Symptoms of acute cholecystitis

Written by Xie Zheng Yuan
Gastroenterology
Updated on February 27, 2025
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Acute cholecystitis is a relatively common digestive system disease in clinical practice, often triggered by the presence of gallstones, leading to acute inflammation of the gallbladder. When an acute cholecystitis attack occurs, it typically presents as pain in the upper right abdomen, accompanied by fever, and sometimes nausea and vomiting, similar to symptoms of gastric discomfort. Additionally, if a gallstone falls and lodges in the cystic duct, or even in the common bile duct, it can cause jaundice, as indicated by the yellowing of the skin and sclera. During a physical examination, it might be possible to detect tenderness in the upper right abdomen, or even rebound tenderness. Another possible positive sign could be Murphy's sign, which are all common manifestations of acute cholecystitis.

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Written by Wu Hai Wu
Gastroenterology
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Do you need to fast and hold your urine for a gallbladder inflammation B-ultrasound?

When undergoing an ultrasound for cholecystitis, fasting is required, but there is no need to hold urine. However, if the examination involves the adnexa of the uterus, bladder, prostate, and other areas, it requires holding urine to perform the test, allowing the prostate, adnexa, etc., to sufficiently distend. This helps in more clearly observing pathological changes. Patients with cholecystitis need to fast before an ultrasound. If food is consumed before the scan, the gallbladder contracts more quickly, making it difficult to accurately identify lesions. Patients with cholecystitis may experience chills, fever, right upper abdominal pain, jaundice, yellowing skin, dark urine, etc. In severe cases, patients may develop septic shock and require active treatment measures.

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Written by Zhao Xin Lan
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Does cholecystitis require surgery?

Whether cholecystitis requires surgery depends on the acute or chronic status of the inflammation and its severity. If it is acute suppurative cholecystitis, emergency surgery is needed to avoid gallbladder perforation and resultant peritonitis, which could lead to serious septic shock, thus emergency surgical treatment is necessary. If it is mild chronic cholecystitis, elective surgery can be considered, and there is no need for emergency treatment. If it is asymptomatic chronic cholecystitis, it can also be managed with dietary adjustments and symptomatic medical treatment, and surgery may not be strictly necessary.

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Written by Huang Gang
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How to treat gallbladder inflammation pain in women?

Women with cholecystitis causing pain, when the condition is more severe, can appropriately consume some antispasmodic and analgesic medications, and simultaneously use antibiotics for treatment, to alleviate these symptoms of pain. Normally, a light diet should be maintained, avoiding overly greasy foods. Smoking and alcohol should be quit, spicy peppers should not be consumed, and it is best to avoid fried foods or barbecued items. Regular attention to developing good dietary and lifestyle habits is necessary to manage the condition and reduce the likelihood of recurrent cholecystitis.

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Written by Zhang Jun Jun
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Which department should I go to for cholecystitis?

Firstly, it is necessary to determine the cause of the cholecystitis. The most common type of cholecystitis is caused by gallstones. If the cholecystitis is an acute episode caused by gallstones, leading to pain, nausea, vomiting, or even high fever, surgical intervention is usually indicated. It is generally recommended to consult with departments such as general surgery or hepatobiliary surgery, as emergency surgery may be needed. The second scenario involves cases where cholecystitis is detected during routine physical examinations without symptoms. Ultrasound may show gallstones or gallbladder polyps. In symptom-free situations, it is possible to consult general departments like gastroenterology, and regular follow-ups and checks of inflammation indicators, as well as abdominal ultrasonography, can be performed to monitor the dynamic changes of the cholecystitis. The third scenario pertains to cholecystitis where new techniques such as MRCP are available. With this technology, gallstones can be removed under endoscopic guidance. Generally, these procedures are performed in the gastroenterology department. Thus, for acute cholecystitis with choledocholithiasis and concurrent biliary pancreatitis, it may be treated with endoscopic techniques under gastroenterology, avoiding the need for traditional or minimally invasive surgery. Therefore, patients with cholecystitis may visit either the hepatobiliary surgery or gastroenterology departments.

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What are the serious consequences of cholecystitis?

The severe consequences of cholecystitis include gangrene and perforation of the gallbladder, leading to obvious signs of peritonitis throughout the abdomen, with noticeable tenderness and rebound pain. For patients with recurrent cholecystitis, it is advisable to use antibiotics for anti-infection treatment as soon as possible, as the condition can only be alleviated after the inflammation is under control. During recurrent episodes, surgical treatment should also be considered promptly. Removal of the gallbladder through surgery is the only way to achieve a radical cure. In most cases, laparoscopic cholecystectomy is chosen because it has the advantages of smaller incisions, less damage, and faster recovery, and is therefore often the preferred option in clinical settings. Patients who have undergone surgery should also avoid spicy and irritating foods to reduce inflammation and better facilitate recovery.