Materiały źródłowe

• #1 Acute Cholecystitis – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/acute-cholecystitis

  Acute cholecystitis is inflammation of the gallbladder that develops over hours, usually because a gallstone obstructs the cystic duct. Symptoms include right upper quadrant pain and tenderness, sometimes accompanied by fever, chills, nausea, and vomiting. […] Most patients have had prior attacks of biliary colic or acute cholecystitis. The pain of cholecystitis is similar in quality and location to biliary colic but lasts longer (ie, 6 hours) and is more severe. Vomiting is common, as is right subcostal tenderness. Within a few hours, the Murphy sign (deep inspiration exacerbates the pain during palpation of the right upper quadrant and halts inspiration) develops along with involuntary guarding of upper abdominal muscles on the right side. Fever, usually low grade, is common. […] Acute cholecystitis begins to subside in 2 to 3 days and resolves within 1 week in 85% of patients, even without treatment.

• #2 Cholecystitis (Gallbladder Inflammation): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15265-gallbladder-swelling–inflammation-cholecystitis

  Common symptoms of acute cholecystitis include: […] Acute cholecystitis is usually caused by something blocking the flow of bile. This can affect more than just your gallbladder. A blockage in your biliary system the system of organs that exchange bile through your bile ducts can cause inflammation and possibly infection throughout. […] A gallstone that obstructs the flow of bile from your gallbladder will cause acute cholecystitis. This type gets steadily worse as your gallbladder swells more and more. […] Severe inflammation and swelling in your organs can cause tissue death (gangrene), which can cause the organ to split or tear (gangrenous cholecystitis). […] Cholecystitis that goes untreated may lead to dangerous complications.

• #3 Acute cholecystitis | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/acute-cholecystitis/

  Acute cholecystitis is swelling (inflammation) of the gallbladder. It is a potentially serious condition that usually needs to be treated in hospital. The main symptom of acute cholecystitis is a sudden sharp pain in the upper right side of your tummy (abdomen) that spreads towards your right shoulder. The affected part of the abdomen is usually extremely tender, and breathing deeply can make the pain worse. Unlike some others types of abdominal pain, the pain associated with acute cholecystitis is usually persistent, and doesnt go away within a few hours. Some people may additional symptoms, such as: a high temperature (fever) […] If your symptoms suggest you have acute cholecystitis, your GP will refer you to hospital immediately for further tests and treatment. Without appropriate treatment, acute cholecystitis can sometimes lead to potentially life-threatening complications. In about 1 in every 5 cases of acute cholecystitis, emergency surgery to remove the gallbladder is needed to treat these complications.

• #4 Cholecystitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cholecystitis/symptoms-causes/syc-20364867

  Cholecystitis (ko-luh-sis-TIE-tis) is swelling and irritation, called inflammation, of the gallbladder. […] Symptoms of cholecystitis may include: Severe pain in the upper right or center belly area. Pain that spreads to the right shoulder or back. Tenderness over the belly area when it’s touched. Nausea. Vomiting. Fever. […] Cholecystitis symptoms often come on after a meal. A large or fatty meal is most likely to cause symptoms. […] If not treated, cholecystitis can lead to serious complications, such as gallbladder rupture. These can be life-threatening. Treatment for cholecystitis often involves surgery to remove the gallbladder.

• #5 Acute Cholecystitis – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/acute-cholecystitis

  Acute cholecystitis is inflammation of the gallbladder that develops over hours, usually because a gallstone obstructs the cystic duct. Symptoms include right upper quadrant pain and tenderness, sometimes accompanied by fever, chills, nausea, and vomiting. […] Most patients have had prior attacks of biliary colic or acute cholecystitis. The pain of cholecystitis is similar in quality and location to biliary colic but lasts longer (ie, 6 hours) and is more severe. Vomiting is common, as is right subcostal tenderness. Within a few hours, the Murphy sign (deep inspiration exacerbates the pain during palpation of the right upper quadrant and halts inspiration) develops along with involuntary guarding of upper abdominal muscles on the right side. Fever, usually low grade, is common. […] Acute cholecystitis begins to subside in 2 to 3 days and resolves within 1 week in 85% of patients, even without treatment.

• #6 Cholecystitis – Liver and Gallbladder Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/gallbladder-and-bile-duct-disorders/cholecystitis

  Typically, people have abdominal pain, fever, and nausea. […] Acute cholecystitis begins suddenly, resulting in severe, steady pain in the upper abdomen. At least 95% of people with acute cholecystitis have gallstones. The inflammation almost always begins without infection, although infection may follow later. Inflammation may cause the gallbladder to fill with fluid and its walls to thicken. […] The pain of acute cholecystitis is similar to biliary colic (pain caused by gallstones) but is more severe and lasts longer. The pain peaks after 15 to 60 minutes and remains constant. It usually occurs in the upper right part of the abdomen. The pain may become excruciating. Most people feel a sharp pain when a doctor presses on the upper right part of the abdomen. Breathing deeply may worsen the pain. The pain often extends to the lower part of the right shoulder blade or to the back. Nausea and vomiting are common.

• #7 Acute cholecystitis | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/acute-cholecystitis/

  Acute cholecystitis is swelling (inflammation) of the gallbladder. It is a potentially serious condition that usually needs to be treated in hospital. The main symptom of acute cholecystitis is a sudden sharp pain in the upper right side of your tummy (abdomen) that spreads towards your right shoulder. The affected part of the abdomen is usually extremely tender, and breathing deeply can make the pain worse. Unlike some others types of abdominal pain, the pain associated with acute cholecystitis is usually persistent, and doesnt go away within a few hours. Some people may additional symptoms, such as: a high temperature (fever) […] If your symptoms suggest you have acute cholecystitis, your GP will refer you to hospital immediately for further tests and treatment. Without appropriate treatment, acute cholecystitis can sometimes lead to potentially life-threatening complications. In about 1 in every 5 cases of acute cholecystitis, emergency surgery to remove the gallbladder is needed to treat these complications.

• #8 Acute cholecystitis – UF Health

  https://ufhealth.org/conditions-and-treatments/acute-cholecystitis

  Acute cholecystitis is sudden swelling and irritation of the gallbladder. It causes severe belly pain. […] The main symptom is pain in the upper right side or upper middle of your belly that usually lasts at least 30 minutes. You may feel: Sharp, cramping, or dull pain, Steady pain, Pain that spreads to your back or below your right shoulder blade. […] Other symptoms that may occur include: Clay-colored stools, Fever, Nausea and vomiting, Yellowing of skin and whites of the eyes (jaundice).

• #9 Acute Cholecystitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459171/

  Acute cholecystitis is inflammation of the gallbladder that occurs due to occlusion of the cystic duct or impaired emptying of the gallbladder. […] Acute cholecystitis refers to inflammation of the gallbladder. The pathophysiologic mechanism of acute cholecystitis is blockage of the cystic duct. […] Cases of acute cholecystitis have similar symptoms only more severe. Often symptoms are mistaken for cardiac issues. The finding of right upper abdominal pain with deep palpation, Murphy sign, is usually classic for this disease. […] For patients with uncomplicated acute cholecystitis, the prognosis is excellent. The mortality rates are very low. Perforation or gangrene of the gallbladder may occur in delayed cases. Patients with acalculous cholecystitis have high mortality varying from 20-50%. […] In severe cases of acute cholecystitis, the intense inflammation can make surgery difficult, resulting in injury to the bile duct, which has substantial morbidity.

• #10 Acute Cholecystitis – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/acute-cholecystitis

  Acute cholecystitis is inflammation of the gallbladder that develops over hours, usually because a gallstone obstructs the cystic duct. Symptoms include right upper quadrant pain and tenderness, sometimes accompanied by fever, chills, nausea, and vomiting. […] Most patients have had prior attacks of biliary colic or acute cholecystitis. The pain of cholecystitis is similar in quality and location to biliary colic but lasts longer (ie, 6 hours) and is more severe. Vomiting is common, as is right subcostal tenderness. Within a few hours, the Murphy sign (deep inspiration exacerbates the pain during palpation of the right upper quadrant and halts inspiration) develops along with involuntary guarding of upper abdominal muscles on the right side. Fever, usually low grade, is common. […] Acute cholecystitis begins to subside in 2 to 3 days and resolves within 1 week in 85% of patients, even without treatment.

• #11 Cholecystitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cholecystitis/symptoms-causes/syc-20364867

  Cholecystitis (ko-luh-sis-TIE-tis) is swelling and irritation, called inflammation, of the gallbladder. […] Symptoms of cholecystitis may include: Severe pain in the upper right or center belly area. Pain that spreads to the right shoulder or back. Tenderness over the belly area when it’s touched. Nausea. Vomiting. Fever. […] Cholecystitis symptoms often come on after a meal. A large or fatty meal is most likely to cause symptoms. […] If not treated, cholecystitis can lead to serious complications, such as gallbladder rupture. These can be life-threatening. Treatment for cholecystitis often involves surgery to remove the gallbladder.

• #12 Cholecystitis: Symptoms, causes, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/172067

  Cholecystitis is an inflammation of the gallbladder. The gallbladder becomes distended, and severe complications can arise. It can happen when a gallstone gets stuck at the opening of the gallbladder. Symptoms can include fever, pain, and nausea. […] Acute cholecystitis starts suddenly, whereas chronic cholecystitis develops slowly over time. In the United States, approximately 200,000 people get acute cholecystitis every year. […] In cases of acute cholecystitis, the pain starts suddenly. It does not go away, and it is intense. Without treatment, it will usually get worse, and breathing in deeply will make it feel more intense. The pain may radiate from the abdomen to the right shoulder or back. […] A slight fever and chills may be present with acute cholecystitis. […] After a meal, especially one that is high in fat, the symptoms will worsen.

• #13 What is Acute Cholecystitis?: Causes, Risk Factors & Symptoms

  https://www.healthline.com/health/acute-cholecystitis

  The most common sign that you have acute cholecystitis is abdominal pain that lasts for several hours. This pain is usually in the middle or right side of your upper abdomen. It may also spread to your right shoulder or back. […] Pain from acute cholecystitis can feel like sharp pain or dull cramps. Its often described as excruciating. […] Other symptoms include: clay-colored stool, vomiting, nausea, fever, yellowing of your skin and the whites of your eyes, pain, typically after a meal, chills, abdominal bloating.

• #14 Acute Cholecystitis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/171886-clinical

  Elderly patients (especially patients with diabetes) may present with vague symptoms and without many key historical and physical findings. Pain and fever may be absent, and localized tenderness may be the only presenting sign. Elderly patients may also progress to complicated cholecystitis rapidly and without warning. […] The physical examination may reveal fever, tachycardia, and signs of peritoneal irritation (eg, tenderness in the right upper quadrant [RUQ] or the epigastric region), often with guarding or rebound. The Murphy sign, described as tenderness and an inspiratory pause elicited during palpation of the RUQ as the patient takes a deep breath, is widely used in the diagnosis of acute cholecystitis. […] The absence of physical findings does not rule out the diagnosis of acute cholecystitis. Many patients present with diffuse epigastric pain without localization to the RUQ. Patients with chronic cholecystitis frequently do not have a palpable RUQ mass because of fibrosis leading to a contracted gallbladder. […] Elderly patients and patients with diabetes frequently have atypical presentations, including the absence of fever and localized tenderness with only vague symptoms.

• #15 Diagnosing Biliary Colic and Acute Cholecystitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0915/p1386.html

  Pain in the area of the gall bladder lasting more than three hours is characteristic of acute cholecystitis. The most common cause is cystic duct obstruction by gallstone(s), and the initial symptom may be epigastric pain. A pain-free interval may occur before symptoms shift to the right upper quadrant. Older patients may have only localized tenderness. As local inflammation becomes more intense, signs and symptoms of tenderness and a local mass can be complicated by systemic toxicity manifested by fever and leukocytosis. The classic Murphy’s sign (abrupt interruption of deep inspiration) is elicited by palpation of the gallbladder area. A palpable mass caused by inflammation and adherent omentum is present in 30 to 40 percent of patients with cholecystitis. Abdominal guarding in response to deep palpation is common. Up to 15 percent of patients with acute cholecystitis are jaundiced.

• #16 Cholecystitis – Liver and Gallbladder Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/gallbladder-and-bile-duct-disorders/cholecystitis

  Fever occurs in about one third of people with acute cholecystitis. The fever tends to rise gradually to above 100.4 F (38 C) and may be accompanied by chills. […] Typically, an attack subsides in 2 to 3 days and completely resolves in a week. If the acute episode persists, it may signal a serious complication. Increasingly severe pain, a high fever, and chills suggest pockets of pus (abscesses) in or a tear (perforation) in the gallbladder. […] Acalculous cholecystitis typically causes sudden, excruciating pain in the upper abdomen in people with no previous symptoms or other evidence of a gallbladder disorder. The inflammation is often very severe and can lead to gangrene or rupture of the gallbladder. […] If untreated, acalculous cholecystitis results in death for 65% of people.

