Cholecystitis

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

To view the entire topic, please or .

Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:

-- The first section of this topic is shown below --

Basics

Description

Cholecystitis is caused by an inflammatory/infectious process involving the gallbladder (GB) wall, in many cases due to impacted gallstones

Etiology

  • Acute calculous cholecystitis:
    • Owing to bile stasis secondary to prolonged obstruction by a gallstone (see “Cholelithiasis”) in the GB neck, cystic duct, or common bile duct
    • Leads to increased intraluminal pressure and mucosal ischemia of the GB wall
    • Release of inflammatory mediators results in distention, edema, and increased vascularity
    • Bacterial inflammation involved in 50–58% of cases – typically a secondary event occurring late in course of disease
  • Acalculous cholecystitis:
    • 20% 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

-- To view the remaining sections of this topic, please or --

Basics

Description

Cholecystitis is caused by an inflammatory/infectious process involving the gallbladder (GB) wall, in many cases due to impacted gallstones

Etiology

  • Acute calculous cholecystitis:
    • Owing to bile stasis secondary to prolonged obstruction by a gallstone (see “Cholelithiasis”) in the GB neck, cystic duct, or common bile duct
    • Leads to increased intraluminal pressure and mucosal ischemia of the GB wall
    • Release of inflammatory mediators results in distention, edema, and increased vascularity
    • Bacterial inflammation involved in 50–58% of cases – typically a secondary event occurring late in course of disease
  • Acalculous cholecystitis:
    • 20% 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

There's more to see -- the rest of this entry is available only to subscribers.