Cholecystitis Quiz

Understanding Cholecystitis

Cholecystitis is the inflammation of the gallbladder, a small organ situated beneath the liver. Its primary function is to store and concentrate bile produced by the liver. This condition is a common cause of abdominal pain and often requires medical intervention. This quiz covers key aspects of its pathophysiology, diagnosis, and management.

What is Cholecystitis?

Cholecystitis occurs when the gallbladder becomes inflamed. This inflammation is most commonly caused by a blockage of the cystic duct, the tube that drains bile from the gallbladder. The trapped bile leads to irritation, pressure buildup, and inflammation of the gallbladder wall. It can be acute (sudden onset) or chronic (long-lasting, often from repeated attacks).

Common Causes and Risk Factors

The vast majority of acute cholecystitis cases are caused by gallstones (cholelithiasis) obstructing the cystic duct. This is known as calculous cholecystitis. Less commonly, acalculous cholecystitis occurs without gallstones, often in critically ill patients. Key risk factors include:

• Female gender: Hormones like estrogen can increase the risk of gallstones.
• Age: Risk increases, particularly over 40.
• Obesity: Associated with higher cholesterol levels in bile.
• Rapid weight loss: Can cause the liver to release more cholesterol into the bile.
• Family history: A genetic predisposition can play a role.
• Certain medical conditions: Diabetes, Crohn’s disease, and cirrhosis increase risk.

Signs and Symptoms

The hallmark symptom of acute cholecystitis is severe, steady pain in the upper right quadrant (RUQ) of the abdomen. This pain may radiate to the right shoulder or back. Other common symptoms include:

• Pain that worsens with deep breaths
• Tenderness over the abdomen when touched
• Nausea and vomiting
• Fever and chills
• Positive Murphy’s sign (inspiratory arrest upon palpation of the RUQ)

Diagnostic Process

Diagnosis typically begins with a physical exam and medical history. A clinician will likely order blood tests to check for signs of inflammation (elevated white blood cell count) and abnormal liver function tests. The primary diagnostic tool is an abdominal ultrasound, which is highly effective at visualizing gallstones, gallbladder wall thickening, and pericholecystic fluid, all signs of cholecystitis. In some cases, a HIDA scan may be used to assess gallbladder function.

Treatment Options

Initial management for acute cholecystitis usually involves hospitalization for bowel rest (NPO – nothing by mouth), intravenous (IV) fluids to prevent dehydration, pain medication, and antibiotics to treat potential infection. The definitive treatment is the surgical removal of the gallbladder, a procedure called cholecystectomy. This is most often performed laparoscopically (laparoscopic cholecystectomy), which is minimally invasive and allows for a quicker recovery.

Potential Complications

If not treated promptly, cholecystitis can lead to severe complications such as gangrene (tissue death) of the gallbladder, perforation (a hole in the gallbladder wall), abscess formation, or the formation of a fistula (an abnormal connection) to an adjacent organ. These complications significantly increase the morbidity and mortality of the condition.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.