• #17 Acute Cholecystitis Symptoms and Nursing Management of Gall Bladder Attacks | Health And Willness

  https://healthandwillness.org/acute-cholecystitis-and-gall-bladder-attacks/

  The patient may report fevers and chills. Fevers are present in 35% of cases, and chills present in 13% of cases. […] Patients with acute cholecystitis generally appear ill and in pain. They are often sitting still since movement exacerbates their pain due to local peritoneal irritation. This is not as obvious in the case of a simple gall bladder attack. […] Symptoms of acute cholecystitis including RUQ abdominal pain, nausea/vomiting, and sometimes fevers and chills. […] Vital signs may show fever, tachycardia, and hypotension if the patient is septic. Abdominal assessment may show RUQ tenderness with guarding. Murphy’s sign is often positive. There may be hypoactive bowel sounds. Jaundice is abnormal with acute cholecystitis but can happen in severe cases. […] Treatment of acute cholecystitis includes IV hydration, pain management, IV antibiotics, and usually surgical removal of the gallbladder.

• #18 Cholecystitis – Liver and Gallbladder Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/gallbladder-and-bile-duct-disorders/cholecystitis

  Typically, people have abdominal pain, fever, and nausea. […] Acute cholecystitis begins suddenly, resulting in severe, steady pain in the upper abdomen. At least 95% of people with acute cholecystitis have gallstones. The inflammation almost always begins without infection, although infection may follow later. Inflammation may cause the gallbladder to fill with fluid and its walls to thicken. […] The pain of acute cholecystitis is similar to biliary colic (pain caused by gallstones) but is more severe and lasts longer. The pain peaks after 15 to 60 minutes and remains constant. It usually occurs in the upper right part of the abdomen. The pain may become excruciating. Most people feel a sharp pain when a doctor presses on the upper right part of the abdomen. Breathing deeply may worsen the pain. The pain often extends to the lower part of the right shoulder blade or to the back. Nausea and vomiting are common.

• #19 Understanding Cholecystitis: A Comprehensive Patient Guide | Symptoms, Causes, Diagnosis and Treatment Options Explained – The Kingsley Clinic

  https://thekingsleyclinic.com/uncategorized/understanding-cholecystitis-a-comprehensive-patient-guide-symptoms-causes-diagnosis-and-treatment-options-explained/

  Approximately 75% of cholecystitis patients experience nausea and vomiting. This is due to the irritation and inflammation of the gallbladder and nearby stomach and intestinal lining. Nausea and vomiting can occur at any stage but are particularly common during acute flare-ups of cholecystitis. […] Around 30-50% of patients with acute cholecystitis may present with a fever. Fever occurs as a response to the infection or inflammation in the gallbladder, signaling the body’s attempt to fight the condition. Chronic cholecystitis may not always involve fever. […] Loss of appetite is experienced by approximately 70% of individuals with cholecystitis. This symptom arises from the body’s response to the gallbladder’s inflammation and discomfort, leading to a decreased desire to eat. This symptom is common in both acute and chronic cases of cholecystitis.

• #20 Understanding Cholecystitis: A Comprehensive Patient Guide | Symptoms, Causes, Diagnosis and Treatment Options Explained – The Kingsley Clinic

  https://thekingsleyclinic.com/uncategorized/understanding-cholecystitis-a-comprehensive-patient-guide-symptoms-causes-diagnosis-and-treatment-options-explained/

  Approximately 75% of cholecystitis patients experience nausea and vomiting. This is due to the irritation and inflammation of the gallbladder and nearby stomach and intestinal lining. Nausea and vomiting can occur at any stage but are particularly common during acute flare-ups of cholecystitis. […] Around 30-50% of patients with acute cholecystitis may present with a fever. Fever occurs as a response to the infection or inflammation in the gallbladder, signaling the body’s attempt to fight the condition. Chronic cholecystitis may not always involve fever. […] Loss of appetite is experienced by approximately 70% of individuals with cholecystitis. This symptom arises from the body’s response to the gallbladder’s inflammation and discomfort, leading to a decreased desire to eat. This symptom is common in both acute and chronic cases of cholecystitis.

• #21 Acute Cholecystitis Symptoms and Nursing Management of Gall Bladder Attacks | Health And Willness

  https://healthandwillness.org/acute-cholecystitis-and-gall-bladder-attacks/

  The patient may report fevers and chills. Fevers are present in 35% of cases, and chills present in 13% of cases. […] Patients with acute cholecystitis generally appear ill and in pain. They are often sitting still since movement exacerbates their pain due to local peritoneal irritation. This is not as obvious in the case of a simple gall bladder attack. […] Symptoms of acute cholecystitis including RUQ abdominal pain, nausea/vomiting, and sometimes fevers and chills. […] Vital signs may show fever, tachycardia, and hypotension if the patient is septic. Abdominal assessment may show RUQ tenderness with guarding. Murphy’s sign is often positive. There may be hypoactive bowel sounds. Jaundice is abnormal with acute cholecystitis but can happen in severe cases. […] Treatment of acute cholecystitis includes IV hydration, pain management, IV antibiotics, and usually surgical removal of the gallbladder.

• #22 Acute cholecystitis

  https://www2.hse.ie/conditions/acute-cholecystitis/

  Acute cholecystitis is inflammation of the gallbladder. It usually happens when a gallstone blocks the cystic duct. […] Acute cholecystitis is serious because of the risk of complications. It usually needs treatment in a hospital with rest, intravenous (through a drip into a vein) fluids and antibiotics. […] The main symptom of acute cholecystitis is sudden, sharp pain in the upper right of your abdomen (tummy). This pain spreads towards your right shoulder. The pain can last longer than 5 hours. […] Some people may have more symptoms, such as: a fever (high temperature of 38 degrees Celsius or above), feeling or being sick, sweating, loss of appetite, jaundice (yellowing of the skin and the whites of the eyes), a bulge in the tummy. […] Getting treatment for acute cholecystitis as soon as possible reduces the risk of serious complications.

• #23 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  The most common presenting symptom of acute cholecystitis is upper abdominal pain. The following characteristics may be reported: […] Pain may radiate to the right shoulder or scapula […] Pain frequently begins in the epigastric region and then localizes to the right upper quadrant (RUQ) […] Pain may initially be „colicky” (it is NOT a true colic) but almost always becomes constant […] Nausea and vomiting are generally present, and fever may be noted. […] Patients with acalculous cholecystitis may present with fever and sepsis alone, without the history of pain. […] The physical examination may reveal the following: […] Fever, tachycardia, and signs of peritoneal irritation (eg, tenderness in the RUQ or epigastric region, often with guarding or rebound) […] Palpable, tender gallbladder or fullness of the RUQ (30%-40% of patients)

• #24 Cholecystitis: Symptoms and Treatment

  https://patient.info/digestive-health/gallstones-and-bile/cholecystitis

  Cholecystitis is a painful condition caused by an inflamed gallbladder. The most common cause is gallstones. […] People with acute cholecystitis are normally admitted to hospital for treatment with painkillers, antibiotics, and fluids given through a drip into a vein. […] The symptoms of acute cholecystitis tend to be quite characteristic. They usually come on rather quickly and people with it often feel very unwell. They are: Pain in the upper tummy (abdomen) – the main symptom. It is usually worse on the right side, under the ribs. The pain may travel (radiate) to the back or to the right shoulder and tends to last several hours. The pain tends to be worse on breathing in deeply. […] A high temperature (fever). […] When examining the tummy (abdomen) of someone with cholecystitis, healthcare professionals might find something called 'Murphy’s sign’, meaning an increase in pain when the doctor places their hand under the ribs on the right hand side, and then asks the person to take a deep breath.

• #25 Diagnosing Biliary Colic and Acute Cholecystitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0915/p1386.html

  Pain in the area of the gall bladder lasting more than three hours is characteristic of acute cholecystitis. The most common cause is cystic duct obstruction by gallstone(s), and the initial symptom may be epigastric pain. A pain-free interval may occur before symptoms shift to the right upper quadrant. Older patients may have only localized tenderness. As local inflammation becomes more intense, signs and symptoms of tenderness and a local mass can be complicated by systemic toxicity manifested by fever and leukocytosis. The classic Murphy’s sign (abrupt interruption of deep inspiration) is elicited by palpation of the gallbladder area. A palpable mass caused by inflammation and adherent omentum is present in 30 to 40 percent of patients with cholecystitis. Abdominal guarding in response to deep palpation is common. Up to 15 percent of patients with acute cholecystitis are jaundiced.

• #26 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  The most common presenting symptom of acute cholecystitis is upper abdominal pain. The following characteristics may be reported: […] Pain may radiate to the right shoulder or scapula […] Pain frequently begins in the epigastric region and then localizes to the right upper quadrant (RUQ) […] Pain may initially be „colicky” (it is NOT a true colic) but almost always becomes constant […] Nausea and vomiting are generally present, and fever may be noted. […] Patients with acalculous cholecystitis may present with fever and sepsis alone, without the history of pain. […] The physical examination may reveal the following: […] Fever, tachycardia, and signs of peritoneal irritation (eg, tenderness in the RUQ or epigastric region, often with guarding or rebound) […] Palpable, tender gallbladder or fullness of the RUQ (30%-40% of patients)

• #27 Diagnosing Biliary Colic and Acute Cholecystitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0915/p1386.html

  Pain in the area of the gall bladder lasting more than three hours is characteristic of acute cholecystitis. The most common cause is cystic duct obstruction by gallstone(s), and the initial symptom may be epigastric pain. A pain-free interval may occur before symptoms shift to the right upper quadrant. Older patients may have only localized tenderness. As local inflammation becomes more intense, signs and symptoms of tenderness and a local mass can be complicated by systemic toxicity manifested by fever and leukocytosis. The classic Murphy’s sign (abrupt interruption of deep inspiration) is elicited by palpation of the gallbladder area. A palpable mass caused by inflammation and adherent omentum is present in 30 to 40 percent of patients with cholecystitis. Abdominal guarding in response to deep palpation is common. Up to 15 percent of patients with acute cholecystitis are jaundiced.

• #28 Acute Cholecystitis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/171886-clinical

  Elderly patients (especially patients with diabetes) may present with vague symptoms and without many key historical and physical findings. Pain and fever may be absent, and localized tenderness may be the only presenting sign. Elderly patients may also progress to complicated cholecystitis rapidly and without warning. […] The physical examination may reveal fever, tachycardia, and signs of peritoneal irritation (eg, tenderness in the right upper quadrant [RUQ] or the epigastric region), often with guarding or rebound. The Murphy sign, described as tenderness and an inspiratory pause elicited during palpation of the RUQ as the patient takes a deep breath, is widely used in the diagnosis of acute cholecystitis. […] The absence of physical findings does not rule out the diagnosis of acute cholecystitis. Many patients present with diffuse epigastric pain without localization to the RUQ. Patients with chronic cholecystitis frequently do not have a palpable RUQ mass because of fibrosis leading to a contracted gallbladder. […] Elderly patients and patients with diabetes frequently have atypical presentations, including the absence of fever and localized tenderness with only vague symptoms.

• #29 Acute Cholecystitis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/171886-clinical

  Elderly patients (especially patients with diabetes) may present with vague symptoms and without many key historical and physical findings. Pain and fever may be absent, and localized tenderness may be the only presenting sign. Elderly patients may also progress to complicated cholecystitis rapidly and without warning. […] The physical examination may reveal fever, tachycardia, and signs of peritoneal irritation (eg, tenderness in the right upper quadrant [RUQ] or the epigastric region), often with guarding or rebound. The Murphy sign, described as tenderness and an inspiratory pause elicited during palpation of the RUQ as the patient takes a deep breath, is widely used in the diagnosis of acute cholecystitis. […] The absence of physical findings does not rule out the diagnosis of acute cholecystitis. Many patients present with diffuse epigastric pain without localization to the RUQ. Patients with chronic cholecystitis frequently do not have a palpable RUQ mass because of fibrosis leading to a contracted gallbladder. […] Elderly patients and patients with diabetes frequently have atypical presentations, including the absence of fever and localized tenderness with only vague symptoms.

• #30 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  Jaundice (~15% of patients). […] The absence of physical findings, however, does not rule out the diagnosis of cholecystitis. […] Acute cholecystitis may present differently in special populations, as follows: […] Elderly (especially diabetics) May present with vague symptoms and without many key historical and physical findings (eg, pain and fever), with localized tenderness being the only presenting sign; may progress to complicated cholecystitis rapidly and without warning. […] Delays in making the diagnosis of acute cholecystitis result in a higher incidence of morbidity and mortality. […] Once complications such as perforation/gangrene develop, the prognosis becomes less favorable. […] Some 25%-30% of patients either develop some type of complication or require emergency surgery.

• #31 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  Jaundice (~15% of patients). […] The absence of physical findings, however, does not rule out the diagnosis of cholecystitis. […] Acute cholecystitis may present differently in special populations, as follows: […] Elderly (especially diabetics) May present with vague symptoms and without many key historical and physical findings (eg, pain and fever), with localized tenderness being the only presenting sign; may progress to complicated cholecystitis rapidly and without warning. […] Delays in making the diagnosis of acute cholecystitis result in a higher incidence of morbidity and mortality. […] Once complications such as perforation/gangrene develop, the prognosis becomes less favorable. […] Some 25%-30% of patients either develop some type of complication or require emergency surgery.

• #32 Acute cholecystitis – UF Health

  https://ufhealth.org/conditions-and-treatments/acute-cholecystitis

  Acute cholecystitis is sudden swelling and irritation of the gallbladder. It causes severe belly pain. […] The main symptom is pain in the upper right side or upper middle of your belly that usually lasts at least 30 minutes. You may feel: Sharp, cramping, or dull pain, Steady pain, Pain that spreads to your back or below your right shoulder blade. […] Other symptoms that may occur include: Clay-colored stools, Fever, Nausea and vomiting, Yellowing of skin and whites of the eyes (jaundice).

• #33 Acute cholecystitis – UF Health

  https://ufhealth.org/conditions-and-treatments/acute-cholecystitis

  Acute cholecystitis is sudden swelling and irritation of the gallbladder. It causes severe belly pain. […] The main symptom is pain in the upper right side or upper middle of your belly that usually lasts at least 30 minutes. You may feel: Sharp, cramping, or dull pain, Steady pain, Pain that spreads to your back or below your right shoulder blade. […] Other symptoms that may occur include: Clay-colored stools, Fever, Nausea and vomiting, Yellowing of skin and whites of the eyes (jaundice).

• #34 Cholecystitis (Gall Bladder Infection): Symptoms, Causes, Treatment

  https://www.webmd.com/digestive-disorders/what-is-cholecystitis

  Nausea and vomiting are common symptoms. They often show up after you’ve eaten a big or especially fatty meal. […] It’s easy to mistake cholecystitis for other health problems, but another telltale sign is intense pain — in your belly, in your back, or under your right shoulder blade. […] You might feel a sharp, sudden pain in the upper right side of your belly. You may also feel pain in your back or below your right shoulder blade. Deep breaths may make it worse. Some other symptoms to watch out for include: Nausea, Vomiting, Fever, Bloating, Yellow skin or eyes (jaundice), Bowel movements that are loose and light-colored. […] Symptoms may get worse after a high-fat meal. If you can’t get comfortable or sit still because your pain is so strong, head to an emergency room. […] Cholecystitis can come on suddenly. You may hear a doctor or nurse call it an acute case. Or it can be a long-term problem. Those cases are called chronic.

• #35

  https://www.healthshare.com.au/questions/43227-what-are-the-symptoms-of-cholecystitis/

  Cholecystitis generally refers to a bacterial infection of the gallbladder. This usually occurs in patients who have gallstones. Gallstones can intermittently obstruct the outlet of the gallbladder causing an inflammation, which if unresolved, becomes a bacterial infection. This is treated with antibiotics and typically removal of the diseased organ. Symptoms of cholecystitis include abdominal pain which persists and worsens over several hours (on the right side of the abdomen, under the ribs), pain which can radiate into the back, nausea and vomiting, a high temperature and cold sweats. These symptoms are quite uncomfortable with cholecystitis and worsen over several hours. […] Acute cholecystitis history at home: 1. Starts after a fatty meal 2. Is felt as right sided pain which is constant but its intensity increases and decreases in waves (colic) 3. Can go through to the back or the right shoulder 4. May be associated with nausea and vomiting. […] In the hospital: 1. Blood tests may show a high white count and inflammatory marker (CRP) 2. Liver enzymes may be elevated if a gallstone has fallen into the common bile duct 3. Ultrasound scan may show a thickened gallbladder wall and some fluid around the gallbladder (pericholecystic fluid).

• #36 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  The most common presenting symptom of acute cholecystitis is upper abdominal pain. The following characteristics may be reported: […] Pain may radiate to the right shoulder or scapula […] Pain frequently begins in the epigastric region and then localizes to the right upper quadrant (RUQ) […] Pain may initially be „colicky” (it is NOT a true colic) but almost always becomes constant […] Nausea and vomiting are generally present, and fever may be noted. […] Patients with acalculous cholecystitis may present with fever and sepsis alone, without the history of pain. […] The physical examination may reveal the following: […] Fever, tachycardia, and signs of peritoneal irritation (eg, tenderness in the RUQ or epigastric region, often with guarding or rebound) […] Palpable, tender gallbladder or fullness of the RUQ (30%-40% of patients)

• #37 Acute cholecystitis ➤ causes, symptoms and treatment

  https://www.operarme.com/blog/acute-cholecystitis-causes-symptoms-and-treatment/

  Acute cholecystitis is the inflammation and subsequent infection of the gallbladder due to blockage of the bile ducts by cholelithiasis. […] The symptoms of acute cholecystitis are similar to those of biliary colic, but in many cases emergency surgery will be necessary. […] Patients suffering from acute cholecystitis have usually suffered from biliary colic in the past. The symptoms of acute cholecystitis are similar to those of biliary colic but with some differences: […] The pain that occurs when one has or presents with acute cholecystitis begins in the upper abdomen or epigastrium and radiates to the right side of the abdomen, just below the ribs in that area. This type of pain is less intense than biliary colic and usually remains constant over time, unlike biliary colic pain, which waxes and wanes over time.

• #38 Cholecystitis – Liver and Gallbladder Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/gallbladder-and-bile-duct-disorders/cholecystitis

  Typically, people have abdominal pain, fever, and nausea. […] Acute cholecystitis begins suddenly, resulting in severe, steady pain in the upper abdomen. At least 95% of people with acute cholecystitis have gallstones. The inflammation almost always begins without infection, although infection may follow later. Inflammation may cause the gallbladder to fill with fluid and its walls to thicken. […] The pain of acute cholecystitis is similar to biliary colic (pain caused by gallstones) but is more severe and lasts longer. The pain peaks after 15 to 60 minutes and remains constant. It usually occurs in the upper right part of the abdomen. The pain may become excruciating. Most people feel a sharp pain when a doctor presses on the upper right part of the abdomen. Breathing deeply may worsen the pain. The pain often extends to the lower part of the right shoulder blade or to the back. Nausea and vomiting are common.

• #39 Acute Cholecystitis – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/acute-cholecystitis

  Acute cholecystitis is inflammation of the gallbladder that develops over hours, usually because a gallstone obstructs the cystic duct. Symptoms include right upper quadrant pain and tenderness, sometimes accompanied by fever, chills, nausea, and vomiting. […] Most patients have had prior attacks of biliary colic or acute cholecystitis. The pain of cholecystitis is similar in quality and location to biliary colic but lasts longer (ie, 6 hours) and is more severe. Vomiting is common, as is right subcostal tenderness. Within a few hours, the Murphy sign (deep inspiration exacerbates the pain during palpation of the right upper quadrant and halts inspiration) develops along with involuntary guarding of upper abdominal muscles on the right side. Fever, usually low grade, is common. […] Acute cholecystitis begins to subside in 2 to 3 days and resolves within 1 week in 85% of patients, even without treatment.

• #40 Cholecystitis – Liver and Gallbladder Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/gallbladder-and-bile-duct-disorders/cholecystitis

  Fever occurs in about one third of people with acute cholecystitis. The fever tends to rise gradually to above 100.4 F (38 C) and may be accompanied by chills. […] Typically, an attack subsides in 2 to 3 days and completely resolves in a week. If the acute episode persists, it may signal a serious complication. Increasingly severe pain, a high fever, and chills suggest pockets of pus (abscesses) in or a tear (perforation) in the gallbladder. […] Acalculous cholecystitis typically causes sudden, excruciating pain in the upper abdomen in people with no previous symptoms or other evidence of a gallbladder disorder. The inflammation is often very severe and can lead to gangrene or rupture of the gallbladder. […] If untreated, acalculous cholecystitis results in death for 65% of people.

• #41 Cholecystitis Symptoms, Tests, and Treatment | ACE Specialist Clinic

  https://acesurgery.sg/24-7-emergency/acute-cholecystitis/

  In conclusion, acute cholecystitis, the inflammation of the gallbladder, is a medical emergency. This is because the serious condition often results in life-threatening complications if left untreated. Patients with acute cholecystitis should seek urgent medical attention as soon as possible to prevent complications. […] Acute cholecystitis commonly persists for a period of 2 to 3 days in most instances. However, the duration of symptoms can vary from individual to individual.

• #42 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  Jaundice (~15% of patients). […] The absence of physical findings, however, does not rule out the diagnosis of cholecystitis. […] Acute cholecystitis may present differently in special populations, as follows: […] Elderly (especially diabetics) May present with vague symptoms and without many key historical and physical findings (eg, pain and fever), with localized tenderness being the only presenting sign; may progress to complicated cholecystitis rapidly and without warning. […] Delays in making the diagnosis of acute cholecystitis result in a higher incidence of morbidity and mortality. […] Once complications such as perforation/gangrene develop, the prognosis becomes less favorable. […] Some 25%-30% of patients either develop some type of complication or require emergency surgery.

• #43 Acute Cholecystitis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/171886-clinical

  Elderly patients (especially patients with diabetes) may present with vague symptoms and without many key historical and physical findings. Pain and fever may be absent, and localized tenderness may be the only presenting sign. Elderly patients may also progress to complicated cholecystitis rapidly and without warning. […] The physical examination may reveal fever, tachycardia, and signs of peritoneal irritation (eg, tenderness in the right upper quadrant [RUQ] or the epigastric region), often with guarding or rebound. The Murphy sign, described as tenderness and an inspiratory pause elicited during palpation of the RUQ as the patient takes a deep breath, is widely used in the diagnosis of acute cholecystitis. […] The absence of physical findings does not rule out the diagnosis of acute cholecystitis. Many patients present with diffuse epigastric pain without localization to the RUQ. Patients with chronic cholecystitis frequently do not have a palpable RUQ mass because of fibrosis leading to a contracted gallbladder. […] Elderly patients and patients with diabetes frequently have atypical presentations, including the absence of fever and localized tenderness with only vague symptoms.

• #44 Acute Cholecystitis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/171886-clinical

  Elderly patients (especially patients with diabetes) may present with vague symptoms and without many key historical and physical findings. Pain and fever may be absent, and localized tenderness may be the only presenting sign. Elderly patients may also progress to complicated cholecystitis rapidly and without warning. […] The physical examination may reveal fever, tachycardia, and signs of peritoneal irritation (eg, tenderness in the right upper quadrant [RUQ] or the epigastric region), often with guarding or rebound. The Murphy sign, described as tenderness and an inspiratory pause elicited during palpation of the RUQ as the patient takes a deep breath, is widely used in the diagnosis of acute cholecystitis. […] The absence of physical findings does not rule out the diagnosis of acute cholecystitis. Many patients present with diffuse epigastric pain without localization to the RUQ. Patients with chronic cholecystitis frequently do not have a palpable RUQ mass because of fibrosis leading to a contracted gallbladder. […] Elderly patients and patients with diabetes frequently have atypical presentations, including the absence of fever and localized tenderness with only vague symptoms.

• #45 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  Jaundice (~15% of patients). […] The absence of physical findings, however, does not rule out the diagnosis of cholecystitis. […] Acute cholecystitis may present differently in special populations, as follows: […] Elderly (especially diabetics) May present with vague symptoms and without many key historical and physical findings (eg, pain and fever), with localized tenderness being the only presenting sign; may progress to complicated cholecystitis rapidly and without warning. […] Delays in making the diagnosis of acute cholecystitis result in a higher incidence of morbidity and mortality. […] Once complications such as perforation/gangrene develop, the prognosis becomes less favorable. […] Some 25%-30% of patients either develop some type of complication or require emergency surgery.

