Information From Your Health Care Provider

CHOLECYSTITIS or CHOLANGITIS

Basic information

description

Cholecystitis is inflammation of the gallbladder. It can be acute or chronic. Cholangitis is inflammation and infection of the bile ducts (tubes that carry bile from the liver to the gallbladder and small intestine). These conditions occur more often in older adults (rarely in children). Cholecystitis affects women more than men.

FREQUENT SIGNS & SYMPTOMS

Cramping pain in the upper right of the abdomen. Pain may also occur in the chest (imitating a heart attack), in the upper back, or the right shoulder. These symptoms frequently follow a meal rich in fats.
Tenderness in the upper abdomen.
Nausea, vomiting, or belching.
Slight fever. High fever and chills if there is infection.
Jaundice (yellow skin and eyes) may occur.
Stools may change color.
Cholangitis may cause mental status changes.

causes

Cholecystitis usually results when a gallstone blocks the outlet of the gallbladder and bile builds up. Chronic cholecystitis results from recurrent inflammation.
Acalculous cholecystitis is inflammation not caused by gallstones. It may be due to severe illness, surgery, burns, or injury.
In cholangitis, the main bile duct becomes blocked by one or more gallstones or a tumor. Bile builds up behind the blockage and leads to a bacterial infection.

risk increases with

Older adults.
Gallstones.
Pregnancy.
Hispanic populations and American Indians.
Being overweight or rapid weight loss.
Certain drugs (e.g., hormone therapy in women).
Major surgery, severe trauma/burns, or critical illness.

PREVENTIVE MEASURES

No specific preventive measures.

expected outcomes

With cholecystitis, some mild attacks clear up on their own. Recurrences are common. Attacks will stop after surgery to remove the gallbladder.
Outcome is generally good in cholangitis. It depends on early diagnosis and treatment and patient's health.

possible complications

Peritonitis (inflammation of abdomen lining).
Blood infection (sepsis).
Liver, kidney, or pancreas problems.
Gallstones may cause intestinal blockage.
Treatments may cause complications.

diagnosis & treatment

general measures

Your health care provider will do a physical exam and ask questions about your symptoms and medical history. Medical tests usually include blood studies along with ultrasound and other imaging techniques.
Specific treatment will depend on severity of symptoms, infection, and your general health. Hospital care is normally needed. Emergency surgery may be required for severe cases. Fluids may be given through a vein (IV).
Treatment may include drugs for pain or other symptoms, antibiotics for infection, and diet changes (once patient can eat).
Surgical removal of the gallbladder (cholecystectomy) is usually recommended for cholecystitis. It may be done using a laparoscope (an instrument placed into 4 small slits in the abdomen) or with open surgery (through an incision).

medications

Drugs for pain and vomiting may be prescribed.
Antibiotics are usually prescribed for infection.

activity

Rest in bed until symptoms disappear or recovery from surgery is complete. While in bed, move your legs often to reduce the risk of deep-vein blood clotting.
Other limits on activity will depend on treatment.

diet

Food intake will be limited during hospital care.
A low-fat diet may be recommended.

notify our office if

You or a family member has symptoms of cholecystitis or cholangitis. If symptoms include shortness of breath, sweating, and nausea, seek emergency help!
Fever, jaundice, recurrent vomiting, or severe pain develops after diagnosis or treatment.