Cholecystitis is a topic covered in the 5-Minute Emergency Consult.

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Cholecystitis is defined as inflammation of the gallbladder.


  • Acute calculous cholecystitis:
    • Owing to bile stasis secondary to prolonged obstruction by a gallstone (see “Cholelithiasis”) in the gallbladder neck, cystic duct, or common bile duct
    • Leads to increased intraluminal pressure and mucosal damage
    • Release of inflammatory mediators results in distention, edema, and increased vascularity.
    • Coliforms and anaerobes lead to infection—primary causal role is controversial.
  • Acalculous cholecystitis:
    • 10% of cases
    • Underlying critical illness leads to biliary stasis and mucosal ischemia.
    • Subsequent mucosal inflammation and infection

Pediatric Considerations
  • Acute calculous cholecystitis extremely rare in childhood (see “Cholelithiasis”)
  • Acalculous cholecystitis more common than calculous form in children:
    • Associated with systemic bacterial infections, scarlet fever, Kawasaki disease, and parasitic infections

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