• #46 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  Patients with acalculous cholecystitis have a mortality ranging from 10%-50%, which far exceeds the expected 4% mortality observed in patients with calculous cholecystitis. […] In patients who are critically ill with acalculous cholecystitis and perforation or gangrene, mortality can be as high as 50%-60%. […] Because of the rapid progression of acute acalculous cholecystitis to gangrene and perforation, early recognition and intervention are required.

• #47 Treatment of acute calculous cholecystitis – UpToDate

  https://www.uptodate.com/contents/treatment-of-acute-calculous-cholecystitis

  Acute cholecystitis is a syndrome of right upper quadrant pain, fever, and leukocytosis associated with gallbladder inflammation. It typically occurs in patients with gallstones (ie, acute calculous cholecystitis [ACC]), while acalculous cholecystitis accounts for a minority (5 to 10 percent) of cases. Complications of acute cholecystitis include gallbladder gangrene or perforation, which can be life-threatening. […] Patients with ACC usually present with severe and steady abdominal pain in the right upper quadrant or epigastrium, fever, and leukocytosis. A positive Murphy’s sign on physical examination supports the diagnosis. In most cases, the diagnosis can be established with an abdominal ultrasound or a cholescintigraphy if the ultrasound is equivocal. […] Cholecystectomy is the mainstay of treatment for ACC. Poor surgical candidates may benefit from initial nonoperative management with antibiotics and a gallbladder drainage procedure; those whose surgical risk improves after resolution of the acute inflammation should undergo elective gallbladder surgery to prevent recurrent symptoms.

• #48 Acalculous Gallbladder Disease: Symptoms and Treatment

  https://www.verywellhealth.com/acalculous-gallbladder-disease-4843353

  Acalculous gallbladder disease symptoms can be chronic (slowly progressing with intermittent or vague symptoms) or acute (sudden and severe). […] Severe symptoms may develop abruptly. The onset of severe symptoms may include: […] Symptoms of acute cholecystitis (including nausea and vomiting, fever, chills, yellowish tinge to the whites of the eyes or skin, bloating of the abdomen, pain that typically occurs after a meal). […] In acute acalculous gallbladder disease, a person is very ill, may have septicemia (a bacterial infection in the bloodstream), and is often in a hospital setting for some type of serious illness or a recovery from major surgery. […] Acute acalculous gallbladder disease often occurs in critically ill, hospitalized, or otherwise at-risk people. Roughly one in three people die because of it. Early diagnosis and treatment are key. Without that, mortality rises to 50%.

• #49 Cholecystitis – Liver and Gallbladder Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/gallbladder-and-bile-duct-disorders/cholecystitis

  Fever occurs in about one third of people with acute cholecystitis. The fever tends to rise gradually to above 100.4 F (38 C) and may be accompanied by chills. […] Typically, an attack subsides in 2 to 3 days and completely resolves in a week. If the acute episode persists, it may signal a serious complication. Increasingly severe pain, a high fever, and chills suggest pockets of pus (abscesses) in or a tear (perforation) in the gallbladder. […] Acalculous cholecystitis typically causes sudden, excruciating pain in the upper abdomen in people with no previous symptoms or other evidence of a gallbladder disorder. The inflammation is often very severe and can lead to gangrene or rupture of the gallbladder. […] If untreated, acalculous cholecystitis results in death for 65% of people.

• #50 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  The most common presenting symptom of acute cholecystitis is upper abdominal pain. The following characteristics may be reported: […] Pain may radiate to the right shoulder or scapula […] Pain frequently begins in the epigastric region and then localizes to the right upper quadrant (RUQ) […] Pain may initially be „colicky” (it is NOT a true colic) but almost always becomes constant […] Nausea and vomiting are generally present, and fever may be noted. […] Patients with acalculous cholecystitis may present with fever and sepsis alone, without the history of pain. […] The physical examination may reveal the following: […] Fever, tachycardia, and signs of peritoneal irritation (eg, tenderness in the RUQ or epigastric region, often with guarding or rebound) […] Palpable, tender gallbladder or fullness of the RUQ (30%-40% of patients)

• #51 Acute Cholecystitis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/171886-clinical

  The most common presenting symptom of acute cholecystitis is upper abdominal pain. In some patients, the pain may radiate to the right shoulder or scapula. Frequently, the pain begins in the epigastric region and then localizes to the right upper quadrant (RUQ). Although the pain may initially be described as colicky, it is not a true colic and becomes constant in virtually all cases. Nausea and vomiting are generally present, and patients may report fever. […] Patients with acalculous cholecystitis may present similarly to patients with calculous cholecystitis, but acalculous cholecystitis frequently occurs suddenly in severely ill patients without a prior history of biliary colic. Often, patients with acalculous cholecystitis may present with fever and sepsis alone, without a history or physical examination findings consistent with acute cholecystitis.

• #52 Acute Cholecystitis – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/acute-cholecystitis

  Without treatment, patients can develop localized or free perforation and peritonitis. Increasing abdominal pain, high fever, and rigors with rebound tenderness or ileus suggest empyema (pus) in the gallbladder, gangrene, or perforation. […] The symptoms are similar to those of acute cholecystitis with gallstones but may be difficult to identify because patients tend to be severely ill (eg, in an intensive care unit) and may be unable to communicate clearly. Abdominal distention or unexplained fever may be the only clue. Untreated, the disease can rapidly progress to gallbladder gangrene and perforation, leading to sepsis, shock, and peritonitis; mortality approaches 65%.

• #53 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  Patients with acalculous cholecystitis have a mortality ranging from 10%-50%, which far exceeds the expected 4% mortality observed in patients with calculous cholecystitis. […] In patients who are critically ill with acalculous cholecystitis and perforation or gangrene, mortality can be as high as 50%-60%. […] Because of the rapid progression of acute acalculous cholecystitis to gangrene and perforation, early recognition and intervention are required.

• #54 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  Patients with acalculous cholecystitis have a mortality ranging from 10%-50%, which far exceeds the expected 4% mortality observed in patients with calculous cholecystitis. […] In patients who are critically ill with acalculous cholecystitis and perforation or gangrene, mortality can be as high as 50%-60%. […] Because of the rapid progression of acute acalculous cholecystitis to gangrene and perforation, early recognition and intervention are required.

• #55 Cholecystitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cholecystitis/symptoms-causes/syc-20364867

  Cholecystitis (ko-luh-sis-TIE-tis) is swelling and irritation, called inflammation, of the gallbladder. […] Symptoms of cholecystitis may include: Severe pain in the upper right or center belly area. Pain that spreads to the right shoulder or back. Tenderness over the belly area when it’s touched. Nausea. Vomiting. Fever. […] Cholecystitis symptoms often come on after a meal. A large or fatty meal is most likely to cause symptoms. […] If not treated, cholecystitis can lead to serious complications, such as gallbladder rupture. These can be life-threatening. Treatment for cholecystitis often involves surgery to remove the gallbladder.

• #56 Acute cholecystitis

  https://www2.hse.ie/conditions/acute-cholecystitis/

  If you have acute cholecystitis, you will need to go to hospital for treatment. […] Initial treatment usually involves: fasting (not eating or drinking) to take the strain off your gallbladder, receiving intravenous (through a drip into a vein) fluids to prevent dehydration, taking medicine for your pain. […] After initial treatment, any gallstones usually fall back into the gallbladder. The inflammation will often improve. […] After initial treatment, you may need your gallbladder removed. This prevents acute cholecystitis from coming back. It also reduces your risk of developing serious complications. […] Without proper treatment, acute cholecystitis can sometimes lead to life-threatening complications. […] The main complications of acute cholecystitis are gangrenous cholecystitis and perforated gallbladder.

• #57 Acute Cholecystitis Symptoms and Nursing Management of Gall Bladder Attacks | Health And Willness

  https://healthandwillness.org/acute-cholecystitis-and-gall-bladder-attacks/

  While many people might only have typical course of illness, some patients with acute cholecystitis can face serious complications. These can come from the inflammation itself, the spread of any infection, or changes in the gallbladder’s structure. It’s important to know and spot these complications early. […] This is a severe form of acute cholecystitis where the gallbladder becomes gangrenous. It occurs due to prolonged inflammation and can lead to perforation if not treated promptly. […] Prolonged inflammation can cause the gallbladder wall to break down, leading to a hole or perforation. This can result in bile leaking into the abdominal cavity, leading to peritonitis. […] In some cases, the gallbladder fills with pus due to an infection, a condition called empyema. This can cause fever and increased pain, requiring urgent drainage or surgery. […] Stones from the gallbladder can block the common bile duct, leading to cholangitis, which is an infection of the bile duct. This condition can be life-threatening and requires immediate intervention.

• #58 The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

  https://www.mdpi.com/2077-0383/13/9/2695

  According to the Tokyo guidelines, AC can be classified into grade I (mild), grade II (moderate), and grade III (severe). Mild AC represents a disease confined to the gallbladder, in the absence of local and/or systemic complications. Differently, moderate AC develops when at least one of the aforementioned local complications occurs, mainly gangrenous cholecystitis, pericholecystic abscess, biliary peritonitis, or emphysematous cholecystitis. An elevated WBC count (>18.000/mm3), a palpable tender mass in the right upper abdominal quadrant, and a duration of symptoms greater than 72 h are also associated with moderate AC. Severe AC occurs when the disease leads to systemic complications, with at least one organ failure (cardiovascular, neurological, respiratory, renal, hepatic, or hematological dysfunction).

• #59

  https://www.nhs.uk/conditions/gallstones/complications/

  Occasionally, a severely inflamed gallbladder can tear, leading to inflammation of the inside lining of the abdomen (peritonitis). […] If this happens, you may need antibiotics given directly into a vein (intravenous antibiotics), and surgery may be required to remove a section of the lining if part of it becomes severely damaged.

• #60

  https://www.laparoscopyhospital.com/forum/forum.php?p=&cat_id=&tid=3537

  Acute cholecystitis is inflammation of the gallbladder, often due to gallstones blocking the cystic duct. […] If your ultrasound (USG) report suggests acute cholecystitis, it’s crucial to follow up with a healthcare provider promptly. […] In many cases of acute cholecystitis, the standard and most effective treatment is surgical removal of the gallbladder, known as cholecystectomy. […] Acute cholecystitis, if left untreated or not managed properly, can lead to several potential complications, including: Gangrene: Severe inflammation can reduce blood flow to the gallbladder, leading to tissue death (gangrene) in the gallbladder. […] Perforation: Inflammation and pressure buildup can cause the gallbladder to rupture, leading to bile leakage and potentially life-threatening infections in the abdominal cavity (peritonitis).

• #61

  https://www.nhs.uk/conditions/gallstones/complications/

  If a bile duct becomes permanently blocked, it can lead to a build-up of bile inside the gallbladder. This can cause the gallbladder to become infected and inflamed. […] The medical term for inflammation of the gallbladder is acute cholecystitis. […] Symptoms include: pain in your upper abdomen that travels towards your shoulder blade (unlike biliary colic, the pain usually lasts longer than 5 hours), a high temperature, a rapid heartbeat. […] An estimated 1 in 10 people with acute cholecystitis also experience jaundice. […] Acute cholecystitis is usually first treated with antibiotics to settle the infection and then keyhole surgery to remove the gallbladder. […] Sometimes a severe infection can lead to a gallbladder abscess (empyema of the gallbladder). Antibiotics alone don’t always treat these and they may need to be drained.

• #62

  https://www.laparoscopyhospital.com/forum/forum.php?p=&cat_id=&tid=3537

  Abscess formation: Pus-filled pockets (abscesses) can develop in the gallbladder or surrounding tissues due to infection. […] Bile duct obstruction: Inflammation can cause the gallbladder or bile ducts to become blocked, leading to jaundice (yellowing of the skin and eyes) and potentially severe liver problems. […] Pancreatitis: Inflammation in the pancreas can occur due to blockage of the pancreatic duct by gallstones or inflammation spreading from the gallbladder. […] Chronic cholecystitis: Repeated episodes of acute cholecystitis can lead to chronic inflammation of the gallbladder, which can cause ongoing pain and digestive problems. […] Gallbladder cancer: Although rare, chronic inflammation and gallstones can increase the risk of developing gallbladder cancer over time. […] Sepsis: In severe cases, untreated acute cholecystitis can lead to a systemic infection (sepsis), which can be life-threatening if not promptly treated.

• #63

  https://www.nhs.uk/conditions/gallstones/complications/

  Occasionally, a severely inflamed gallbladder can tear, leading to inflammation of the inside lining of the abdomen (peritonitis). […] If this happens, you may need antibiotics given directly into a vein (intravenous antibiotics), and surgery may be required to remove a section of the lining if part of it becomes severely damaged.

• #64 Cholecystitis – Harvard Health

  https://www.health.harvard.edu/a_to_z/cholecystitis-a-to-z

  Acute cholecystitis is the sudden inflammation of the gallbladder that causes marked abdominal pain, often with nausea, vomiting, and fever. […] Symptoms of acute cholecystitis may include: Pain. You may feel this discomfort in the center of the upper abdomen, just below the breastbone, or in the upper right portion of the abdomen, near the gallbladder and liver. In some people, the pain extends to the right shoulder. Symptoms typically start after eating. Fever and possibly chills. Nausea and/or vomiting. Jaundice (yellowing of the skin or eyes), dark urine and pale, grayish bowel movements. These symptoms appear when gallstones pass out of the gallbladder and into the common bile duct, blocking the flow of bile out of the liver. […] If you have acute cholecystitis, however, and infection and inflammation continue, your symptoms may get worse and you could develop complications, including a hole in the inflamed gallbladder wall (gallbladder perforation) and an infection that spreads to the lining of the abdomen (peritonitis). This is why people with cholecystitis usually are treated and observed in a hospital until their symptoms improve. […] Most people recover from episodes of acute cholecystitis within a few days to a few weeks. Rarely, a person can become critically ill from a complication, such as gallbladder perforation, cholangitis or pancreatitis and in rare cases the condition can be fatal.

• #65 Acute Cholecystitis Symptoms and Nursing Management of Gall Bladder Attacks | Health And Willness

  https://healthandwillness.org/acute-cholecystitis-and-gall-bladder-attacks/

  While many people might only have typical course of illness, some patients with acute cholecystitis can face serious complications. These can come from the inflammation itself, the spread of any infection, or changes in the gallbladder’s structure. It’s important to know and spot these complications early. […] This is a severe form of acute cholecystitis where the gallbladder becomes gangrenous. It occurs due to prolonged inflammation and can lead to perforation if not treated promptly. […] Prolonged inflammation can cause the gallbladder wall to break down, leading to a hole or perforation. This can result in bile leaking into the abdominal cavity, leading to peritonitis. […] In some cases, the gallbladder fills with pus due to an infection, a condition called empyema. This can cause fever and increased pain, requiring urgent drainage or surgery. […] Stones from the gallbladder can block the common bile duct, leading to cholangitis, which is an infection of the bile duct. This condition can be life-threatening and requires immediate intervention.

• #66

  https://www.laparoscopyhospital.com/forum/forum.php?p=&cat_id=&tid=3537

  Abscess formation: Pus-filled pockets (abscesses) can develop in the gallbladder or surrounding tissues due to infection. […] Bile duct obstruction: Inflammation can cause the gallbladder or bile ducts to become blocked, leading to jaundice (yellowing of the skin and eyes) and potentially severe liver problems. […] Pancreatitis: Inflammation in the pancreas can occur due to blockage of the pancreatic duct by gallstones or inflammation spreading from the gallbladder. […] Chronic cholecystitis: Repeated episodes of acute cholecystitis can lead to chronic inflammation of the gallbladder, which can cause ongoing pain and digestive problems. […] Gallbladder cancer: Although rare, chronic inflammation and gallstones can increase the risk of developing gallbladder cancer over time. […] Sepsis: In severe cases, untreated acute cholecystitis can lead to a systemic infection (sepsis), which can be life-threatening if not promptly treated.

• #67 The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

  https://www.mdpi.com/2077-0383/13/9/2695

  Acute cholecystitis (AC), generally associated with the presence of gallstones, is a relatively frequent disease that can lead to serious complications. For these reasons, AC warrants prompt clinical diagnosis and management. There is general agreement in terms of considering early laparoscopic cholecystectomy (ELC) to be the best treatment for AC. The optimal timeframe to perform ELC is within 72 h from diagnosis, with a possible extension of up to 7–10 days from symptom onset. […] AC is an acute inflammatory disease of the gallbladder that sometimes can progress to a number of local complications, such as gangrenous cholecystitis, gallbladder perforation, pericholecystic abscess, biliary peritonitis, biliary fistula, emphysematous cholecystitis, gallbladder empyema, and hemorrhagic cholecystitis. In a minority of cases, systemic complications may occur.

• #68

  https://www.laparoscopyhospital.com/forum/forum.php?p=&cat_id=&tid=3537

  Abscess formation: Pus-filled pockets (abscesses) can develop in the gallbladder or surrounding tissues due to infection. […] Bile duct obstruction: Inflammation can cause the gallbladder or bile ducts to become blocked, leading to jaundice (yellowing of the skin and eyes) and potentially severe liver problems. […] Pancreatitis: Inflammation in the pancreas can occur due to blockage of the pancreatic duct by gallstones or inflammation spreading from the gallbladder. […] Chronic cholecystitis: Repeated episodes of acute cholecystitis can lead to chronic inflammation of the gallbladder, which can cause ongoing pain and digestive problems. […] Gallbladder cancer: Although rare, chronic inflammation and gallstones can increase the risk of developing gallbladder cancer over time. […] Sepsis: In severe cases, untreated acute cholecystitis can lead to a systemic infection (sepsis), which can be life-threatening if not promptly treated.

• #69 Acute Cholecystitis Symptoms and Nursing Management of Gall Bladder Attacks | Health And Willness

  https://healthandwillness.org/acute-cholecystitis-and-gall-bladder-attacks/

  While many people might only have typical course of illness, some patients with acute cholecystitis can face serious complications. These can come from the inflammation itself, the spread of any infection, or changes in the gallbladder’s structure. It’s important to know and spot these complications early. […] This is a severe form of acute cholecystitis where the gallbladder becomes gangrenous. It occurs due to prolonged inflammation and can lead to perforation if not treated promptly. […] Prolonged inflammation can cause the gallbladder wall to break down, leading to a hole or perforation. This can result in bile leaking into the abdominal cavity, leading to peritonitis. […] In some cases, the gallbladder fills with pus due to an infection, a condition called empyema. This can cause fever and increased pain, requiring urgent drainage or surgery. […] Stones from the gallbladder can block the common bile duct, leading to cholangitis, which is an infection of the bile duct. This condition can be life-threatening and requires immediate intervention.

• #70

  https://www.laparoscopyhospital.com/forum/forum.php?p=&cat_id=&tid=3537

  Abscess formation: Pus-filled pockets (abscesses) can develop in the gallbladder or surrounding tissues due to infection. […] Bile duct obstruction: Inflammation can cause the gallbladder or bile ducts to become blocked, leading to jaundice (yellowing of the skin and eyes) and potentially severe liver problems. […] Pancreatitis: Inflammation in the pancreas can occur due to blockage of the pancreatic duct by gallstones or inflammation spreading from the gallbladder. […] Chronic cholecystitis: Repeated episodes of acute cholecystitis can lead to chronic inflammation of the gallbladder, which can cause ongoing pain and digestive problems. […] Gallbladder cancer: Although rare, chronic inflammation and gallstones can increase the risk of developing gallbladder cancer over time. […] Sepsis: In severe cases, untreated acute cholecystitis can lead to a systemic infection (sepsis), which can be life-threatening if not promptly treated.

• #71 Cholecystitis – Wikipedia

  https://en.wikipedia.org/wiki/Cholecystitis

  Symptoms include right upper abdominal pain, pain in the right shoulder, nausea, vomiting, and occasionally fever. […] The pain becomes severe and constant in cholecystitis. Nausea is common and vomiting occurs in 75% of people with cholecystitis. […] Complications of acute cholecystitis include gallstone pancreatitis, common bile duct stones, or inflammation of the common bile duct. […] Gallstones blocking the flow of bile account for 90% of cases of cholecystitis (acute calculous cholecystitis). Blockage of bile flow leads to thickening and buildup of bile causing an enlarged, red, and tense gallbladder. […] The presentation of acalculous cholecystitis is similar to calculous cholecystitis. […] Chronic cholecystitis occurs after repeated episodes of acute cholecystitis and is almost always due to gallstones.

• #72

  https://www.laparoscopyhospital.com/forum/forum.php?p=&cat_id=&tid=3537

  Abscess formation: Pus-filled pockets (abscesses) can develop in the gallbladder or surrounding tissues due to infection. […] Bile duct obstruction: Inflammation can cause the gallbladder or bile ducts to become blocked, leading to jaundice (yellowing of the skin and eyes) and potentially severe liver problems. […] Pancreatitis: Inflammation in the pancreas can occur due to blockage of the pancreatic duct by gallstones or inflammation spreading from the gallbladder. […] Chronic cholecystitis: Repeated episodes of acute cholecystitis can lead to chronic inflammation of the gallbladder, which can cause ongoing pain and digestive problems. […] Gallbladder cancer: Although rare, chronic inflammation and gallstones can increase the risk of developing gallbladder cancer over time. […] Sepsis: In severe cases, untreated acute cholecystitis can lead to a systemic infection (sepsis), which can be life-threatening if not promptly treated.

• #73 The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

  https://www.mdpi.com/2077-0383/13/9/2695

  According to the Tokyo guidelines, AC can be classified into grade I (mild), grade II (moderate), and grade III (severe). Mild AC represents a disease confined to the gallbladder, in the absence of local and/or systemic complications. Differently, moderate AC develops when at least one of the aforementioned local complications occurs, mainly gangrenous cholecystitis, pericholecystic abscess, biliary peritonitis, or emphysematous cholecystitis. An elevated WBC count (>18.000/mm3), a palpable tender mass in the right upper abdominal quadrant, and a duration of symptoms greater than 72 h are also associated with moderate AC. Severe AC occurs when the disease leads to systemic complications, with at least one organ failure (cardiovascular, neurological, respiratory, renal, hepatic, or hematological dysfunction).

• #74 Acute Cholecystitis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/171886-clinical

  Elderly patients (especially patients with diabetes) may present with vague symptoms and without many key historical and physical findings. Pain and fever may be absent, and localized tenderness may be the only presenting sign. Elderly patients may also progress to complicated cholecystitis rapidly and without warning. […] The physical examination may reveal fever, tachycardia, and signs of peritoneal irritation (eg, tenderness in the right upper quadrant [RUQ] or the epigastric region), often with guarding or rebound. The Murphy sign, described as tenderness and an inspiratory pause elicited during palpation of the RUQ as the patient takes a deep breath, is widely used in the diagnosis of acute cholecystitis. […] The absence of physical findings does not rule out the diagnosis of acute cholecystitis. Many patients present with diffuse epigastric pain without localization to the RUQ. Patients with chronic cholecystitis frequently do not have a palpable RUQ mass because of fibrosis leading to a contracted gallbladder. […] Elderly patients and patients with diabetes frequently have atypical presentations, including the absence of fever and localized tenderness with only vague symptoms.

• #75 Acute Cholecystitis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/171886-clinical

  Elderly patients (especially patients with diabetes) may present with vague symptoms and without many key historical and physical findings. Pain and fever may be absent, and localized tenderness may be the only presenting sign. Elderly patients may also progress to complicated cholecystitis rapidly and without warning. […] The physical examination may reveal fever, tachycardia, and signs of peritoneal irritation (eg, tenderness in the right upper quadrant [RUQ] or the epigastric region), often with guarding or rebound. The Murphy sign, described as tenderness and an inspiratory pause elicited during palpation of the RUQ as the patient takes a deep breath, is widely used in the diagnosis of acute cholecystitis. […] The absence of physical findings does not rule out the diagnosis of acute cholecystitis. Many patients present with diffuse epigastric pain without localization to the RUQ. Patients with chronic cholecystitis frequently do not have a palpable RUQ mass because of fibrosis leading to a contracted gallbladder. […] Elderly patients and patients with diabetes frequently have atypical presentations, including the absence of fever and localized tenderness with only vague symptoms.

• #76 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  Jaundice (~15% of patients). […] The absence of physical findings, however, does not rule out the diagnosis of cholecystitis. […] Acute cholecystitis may present differently in special populations, as follows: […] Elderly (especially diabetics) May present with vague symptoms and without many key historical and physical findings (eg, pain and fever), with localized tenderness being the only presenting sign; may progress to complicated cholecystitis rapidly and without warning. […] Delays in making the diagnosis of acute cholecystitis result in a higher incidence of morbidity and mortality. […] Once complications such as perforation/gangrene develop, the prognosis becomes less favorable. […] Some 25%-30% of patients either develop some type of complication or require emergency surgery.

