What are the other Names for this Condition? (Also known as/Synonyms)
- Chronic Cholecystitis, NOS
What is Chronic Cholecystitis? (Definition/Background Information)
- Chronic Cholecystitis is inflammation and irritation of the gallbladder that persists over time
- The gallbladder is a sac-like organ located close to the liver. It stores bile, which is an enzyme used to digest fat
- Chronic Cholecystitis may result from repeated attacks of Acute Cholecystitis
- Acute Cholecystitis is abdominal pain caused by an inflamed and infected gallbladder. This is due to the blockage of flow of bile, resulting from a gallstone
- Chronic Cholecystitis occurs more often in women than men, especially after the age of 40 years
Who gets Chronic Cholecystitis? (Age and Sex Distribution)
- All races and ethnic groups are prone to this disorder
What are the Risk Factors for Chronic Cholecystitis? (Predisposing Factors)
The risk factors for Chronic Cholecystitis are:
- Age 60 years or more
- Pregnant women, or those who have had several pregnancies
- Women under estrogen replacement therapy, or those who take birth-control pills
- Obese individuals
- Individuals who have lost weight rapidly
- Consuming a high-fat diet
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Chronic Cholecystitis? (Etiology)
- Chronic Cholecystitis occurs due to repeated bouts/attacks of Acute Cholecystitis. A leading cause of these attacks is due to the presence of gallstones in the gallbladder. These attacks of inflammation, irritation, swelling, and infection, cause the walls of gallbladder to thicken and shrink in size
- With persistent inflammation, the capacity of the gallbladder to store, concentrate, and release bile, decreases
What are the Signs and Symptoms of Chronic Cholecystitis?
- Chronic Cholecystitis manifests with a set of nonspecific symptoms, which include nausea, vague, abdominal pain, belching, and diarrhea
- Acute Cholecystitis on the other hand, causes right upper quadrant abdominal pain; though, the pain may be referred to the shoulder. This is accompanied by low-grade fever, diarrhea, vomiting, nausea and increased white cell counts in blood
- Chronic Cholecystitis often develops as a result of repeated attacks of Acute Cholecystitis
- When severe symptoms, like jaundice, high-fever, and shock, are observed; then, it indicates the development of complications, like abscess formation, perforation, or intestinal obstruction
How is Chronic Cholecystitis Diagnosed?
Chronic Cholecystitis is diagnosed by a medical history, physical exam, and lab tests. These include:
- Abdominal computed tomography scan: This test provides an excellent view of the gallbladder and its surrounding structures, like liver, bile ducts, intestines, and pancreas
- Abdominal ultrasound of the gallbladder and bile ducts: It is a non-invasive procedure that uses sound waves to create images of the affected regions. Normally, physicians recommend an ultrasound as the first test, to confirm cholecystitis
- Gallbladder scan (HIDA scan): This test looks for a blocked gallbladder or bile ducts. A radioactive chemical is injected, which passes through the blood into the bile ducts. Pictures taken by a special camera, along the chemical flow path, aids in the detection of any bile duct or gallbladder blockages
Other tests may include:
- Complete blood count showing elevated white cell count
- Amylase and lipase, to diagnose diseases of the pancreas
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Chronic Cholecystitis?
The complications of Chronic Cholecystitis include:
- Cancer of the gallbladder (rare)
- Worsening of the condition
- Acute Cholecystitis can lead to Chronic Cholecystitis. Severe Acute Cholecystitis may result in gallbladder rupture, which may lead to death, if it is not treated promptly
How is Chronic Cholecystitis Treated?
- Laparoscopic Cholecystectomy is the treatment of choice for Chronic Cholecystitis. The surgical procedure to remove the gallbladder is called cholecystectomy. Laparoscopic cholecystectomy is a technique in which smaller surgical cuts are used. Due to this, there is a faster recovery. The patients may be discharged from the hospital, on the same day of performing the surgery, or the next morning (after an overnight observation)
- If open cholecystectomy procedure is used, then a larger cut in the upper right part of the abdomen, is used
- Some individuals, who are medically too ill to have a surgery performed, due to the presence of other diseases, oral medications may be used to dissolve the gallstones, in such cases. This treatment method may take two or more years to work effectively, and there is a risk of the gallstones recurring after the treatment
How can Chronic Cholecystitis be Prevented?
- Chronic Cholecystitis is not always preventable
- Eating less fatty foods, controlling weight, and avoiding the risk factors, may relieve symptoms
- A removal of gallbladder (cholecystectomy) and gallstones, will prevent further attacks
What is the Prognosis of Chronic Cholecystitis? (Outcomes/Resolutions)
- The prognosis of Chronic Cholecystitis is generally good with prompt and effective treatment. The condition rarely leads to death, and serious complications are also rare
- Cholecystectomy is a common surgical procedure having a very low risk
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