Acute cholecystitis is inflammation (swelling) of the gallbladder. It is usually caused by a gallstone that becomes trapped in one of the ducts or openings of the gallbladder.
The most common symptoms of acute cholecystitis are:
- a severe, sharp and constant pain in the upper right abdomen (tummy), which may be worse when breathing deeply or if the abdomen is touched
- a high temperature, or fever, of 38C (100.4F) or above
Although acute cholecystitis is not a medical emergency, if it is not treated, it can lead to a number of serious and potentially fatal complications, such as:
- the death of the tissue of the gallbladder, called gangrenous cholecystitis, which can cause a serious infection
- the gallbladder splitting open, which is known as a perforated gallbladder
Therefore, if acute cholecystitis is suspected, immediate referral to hospital is recommended.
The gallbladder
The gallbladder is a small, pear-shaped organ that is located underneath the liver. The main purpose of the gallbladder is to store and concentrate bile.
Bile is a liquid produced by the liver that helps digest fats. It is passed from the liver through a series of channels, called bile ducts, into the gallbladder, where it is stored.
Over time, bile becomes more concentrated, which increases its effectiveness at digesting fats. The gallbladder releases bile into the digestive system when it is needed.
The gallbladder is a useful, but not essential, organ. The gallbladder can safely be removed without interfering with your ability to digest food.
Gallstones
Gallstones are small stones that form in the gallbladder. They are usually made of cholesterol.
If a gallstone becomes trapped in the main opening of the gallbladder, called the cystic duct, it can cause the gallbladder to become severely inflamed. Exactly why the blocked duct causes such severe levels of inflammation is unclear.
See the Health A-Z topic about Gallstones for more information.
How common is acute cholecystitis?
Acute cholecystitis is a fairly uncommon complication of gallstones. In England, it is estimated that 10-15% of the adult population has gallstones. In most cases, they do not cause symptoms.
About 1-4% of people with gallstones experience infrequent episodes of pain, known as biliary colic. Around one in five of these people develops acute cholecystitis if their gallbladder is not surgically removed.
Each year in England, there are an estimated 13,000 admissions to hospital for acute cholecystitis.
Outlook
The outlook for acute cholecystitis is generally good, as long as the condition is diagnosed promptly and treatment begins before any complications develop.
Acute cholecystitis can be treated by removing the gallbladder in a procedure known as a cholecystectomy.
Emergency surgery is usually required to treat complications that arise from acute cholecystitis. Despite the best efforts of the surgical team, this type of surgery is not always successful, particularly in older people or people who have other serious health conditions.
During 2008 in England and Wales, there were 222 deaths as a result of acute cholecystitis, mostly in people aged 70 years or over.
