Gallstones are often the source of cholecystitis. If the gallstone blocks one of the cystic ducts it can lead to a concentration or thickening of the bile called inspissation. It can also lead to a state where the normal flow of the bile is completely stopped called stasis. This can cause additional infection produced by the bacteria and other organisms of the intestines.
The first symptom of cholecystitis is usually pain in the upper right-hand quadrant of your abdomen. It can start out spasmodic but is most of the time severe and consistent pain. Referred pain is if it is felt in your right shoulder or below your shoulder blade.
The gallbladder area may be swollen and tender, and is most often accompanied by a slightly increased temperature, vomiting, nausea, and watery stools.
As the condition gets worse, life-threating conditions supervene including greatly increased temperatures, jaundice – which is an indication of liver problems, or shock.
A perforation of the gallbladder would cause the bile to leak into the abdominal cavity, and in essence, cause a digesting of your other organs. If it forms a fistula or an opening with the small bowel it can lead to intestinal obstruction, which can also be life-threatening.
Diagnosis of cholecystitis is found with physical examination, history of any of these symptoms, laboratory findings, and imaging tests. Ultrasound would be elicited upon a positive Murphy’s sign. This is a part of an abdominal examination in which the physician will ask the patient to breathe in and out while the physician places a hand below the ribs on the right side.
If the gallbladder is inflamed the patient will stop breathing and exhibit pain when the gallbladder comes in contact with the doctor’s fingers.
Another radiology test used to diagnose cholecystitis is a CT scan. Either CT scan or ultrasound would show a thickening of the gallbladder wall, extra fluid and the positive Murphy’s sign. Blood tests would show elevated hydrolase enzyme responsible for removing phosphates, increased bilirubin which is a compound of the bile, and maybe increased white blood count which is consistent with infection.
Complications of cholecystitis include rupturing of the gallbladder, or ascending cholangitis, which is an infection caused by bacteria of the bile duct. Rokitansky-Aschoff sinuses, pockets or out-pouch in the wall of the gallbladder, are formed as a result of increased pressure and recurrent damage to the wall of the gallbladder.
Cholecystitis is a serious illness and the signs and symptoms of it should not be ignored. Talk with your doctors if you notice any cholecystitis symptoms.