• #77 The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

  https://www.mdpi.com/2077-0383/13/9/2695

  According to the Tokyo guidelines, AC can be classified into grade I (mild), grade II (moderate), and grade III (severe). Mild AC represents a disease confined to the gallbladder, in the absence of local and/or systemic complications. Differently, moderate AC develops when at least one of the aforementioned local complications occurs, mainly gangrenous cholecystitis, pericholecystic abscess, biliary peritonitis, or emphysematous cholecystitis. An elevated WBC count (>18.000/mm3), a palpable tender mass in the right upper abdominal quadrant, and a duration of symptoms greater than 72 h are also associated with moderate AC. Severe AC occurs when the disease leads to systemic complications, with at least one organ failure (cardiovascular, neurological, respiratory, renal, hepatic, or hematological dysfunction).

• #78 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  Patients with acalculous cholecystitis have a mortality ranging from 10%-50%, which far exceeds the expected 4% mortality observed in patients with calculous cholecystitis. […] In patients who are critically ill with acalculous cholecystitis and perforation or gangrene, mortality can be as high as 50%-60%. […] Because of the rapid progression of acute acalculous cholecystitis to gangrene and perforation, early recognition and intervention are required.

• #79 The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

  https://www.mdpi.com/2077-0383/13/9/2695

  According to the Tokyo guidelines, AC can be classified into grade I (mild), grade II (moderate), and grade III (severe). Mild AC represents a disease confined to the gallbladder, in the absence of local and/or systemic complications. Differently, moderate AC develops when at least one of the aforementioned local complications occurs, mainly gangrenous cholecystitis, pericholecystic abscess, biliary peritonitis, or emphysematous cholecystitis. An elevated WBC count (>18.000/mm3), a palpable tender mass in the right upper abdominal quadrant, and a duration of symptoms greater than 72 h are also associated with moderate AC. Severe AC occurs when the disease leads to systemic complications, with at least one organ failure (cardiovascular, neurological, respiratory, renal, hepatic, or hematological dysfunction).

• #80 Acute Cholecystitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK459171/

  Acute cholecystitis is inflammation of the gallbladder that occurs due to occlusion of the cystic duct or impaired emptying of the gallbladder. […] Acute cholecystitis refers to inflammation of the gallbladder. The pathophysiologic mechanism of acute cholecystitis is blockage of the cystic duct. […] Cases of acute cholecystitis have similar symptoms only more severe. Often symptoms are mistaken for cardiac issues. The finding of right upper abdominal pain with deep palpation, Murphy sign, is usually classic for this disease. […] Regardless of the cause of the blockage, the gallbladder wall edema will eventually cause wall ischemia and become gangrenous. The gangrenous gallbladder can become infected by gas-forming organisms, causing acute emphysematous cholecystitis; all of these conditions can quickly become life-threatening, and rupture has a high rate of mortality. […] For patients with uncomplicated acute cholecystitis, the prognosis is excellent. The mortality rates are very low. Perforation or gangrene of the gallbladder may occur in delayed cases. Patients with acalculous cholecystitis have high mortality varying from 20-50%.

• #81 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=85&contentid=p00661

  Cholecystitis can happen suddenly (acute) or long-term (chronic). […] In most cases, an attack of cholecystitis lasts 2 to 3 days. Each persons symptoms may vary. Symptoms may include: Intense, sudden pain in the upper right or center part of your belly […] The symptoms of cholecystitis may look like other health problems. Always see your healthcare provider to be sure. […] If your gallbladder has not been removed and you have more attacks of cholecystitis, you may develop long-term (chronic) cholecystitis. […] Chronic cholecystitis may not cause any symptoms. But it can damage the walls of your gallbladder. The walls can become scarred and get thicker. Your gallbladder will start to get smaller. Over time, it will be less able to store and release bile. You will need surgery to remove your gallbladder.

• #82 Cholecystitis – Wikipedia

  https://en.wikipedia.org/wiki/Cholecystitis

  Symptoms include right upper abdominal pain, pain in the right shoulder, nausea, vomiting, and occasionally fever. […] The pain becomes severe and constant in cholecystitis. Nausea is common and vomiting occurs in 75% of people with cholecystitis. […] Complications of acute cholecystitis include gallstone pancreatitis, common bile duct stones, or inflammation of the common bile duct. […] Gallstones blocking the flow of bile account for 90% of cases of cholecystitis (acute calculous cholecystitis). Blockage of bile flow leads to thickening and buildup of bile causing an enlarged, red, and tense gallbladder. […] The presentation of acalculous cholecystitis is similar to calculous cholecystitis. […] Chronic cholecystitis occurs after repeated episodes of acute cholecystitis and is almost always due to gallstones.

• #83 Cholecystitis vs. cholelithiasis: Definitions and more

  https://www.medicalnewstoday.com/articles/cholecystitis-vs-cholelithiasis

  Cholecystitis mainly leads to a sharp, sudden pain toward the upper-right side of the belly, according to the NHS. This pain may feel like it is moving toward the right shoulder. The painful part of the belly may feel tender to the touch, and the pain may worsen while breathing deeply. It often lasts for longer than a few hours. […] Some people experience other symptoms, such as: fever, nausea and vomiting, excessive sweating, appetite loss, jaundice, a bulge in the belly. […] A less severe, ongoing version of these symptoms may occur due to faulty gallbladder emptying, known as chronic cholecystitis. This can lead to biliary colic episodes of more noticeable symptoms. […] However, severe presentations of these symptoms require urgent treatment. […] Gallstones do not usually cause symptoms. Doctors refer to these as silent gallstones, and they do not affect gallbladder, pancreas, or liver function or require treatment.

• #84 Cholecystitis vs. cholelithiasis: Definitions and more

  https://www.medicalnewstoday.com/articles/cholecystitis-vs-cholelithiasis

  However, symptoms of cholecystitis may flare up due to an acute gallbladder attack caused by gallstones blocking the duct. These symptoms may occur in response to specific dietary triggers, such as greasy or spicy foods. […] Cholelithiasis (gallstones) is a common cause of cholecystitis, which is inflammation of the gallbladder. […] Many gallstones do not cause symptoms, but those that do can cause an inflamed gallbladder, which leads to cholecystitis symptoms such as sharp belly pain, fever, and nausea. […] This requires urgent treatment and often leads to the removal of the gallbladder through a cholecystectomy. However, people can survive without a gallbladder, and cholecystectomies can help prevent severe complications.

• #85 Cholecystitis (Gallbladder Inflammation): Signs & Symptoms

  https://www.health.com/cholecystitis-symptoms-8634420

  Cholecystitis is the inflammation and irritation of your gallbladderthe pear-shaped, digestive organ that sits beneath the liver, on the right side of your abdomen. This condition is often a complication of gallstones and occurs when bile (digestive fluid) cant exit the gallbladder into the intestines properly. The buildup of bile can cause inflammation and lead to symptoms like abdominal pain and bloating. […] However, acute (short-term) cholecystitis symptoms can happen rapidly, which may be signs of a medical emergency. […] The primary sign of cholecystitis is abdominal pain. […] However, acute cholecystitis causes sudden attacks of sharper, more severe stabs of pain. […] Cholecystitis also affects your ability to digest foods. […] In addition to pain, this condition leads to digestive symptoms, such as bloating, nausea, and gas.

• #86 Cholecystitis: Symptoms, causes, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/172067

  The symptoms usually appear gradually over the course of weeks or months, and people do not typically experience fever or chills. The pain may worsen over time, and the condition can progress to the acute version. […] In many cases, doctors will recommend surgery for acute cholecystitis because there is a high rate of recurrence from inflammation related to gallstones. […] If there is a low risk of complications, the person can have surgery in an outpatient procedure. If a person is already experiencing complications, they will need immediate surgery to remove the gallbladder. […] Gangrenous cholecystitis is a serious complication of acute cholecystitis that results in tissue death. If gallbladder tissue dies, gangrene develops and leads to the perforation or bursting of the bladder. Without treatment, this can lead to sepsis and death.

• #87 Understanding Cholecystitis: A Comprehensive Patient Guide | Symptoms, Causes, Diagnosis and Treatment Options Explained – The Kingsley Clinic

  https://thekingsleyclinic.com/uncategorized/understanding-cholecystitis-a-comprehensive-patient-guide-symptoms-causes-diagnosis-and-treatment-options-explained/

  Approximately 75% of cholecystitis patients experience nausea and vomiting. This is due to the irritation and inflammation of the gallbladder and nearby stomach and intestinal lining. Nausea and vomiting can occur at any stage but are particularly common during acute flare-ups of cholecystitis. […] Around 30-50% of patients with acute cholecystitis may present with a fever. Fever occurs as a response to the infection or inflammation in the gallbladder, signaling the body’s attempt to fight the condition. Chronic cholecystitis may not always involve fever. […] Loss of appetite is experienced by approximately 70% of individuals with cholecystitis. This symptom arises from the body’s response to the gallbladder’s inflammation and discomfort, leading to a decreased desire to eat. This symptom is common in both acute and chronic cases of cholecystitis.

• #88 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=85&contentid=p00661

  Cholecystitis can happen suddenly (acute) or long-term (chronic). […] In most cases, an attack of cholecystitis lasts 2 to 3 days. Each persons symptoms may vary. Symptoms may include: Intense, sudden pain in the upper right or center part of your belly […] The symptoms of cholecystitis may look like other health problems. Always see your healthcare provider to be sure. […] If your gallbladder has not been removed and you have more attacks of cholecystitis, you may develop long-term (chronic) cholecystitis. […] Chronic cholecystitis may not cause any symptoms. But it can damage the walls of your gallbladder. The walls can become scarred and get thicker. Your gallbladder will start to get smaller. Over time, it will be less able to store and release bile. You will need surgery to remove your gallbladder.

• #89 Chronic cholecystitis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/chronic-cholecystitis

  Acute cholecystitis is a painful condition that may lead to chronic cholecystitis. It is not clear whether chronic cholecystitis causes any symptoms. […] Symptoms of acute cholecystitis can include: Sharp, cramping, or dull pain in upper right or upper middle of your belly. Steady pain lasting about 30 minutes. Pain that spreads to your back or below your right shoulder blade. Clay-colored stools. Fever. Nausea and vomiting. Yellowing of skin and whites of the eyes (jaundice).

• #90 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=85&contentid=p00661

  Cholecystitis can happen suddenly (acute) or long-term (chronic). […] In most cases, an attack of cholecystitis lasts 2 to 3 days. Each persons symptoms may vary. Symptoms may include: Intense, sudden pain in the upper right or center part of your belly […] The symptoms of cholecystitis may look like other health problems. Always see your healthcare provider to be sure. […] If your gallbladder has not been removed and you have more attacks of cholecystitis, you may develop long-term (chronic) cholecystitis. […] Chronic cholecystitis may not cause any symptoms. But it can damage the walls of your gallbladder. The walls can become scarred and get thicker. Your gallbladder will start to get smaller. Over time, it will be less able to store and release bile. You will need surgery to remove your gallbladder.

• #91 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=85&contentid=p00661

  Cholecystitis can happen suddenly (acute) or long-term (chronic). […] In most cases, an attack of cholecystitis lasts 2 to 3 days. Each persons symptoms may vary. Symptoms may include: Intense, sudden pain in the upper right or center part of your belly […] The symptoms of cholecystitis may look like other health problems. Always see your healthcare provider to be sure. […] If your gallbladder has not been removed and you have more attacks of cholecystitis, you may develop long-term (chronic) cholecystitis. […] Chronic cholecystitis may not cause any symptoms. But it can damage the walls of your gallbladder. The walls can become scarred and get thicker. Your gallbladder will start to get smaller. Over time, it will be less able to store and release bile. You will need surgery to remove your gallbladder.

• #92 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=85&contentid=p00661

  Cholecystitis can happen suddenly (acute) or long-term (chronic). […] In most cases, an attack of cholecystitis lasts 2 to 3 days. Each persons symptoms may vary. Symptoms may include: Intense, sudden pain in the upper right or center part of your belly […] The symptoms of cholecystitis may look like other health problems. Always see your healthcare provider to be sure. […] If your gallbladder has not been removed and you have more attacks of cholecystitis, you may develop long-term (chronic) cholecystitis. […] Chronic cholecystitis may not cause any symptoms. But it can damage the walls of your gallbladder. The walls can become scarred and get thicker. Your gallbladder will start to get smaller. Over time, it will be less able to store and release bile. You will need surgery to remove your gallbladder.

• #93

  https://www.laparoscopyhospital.com/forum/forum.php?p=&cat_id=&tid=3537

  Abscess formation: Pus-filled pockets (abscesses) can develop in the gallbladder or surrounding tissues due to infection. […] Bile duct obstruction: Inflammation can cause the gallbladder or bile ducts to become blocked, leading to jaundice (yellowing of the skin and eyes) and potentially severe liver problems. […] Pancreatitis: Inflammation in the pancreas can occur due to blockage of the pancreatic duct by gallstones or inflammation spreading from the gallbladder. […] Chronic cholecystitis: Repeated episodes of acute cholecystitis can lead to chronic inflammation of the gallbladder, which can cause ongoing pain and digestive problems. […] Gallbladder cancer: Although rare, chronic inflammation and gallstones can increase the risk of developing gallbladder cancer over time. […] Sepsis: In severe cases, untreated acute cholecystitis can lead to a systemic infection (sepsis), which can be life-threatening if not promptly treated.

• #94 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=85&contentid=p00661

  Cholecystitis can happen suddenly (acute) or long-term (chronic). […] In most cases, an attack of cholecystitis lasts 2 to 3 days. Each persons symptoms may vary. Symptoms may include: Intense, sudden pain in the upper right or center part of your belly […] The symptoms of cholecystitis may look like other health problems. Always see your healthcare provider to be sure. […] If your gallbladder has not been removed and you have more attacks of cholecystitis, you may develop long-term (chronic) cholecystitis. […] Chronic cholecystitis may not cause any symptoms. But it can damage the walls of your gallbladder. The walls can become scarred and get thicker. Your gallbladder will start to get smaller. Over time, it will be less able to store and release bile. You will need surgery to remove your gallbladder.

• #95 Cholecystitis (Gallbladder Inflammation) Signs & Treatment | Ada

  https://ada.com/conditions/cholecystitis/

  If left untreated, cholecystitis can result in serious complications, some of which may be life-threatening. Possible complications include: Gangrenous cholecystitis, where gallbladder tissue dies and becomes susceptible to infection, potentially resulting in sepsis; Gallbladder perforation, where the gallbladder ruptures and bile leaks out, potentially resulting in infection within the abdomen itself or an abscess forming. […] In these cases, emergency treatment is usually required. If the following symptoms are present, it is important to seek medical help immediately: Sudden, severe pain in the belly, which worsens; High fever; Chills, shivering and sweating; Vomiting; Rapid heartbeat. […] Sometimes, gallbladder inflammation persists for a long period of time. In such cases, the term chronic cholecystitis is used. Chronic gallbladder inflammation is almost always caused by gallstones. With repeat episodes of acute cholecystitis, sometimes called gallbladder attacks, which occur in chronic cholecystitis, the gallbladder can become damaged, and its functioning may be impaired. Treatment typically involves surgery to remove the gallbladder (cholecystectomy). […] If gallbladder inflammation is known or suspected, it is important to seek medical treatment to minimize the risk of complications occurring.

• #96 Acute cholecystitis

  https://www2.hse.ie/conditions/acute-cholecystitis/

  Acute cholecystitis is inflammation of the gallbladder. It usually happens when a gallstone blocks the cystic duct. […] Acute cholecystitis is serious because of the risk of complications. It usually needs treatment in a hospital with rest, intravenous (through a drip into a vein) fluids and antibiotics. […] The main symptom of acute cholecystitis is sudden, sharp pain in the upper right of your abdomen (tummy). This pain spreads towards your right shoulder. The pain can last longer than 5 hours. […] Some people may have more symptoms, such as: a fever (high temperature of 38 degrees Celsius or above), feeling or being sick, sweating, loss of appetite, jaundice (yellowing of the skin and the whites of the eyes), a bulge in the tummy. […] Getting treatment for acute cholecystitis as soon as possible reduces the risk of serious complications.

• #97 Cholecystitis (Gallbladder Inflammation): Signs & Symptoms

  https://www.health.com/cholecystitis-symptoms-8634420

  Acute cholecystitis warrants prompt medical attention and can be a medical emergency. […] Get immediate help if you experience any characteristic signs of a cholecystitis attack: Sudden, sharp pain in the abdomen. […] Cholecystitis occurs when your gallbladder becomes inflamed, causing attacks of severe pain in the upper right abdomen. […] If you have symptoms like sudden and sharp pain, alongside nausea and fever, it’s important to get medical care as soon as possible.

• #98 Acute cholecystitis

  https://www2.hse.ie/conditions/acute-cholecystitis/

  If you have acute cholecystitis, you will need to go to hospital for treatment. […] Initial treatment usually involves: fasting (not eating or drinking) to take the strain off your gallbladder, receiving intravenous (through a drip into a vein) fluids to prevent dehydration, taking medicine for your pain. […] After initial treatment, any gallstones usually fall back into the gallbladder. The inflammation will often improve. […] After initial treatment, you may need your gallbladder removed. This prevents acute cholecystitis from coming back. It also reduces your risk of developing serious complications. […] Without proper treatment, acute cholecystitis can sometimes lead to life-threatening complications. […] The main complications of acute cholecystitis are gangrenous cholecystitis and perforated gallbladder.

• #99 Acute cholecystitis

  https://www2.hse.ie/conditions/acute-cholecystitis/

  If you have acute cholecystitis, you will need to go to hospital for treatment. […] Initial treatment usually involves: fasting (not eating or drinking) to take the strain off your gallbladder, receiving intravenous (through a drip into a vein) fluids to prevent dehydration, taking medicine for your pain. […] After initial treatment, any gallstones usually fall back into the gallbladder. The inflammation will often improve. […] After initial treatment, you may need your gallbladder removed. This prevents acute cholecystitis from coming back. It also reduces your risk of developing serious complications. […] Without proper treatment, acute cholecystitis can sometimes lead to life-threatening complications. […] The main complications of acute cholecystitis are gangrenous cholecystitis and perforated gallbladder.

• #100 Acute Cholecystitis Symptoms and Nursing Management of Gall Bladder Attacks | Health And Willness

  https://healthandwillness.org/acute-cholecystitis-and-gall-bladder-attacks/

  The patient may report fevers and chills. Fevers are present in 35% of cases, and chills present in 13% of cases. […] Patients with acute cholecystitis generally appear ill and in pain. They are often sitting still since movement exacerbates their pain due to local peritoneal irritation. This is not as obvious in the case of a simple gall bladder attack. […] Symptoms of acute cholecystitis including RUQ abdominal pain, nausea/vomiting, and sometimes fevers and chills. […] Vital signs may show fever, tachycardia, and hypotension if the patient is septic. Abdominal assessment may show RUQ tenderness with guarding. Murphy’s sign is often positive. There may be hypoactive bowel sounds. Jaundice is abnormal with acute cholecystitis but can happen in severe cases. […] Treatment of acute cholecystitis includes IV hydration, pain management, IV antibiotics, and usually surgical removal of the gallbladder.

• #101 Acute cholecystitis

  https://www2.hse.ie/conditions/acute-cholecystitis/

  If you have acute cholecystitis, you will need to go to hospital for treatment. […] Initial treatment usually involves: fasting (not eating or drinking) to take the strain off your gallbladder, receiving intravenous (through a drip into a vein) fluids to prevent dehydration, taking medicine for your pain. […] After initial treatment, any gallstones usually fall back into the gallbladder. The inflammation will often improve. […] After initial treatment, you may need your gallbladder removed. This prevents acute cholecystitis from coming back. It also reduces your risk of developing serious complications. […] Without proper treatment, acute cholecystitis can sometimes lead to life-threatening complications. […] The main complications of acute cholecystitis are gangrenous cholecystitis and perforated gallbladder.

• #102 Cholecystitis: Symptoms and Treatment

  https://patient.info/digestive-health/gallstones-and-bile/cholecystitis

  The main treatments for cholecystitis are: Pain relief. […] Surgery to remove the gallbladder. This is called a cholecystectomy. […] For many people, surgery to remove the gallbladder (cholecystectomy) is recommended, because there is a high risk of cholecystitis occurring again, and it may cause serious problems. […] Surgery is usually recommended for people with cholecystitis. Treatment with antibiotics, fluids, and pain relief can settle down the inflammation from cholecystitis, but there’s a high chance of it coming back without surgery.

• #103 Cholecystitis: Symptoms and Treatment

  https://patient.info/digestive-health/gallstones-and-bile/cholecystitis

  The main treatments for cholecystitis are: Pain relief. […] Surgery to remove the gallbladder. This is called a cholecystectomy. […] For many people, surgery to remove the gallbladder (cholecystectomy) is recommended, because there is a high risk of cholecystitis occurring again, and it may cause serious problems. […] Surgery is usually recommended for people with cholecystitis. Treatment with antibiotics, fluids, and pain relief can settle down the inflammation from cholecystitis, but there’s a high chance of it coming back without surgery.

• #104 Acute cholecystitis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000084

  Acute cholecystitis is a major complication of cholelithiasis (i.e., gallstones); symptomatic gallstones are common before developing cholecystitis. […] Patients typically present with pain and localised tenderness, with or without guarding, in the upper right quadrant. […] There may be evidence of a systemic inflammatory response with fever, elevated white cell count, and raised C-reactive protein. […] Treatment is with antibiotics, analgesia, and fluid resuscitation as required, likely to be followed by an early cholecystectomy.

• #105 Doctor explains Acute Cholecystitis (Gall bladder inflammation) | Causes, symptoms, treatment & more – Dr. James O’Donovan

  https://www.doctorodonovan.com/videos/acute-gallbladder-treatment

  Acute cholecystitis is characterized by sudden onset and urgent symptoms, while chronic cholecystitis involves long-standing inflammation. […] The hallmark symptom of acute cholecystitis is severe upper abdominal pain, particularly in the upper right quadrant. This pain may radiate to the right shoulder blade or back and can be sharp, dull, or crampy. It often intensifies with deep breathing. Other common symptoms include: Nausea and vomiting, Fever (over 100F) in some cases, Abdominal bloating, Muscle stiffness in the right abdomen, General weakness and fatigue, especially in older adults. […] If diagnosed with acute cholecystitis, hospitalization is often necessary for treatment. Initial management typically involves: Fasting to relieve strain on the gallbladder, Intravenous (IV) fluids to prevent dehydration, Pain management, Antibiotics if a bacterial infection is suspected.

• #106 Acute cholecystitis

  https://www2.hse.ie/conditions/acute-cholecystitis/

  If you have acute cholecystitis, you will need to go to hospital for treatment. […] Initial treatment usually involves: fasting (not eating or drinking) to take the strain off your gallbladder, receiving intravenous (through a drip into a vein) fluids to prevent dehydration, taking medicine for your pain. […] After initial treatment, any gallstones usually fall back into the gallbladder. The inflammation will often improve. […] After initial treatment, you may need your gallbladder removed. This prevents acute cholecystitis from coming back. It also reduces your risk of developing serious complications. […] Without proper treatment, acute cholecystitis can sometimes lead to life-threatening complications. […] The main complications of acute cholecystitis are gangrenous cholecystitis and perforated gallbladder.

• #107 Acute cholecystitis

  https://www2.hse.ie/conditions/acute-cholecystitis/

  If you have acute cholecystitis, you will need to go to hospital for treatment. […] Initial treatment usually involves: fasting (not eating or drinking) to take the strain off your gallbladder, receiving intravenous (through a drip into a vein) fluids to prevent dehydration, taking medicine for your pain. […] After initial treatment, any gallstones usually fall back into the gallbladder. The inflammation will often improve. […] After initial treatment, you may need your gallbladder removed. This prevents acute cholecystitis from coming back. It also reduces your risk of developing serious complications. […] Without proper treatment, acute cholecystitis can sometimes lead to life-threatening complications. […] The main complications of acute cholecystitis are gangrenous cholecystitis and perforated gallbladder.

• #108 Cholecystitis: Symptoms and Treatment

  https://patient.info/digestive-health/gallstones-and-bile/cholecystitis

  The main treatments for cholecystitis are: Pain relief. […] Surgery to remove the gallbladder. This is called a cholecystectomy. […] For many people, surgery to remove the gallbladder (cholecystectomy) is recommended, because there is a high risk of cholecystitis occurring again, and it may cause serious problems. […] Surgery is usually recommended for people with cholecystitis. Treatment with antibiotics, fluids, and pain relief can settle down the inflammation from cholecystitis, but there’s a high chance of it coming back without surgery.

• #109

  https://www.nhs.uk/conditions/gallstones/complications/

  If a bile duct becomes permanently blocked, it can lead to a build-up of bile inside the gallbladder. This can cause the gallbladder to become infected and inflamed. […] The medical term for inflammation of the gallbladder is acute cholecystitis. […] Symptoms include: pain in your upper abdomen that travels towards your shoulder blade (unlike biliary colic, the pain usually lasts longer than 5 hours), a high temperature, a rapid heartbeat. […] An estimated 1 in 10 people with acute cholecystitis also experience jaundice. […] Acute cholecystitis is usually first treated with antibiotics to settle the infection and then keyhole surgery to remove the gallbladder. […] Sometimes a severe infection can lead to a gallbladder abscess (empyema of the gallbladder). Antibiotics alone don’t always treat these and they may need to be drained.

