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Cholecystitis

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

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Basics

Description

Cholecystitis is defined as inflammation of the gallbladder.

Etiology

  • 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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Citation

Rosen, Peter, et al., editors. "Cholecystitis." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307605/all/Cholecystitis.
Cholecystitis. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307605/all/Cholecystitis. Accessed June 27, 2019.
Cholecystitis. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307605/all/Cholecystitis
Cholecystitis [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 June 27]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307605/all/Cholecystitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Cholecystitis ID - 307605 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307605/all/Cholecystitis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -