poor candidates for surgery because of other diseases or conditions, the [[gallstones]] may be dissolved with medication taken by mouth.


==Where to find medical care for Cholecystitis?==
==Where to find medical care for Cholecystitis?==
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==Prevention of Cholecystitis==
==Prevention of Cholecystitis==
===Acute Cholecystitis===
Removal of the [[gall bladder]] and [[gallstones]] will prevent further attacks. Follow a low-fat diet if you are prone to gallstone attacks.


===Chronic Cholecystitis===
===Chronic Cholecystitis===
The condition is not always preventable. Eating less fatty foods may relieve symptoms in people with acute cholecystitis who have not had their [[gall bladder]] removed. However, the benefit of a low-fat diet has not been proven.
The condition is not always preventable. Eating less fatty foods may relieve symptoms in people with acute cholecystitis who have not had their [[gallbladder]] removed. However, the benefit of a low-fat diet has not been proven.


==What to expect (Outlook/Prognosis)?==
==What to expect (Outlook/Prognosis)?==
===Acute Cholecystitis===
Patients who have surgery to remove the [[gall bladder]] usually do very well.
==Possible Complications==
* [[Empyema]] (pus in the [[gall bladder]])
* [[Gangrene]] (tissue death) of the [[gall bladder]]
* Injury to the [[bile ducts]] draining the [[liver]] (a rare complication of [[cholecystectomy]])
* [[Pancreatitis]]
* [[Peritonitis]] ([[inflammation]] of the lining of the [[abdomen]])
===Chronic Cholecystitis===
[[Cholecystectomy]] is a common procedure with a low risk.


===Possible complications of cholecystitis===
===Possible complications of cholecystitis===
* [[Gangrene]] (tissue death) of the [[gallbladder]]
* [[Cancer]] of the gallbladder (rarely)
* [[Cancer]] of the gallbladder (rarely)
* [[Jaundice]]
* [[Jaundice]]
* [[Pancreatitis]]
* [[Pancreatitis]]
* Worsening of the condition
* Worsening of the condition


==Sources==
==Sources==
*http://www.nlm.nih.gov/medlineplus/ency/article/000264.htm
*http://www.nlm.nih.gov/medlineplus/ency/article/000264.htm
*http://www.nlm.nih.gov/medlineplus/ency/article/000217.htm
*http://www.nlm.nih.gov/medlineplus/ency/article/000217.htm


[[Category:Patient information]]
[[Category:Patient information]]
[[Category:Mature chapter]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology patient information]]
[[Category:Infectious disease]]
[[Category:Infectious disease patient information]]
[[Category:Hepatology]]
[[Category:Hepatology]]
[[Category:Hepatology patient information]]
[[Category:Inflammations]]
[[Category:General surgery]]
[[Category:Emergency medicine]]
[[Category:Disease]]


{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 20:10, 9 February 2018

Cholecystitis

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Cholecystitis?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

Cholecystitis On the Web

Ongoing Trials at Clinical Trials.gov

Images of Cholecystitis

Videos on Cholecystitis

FDA on Cholecystitis

CDC on Cholecystitis

Cholecystitisin the news

Blogs on Cholecystitis

Directions to Hospitals Treating Cholecystitis

Risk calculators and risk factors for Cholecystitis

For the WikiDoc page for this topic, click here.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Meagan E. Doherty, Furqan M M. M.B.B.S[2]

Overview

Chronic cholecystitis is the chronic inflammation of the gallbladder. Chronic cholecystitis is causes abdominal pain, nausea, and vomiting. The abdominal pain is usually worsened after eating fatty or greasy food. Chronic cholecystitis is long-standing swelling and irritation of the gallbladder. The diagnosis is established by the combination of physical examination, laboratory, and imaging findings. The treatment of cholecystitis is mainly surgical removal of gallbladder. Possible complications of chronic cholecystitis are the gangrene, perforation, and malignancy of the gallbladder.

What are the symptoms of Chronic Cholecystitis?

Chronic Cholecystitis

  • Attacks of upper abdominal pain, often with nausea or vomiting
  • Abdominal pain that is located on the upper right side or upper middle of the abdomen
    • The pain may:
      • Spread to the back or below the right shoulder blade
      • Worsened by eating fatty or greasy foods

Other symptoms that may occur include:

What causes Cholecystitis?

Chronic Cholecystitis

  • Chronic cholecystitis is usually caused by gallstones in the gallbladder.
  • It is usually preceded by repeated attacks of acute cholecystitis.
  • This leads to thickening of the gallbladder walls.
  • The gallbladder begins to shrink and eventually loses the ability to perform its function, which is concentrating, storing, and releasing bile.

Who is at highest risk?

Risk factors for chronic cholecystitis include:

  • Gender: The disease occurs more often in women than in men
  • Age: The incidence increases after age 40
  • The presence or development of gallstones
  • Race: Native Americans have a higher rate of gallstones

Diagnosis

Chronic Cholecystitis

Your doctor may order the following blood tests:

Imaging tests that can show gallstones or inflammation include:

Diseases with similar symptoms

Acute Cholecystitis

Chronic Cholecystitis

When to seek urgent medical care?

Chronic Cholecystitis

Call for an appointment with your healthcare provider if you develop any symptoms of cholecystitis.

Treatment options

Chronic Cholecystitis

Surgery is the usual treatment. Surgery to remove the gallbladder (cholecystectomy) can be performed as an open or laparoscopic procedure. The open procedure requires a large cut in the upper-right part of the abdomen. Laparoscopic surgery uses instruments and a small camera inserted through a cluster of a few small cuts.

In patients who are poor candidates for surgery because of other diseases or conditions, the gallstones may be dissolved with medication taken by mouth.

Medications to avoid

Patients diagnosed with Cholecystitis should avoid using the following medications:

  • Fenofibrate
  • Gemfibrozil
    If you have been diagnosed with Cholecystitis, consult your physician before starting or stopping any of these medications.


Where to find medical care for Cholecystitis?

Directions to Hospitals Treating Cholecystitis

Prevention of Cholecystitis

Chronic Cholecystitis

The condition is not always preventable. Eating less fatty foods may relieve symptoms in people with acute cholecystitis who have not had their gallbladder removed. However, the benefit of a low-fat diet has not been proven.

What to expect (Outlook/Prognosis)?

Possible complications of cholecystitis


Sources

Template:WH Template:WS