Acute Cholecystitis - Causes, Symptoms, Physical Signs, Diagnosis & Treatment
Acute cholecystitis is defined as inflammation of the gallbladder. Major functions of the gallbladder are to store excess bile, and concentration of bile. Bile is produced in the liver and has many important functions. Some of them include facilitation of lipid digestion and absorption, excretion of bilirubin and excess cholesterol, and neutralization of the acidity in the duodenum. Bile consists of about 95% of water, in which are dissolved a number of solid constituents, including bile salts; bilirubin phospholipid; cholesterol; drugs and their metabolites; and other compounds such as amino acids and enzymes, vitamins, heavy metals etc.
The most common cause of acute cholecystitis is gallstone disease. When gallstones get lodged in the cystic duct, it causes gallbladder wall irritation and damage when the gallbladder contracts, which leads to gallbladder inflammation, giving rise to the signs and symptoms of acute cholecystitis. In addition to inflammation, there is gallbladder distension, and the pressure within the gallbladder is also increased. This will facilitate bacterial growth, especially the E coli. A minority of acute cholecystitis cases can occur without gallstone disease. This condition is called Ae calculous acute cholecystitis and is associated with gallbladder stasis and ischemia. It is mainly seen in critically ill patients who are hospitalized and on prolonged immobilization. Risk factors for developing this condition include sepsis. Diabetes mellitus. Immune suppression. Cytomegalovirus infection. Total parenteral nutrition. Major trauma. And burns.
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