• #110 Cholecystitis | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/cholecystitis/

  The gallbladder is an organ that stores bile, a fluid that helps break down fats from food. An inflamed gallbladder is called cholecystitis. This condition can be acute (happen suddenly) or chronic (occur over time). […] Signs of cholecystitis may include: Crampy pain that comes and goes in the upper right or upper middle area of the abdomen, Fever or chills, Abdominal swelling, Nausea or vomiting. […] The ultimate treatment for cholecystitis is to remove the gallbladder with an operation called a laparoscopic cholecystectomy. The timing of this procedure will depend on your childs symptoms and level of sickness when we diagnose them.

• #111 Acute Cholecystitis – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/acute-cholecystitis

  Acute cholecystitis is inflammation of the gallbladder that develops over hours, usually because a gallstone obstructs the cystic duct. Symptoms include right upper quadrant pain and tenderness, sometimes accompanied by fever, chills, nausea, and vomiting. […] Most patients have had prior attacks of biliary colic or acute cholecystitis. The pain of cholecystitis is similar in quality and location to biliary colic but lasts longer (ie, 6 hours) and is more severe. Vomiting is common, as is right subcostal tenderness. Within a few hours, the Murphy sign (deep inspiration exacerbates the pain during palpation of the right upper quadrant and halts inspiration) develops along with involuntary guarding of upper abdominal muscles on the right side. Fever, usually low grade, is common. […] Acute cholecystitis begins to subside in 2 to 3 days and resolves within 1 week in 85% of patients, even without treatment.

• #112 The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

  https://www.mdpi.com/2077-0383/13/9/2695

  Acute cholecystitis (AC), generally associated with the presence of gallstones, is a relatively frequent disease that can lead to serious complications. For these reasons, AC warrants prompt clinical diagnosis and management. There is general agreement in terms of considering early laparoscopic cholecystectomy (ELC) to be the best treatment for AC. The optimal timeframe to perform ELC is within 72 h from diagnosis, with a possible extension of up to 7–10 days from symptom onset. […] AC is an acute inflammatory disease of the gallbladder that sometimes can progress to a number of local complications, such as gangrenous cholecystitis, gallbladder perforation, pericholecystic abscess, biliary peritonitis, biliary fistula, emphysematous cholecystitis, gallbladder empyema, and hemorrhagic cholecystitis. In a minority of cases, systemic complications may occur.

• #113 Biliary Colic and Cholecystitis – TeachMeSurgery

  https://teachmesurgery.com/hpb/gall-bladder/colic-and-cholecystitis/

  Patients with acute cholecystitis will report a constant pain in the RUQ or epigastrium, associated with signs of inflammation, such as fever or lethargy. […] Patients with acute cholecystitis will be tender in the RUQ and may demonstrate a positive Murphys sign. […] Studies have shown for those who are symptomatic, over 50% will present as biliary colic and 35% as an acute cholecystitis. […] Biliary colic occurs when the gallbladder neck becomes impacted by a gallstone. […] Patients with acute cholecystitis should be started on appropriate intravenous antibiotics (such as co-amoxiclav +/- metronidazole). […] A laparoscopic cholecystectomy is indicated within 1 week of presentation, as per NICE guidance, however this ideally should be done within 72hrs of presentation for a likely simpler procedure.

• #114 Acute Cholecystitis – Zero To Finals

  https://zerotofinals.com/surgery/general/acutecholecystitis/

  Acute cholecystitis refers to inflammation of the gallbladder, which is caused by a blockage of the cystic duct preventing the gallbladder from draining. It is a key complication of gallstones, and the majority of cases (around 95%) are caused by gallstones (calculous cholecystitis). The main presenting symptom of cholecystitis is pain in the right upper quadrant (RUQ). This may radiate to the right shoulder. Other features include: Fever, Nausea, Vomiting, Tachycardia (fast heart rate) and tachypnoea (raised respiratory rate), Right upper quadrant tenderness, Murphy’s sign, Raised inflammatory markers and white blood cells. Murphy’s sign is suggestive of acute cholecystitis: Place a hand in RUQ and apply pressure. Ask the patient to take a deep breath in. The gallbladder will move downwards during inspiration and come in contact with your hand. Stimulation of the inflamed gallbladder results in acute pain and sudden stopping of inspiration. Patients with suspected acute cholecystitis need emergency admission for investigations and management. Cholecystectomy (removal of the gallbladder) is usually be performed during the acute admission, within 72 hours of symptoms. In some cases, it may be delayed for 6-8 weeks after the acute episode to allow the inflammation to settle. […] Gallbladder empyema refers to infected tissue and pus collecting in the gallbladder.

• #115 Treatment of acute calculous cholecystitis – UpToDate

  https://www.uptodate.com/contents/treatment-of-acute-calculous-cholecystitis

  Acute cholecystitis is a syndrome of right upper quadrant pain, fever, and leukocytosis associated with gallbladder inflammation. It typically occurs in patients with gallstones (ie, acute calculous cholecystitis [ACC]), while acalculous cholecystitis accounts for a minority (5 to 10 percent) of cases. Complications of acute cholecystitis include gallbladder gangrene or perforation, which can be life-threatening. […] Patients with ACC usually present with severe and steady abdominal pain in the right upper quadrant or epigastrium, fever, and leukocytosis. A positive Murphy’s sign on physical examination supports the diagnosis. In most cases, the diagnosis can be established with an abdominal ultrasound or a cholescintigraphy if the ultrasound is equivocal. […] Cholecystectomy is the mainstay of treatment for ACC. Poor surgical candidates may benefit from initial nonoperative management with antibiotics and a gallbladder drainage procedure; those whose surgical risk improves after resolution of the acute inflammation should undergo elective gallbladder surgery to prevent recurrent symptoms.

• #116 All about Cholecystitis – Symptoms, Diagnosis, and Treatment | Medanta

  https://www.medanta.org/patient-education-blog/all-about-cholecystitis-symptoms-diagnosis-and-treatment

  The primary and foremost indication is extreme pain in the upper right section of the abdomen. The pain might transfer to the back and right shoulder as well. The pain is at its peak when you have eaten something or are taking long breaths. Some other common signs to look for are as below. […] Mild fever that may not be experienced by older adults. This symptom is also not likely to be observed in chronic cholecystitis patients. […] Two kinds of surgeries can be performed to treat acute cholecystitis. One is to remove the entire gallbladder which is usually done through a laparoscope. In case, the patient is too weak for surgery, then the treatment option is to drain the entire organ percutaneously with the help of USG to prevent the infection from spreading any further.

• #117 Acute Cholecystitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK459171/

  Acute cholecystitis is inflammation of the gallbladder that occurs due to occlusion of the cystic duct or impaired emptying of the gallbladder. […] Acute cholecystitis refers to inflammation of the gallbladder. The pathophysiologic mechanism of acute cholecystitis is blockage of the cystic duct. […] Cases of acute cholecystitis have similar symptoms only more severe. Often symptoms are mistaken for cardiac issues. The finding of right upper abdominal pain with deep palpation, Murphy sign, is usually classic for this disease. […] Regardless of the cause of the blockage, the gallbladder wall edema will eventually cause wall ischemia and become gangrenous. The gangrenous gallbladder can become infected by gas-forming organisms, causing acute emphysematous cholecystitis; all of these conditions can quickly become life-threatening, and rupture has a high rate of mortality. […] For patients with uncomplicated acute cholecystitis, the prognosis is excellent. The mortality rates are very low. Perforation or gangrene of the gallbladder may occur in delayed cases. Patients with acalculous cholecystitis have high mortality varying from 20-50%.

• #118 Acute Cholecystitis | The Surgery Group

  https://thesurgerygroup.com/condition/acute-cholecystitis/

  When the gallbladder becomes inflamed it can be painful at best and dangerous at worst. Surgery is often needed to solve this urgent problem. […] When your gallbladder becomes severely inflamed, that condition is known as acute cholecystitis. […] The most commonly experienced symptom of acute cholecystitis is abdominal pain of several hours’ duration. This pain is most often felt in the upper right or center of your abdomen. You may also feel it spread into your flank, back, or your right shoulder. Other symptoms that can accompany the pain include: Fever, Nausea and vomiting, Pain after a meal, Bloating in the abdomen, Chills. […] Gallbladder inflammation can be serious and in some cases life-threatening if left untreated. Most patients are hospitalized for antibiotics and IV fluids. Removal of the gallbladder is the usual next step depending on the patient’s condition. […] After surgery, patients usually recover rapidly and completely. Some patients are too ill for surgery right away, and instead, a drainage tube is placed into the gallbladder to help treat the underlying infection. Eventually, these patients will need gallbladder removal too.

• #119 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  Jaundice (~15% of patients). […] The absence of physical findings, however, does not rule out the diagnosis of cholecystitis. […] Acute cholecystitis may present differently in special populations, as follows: […] Elderly (especially diabetics) May present with vague symptoms and without many key historical and physical findings (eg, pain and fever), with localized tenderness being the only presenting sign; may progress to complicated cholecystitis rapidly and without warning. […] Delays in making the diagnosis of acute cholecystitis result in a higher incidence of morbidity and mortality. […] Once complications such as perforation/gangrene develop, the prognosis becomes less favorable. […] Some 25%-30% of patients either develop some type of complication or require emergency surgery.

• #120 Acute Cholecystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/171886-overview

  Patients with acalculous cholecystitis have a mortality ranging from 10%-50%, which far exceeds the expected 4% mortality observed in patients with calculous cholecystitis. […] In patients who are critically ill with acalculous cholecystitis and perforation or gangrene, mortality can be as high as 50%-60%. […] Because of the rapid progression of acute acalculous cholecystitis to gangrene and perforation, early recognition and intervention are required.

• #121 Acute Cholecystitis – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/acute-cholecystitis

  Without treatment, patients can develop localized or free perforation and peritonitis. Increasing abdominal pain, high fever, and rigors with rebound tenderness or ileus suggest empyema (pus) in the gallbladder, gangrene, or perforation. […] The symptoms are similar to those of acute cholecystitis with gallstones but may be difficult to identify because patients tend to be severely ill (eg, in an intensive care unit) and may be unable to communicate clearly. Abdominal distention or unexplained fever may be the only clue. Untreated, the disease can rapidly progress to gallbladder gangrene and perforation, leading to sepsis, shock, and peritonitis; mortality approaches 65%.

• #122 Cholecystitis – Liver and Gallbladder Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/gallbladder-and-bile-duct-disorders/cholecystitis

  Fever occurs in about one third of people with acute cholecystitis. The fever tends to rise gradually to above 100.4 F (38 C) and may be accompanied by chills. […] Typically, an attack subsides in 2 to 3 days and completely resolves in a week. If the acute episode persists, it may signal a serious complication. Increasingly severe pain, a high fever, and chills suggest pockets of pus (abscesses) in or a tear (perforation) in the gallbladder. […] Acalculous cholecystitis typically causes sudden, excruciating pain in the upper abdomen in people with no previous symptoms or other evidence of a gallbladder disorder. The inflammation is often very severe and can lead to gangrene or rupture of the gallbladder. […] If untreated, acalculous cholecystitis results in death for 65% of people.

• #123 Acute Cholecystitis | The Surgery Group

  https://thesurgerygroup.com/condition/acute-cholecystitis/

  When the gallbladder becomes inflamed it can be painful at best and dangerous at worst. Surgery is often needed to solve this urgent problem. […] When your gallbladder becomes severely inflamed, that condition is known as acute cholecystitis. […] The most commonly experienced symptom of acute cholecystitis is abdominal pain of several hours’ duration. This pain is most often felt in the upper right or center of your abdomen. You may also feel it spread into your flank, back, or your right shoulder. Other symptoms that can accompany the pain include: Fever, Nausea and vomiting, Pain after a meal, Bloating in the abdomen, Chills. […] Gallbladder inflammation can be serious and in some cases life-threatening if left untreated. Most patients are hospitalized for antibiotics and IV fluids. Removal of the gallbladder is the usual next step depending on the patient’s condition. […] After surgery, patients usually recover rapidly and completely. Some patients are too ill for surgery right away, and instead, a drainage tube is placed into the gallbladder to help treat the underlying infection. Eventually, these patients will need gallbladder removal too.

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