Inflammed Vesicle: What is it? Causes, Symptoms, Diagnosis, Complications and Treatment

Index

It is inflammation usually due to an accumulation of stones (cholelithiasis) inside the gallbladder.

These stones get stuck in the opening of the gallbladder. It can cause fever, pain, nausea, and serious complications.

If left untreated, it can cause perforation of the gallbladder, death of tissue and gangrene, fibrosis and reduction of the gallbladder, or secondary bacterial infections.

Gallstones ( cholelithiasis ) are involved in 95 percent of cases of cholecystitis. These can be formed from cholesterol, a pigment known as bilirubin, or a mixture.

Bile dung can also be caused when bile accumulates in the bile ducts.

Other causes include trauma, critical illness, immunodeficiency, or certain medications. Some chronic medical conditions, such as kidney failure, coronary heart disease, or certain types of cancer, also increase the risk of cholecystitis.

Acute cholecystitis begins suddenly. Chronic cholecystitis develops slowly over time.

Causes

The gallbladder is a small pear-shaped organ connected to the liver on the right side of the abdomen. It stores bile and releases it into the small intestine to aid in the digestion of fat.

The gallbladder contains bile, a fluid released after eating, especially after a high-fat meal, and this bile aids digestion. Bile travels from the gallbladder through the cystic duct, a small tube leading to the common bile duct and the small intestine.

The leading cause of cholecystitis is that gallstones or bile dust are trapped in the gallbladder’s opening. This is sometimes called pseudolith or “false stone.”

Other causes include:

Injury to the abdomen from burns, sepsis or trauma, or due to surgery.
Immunodeficiency.
Long fasting.
Vasculitis.

An infection in the bile can cause inflammation of the gallbladder.

A tumor can prevent bile from leaving the gallbladder properly, resulting in an accumulation of bile. This can lead to cholecystitis.

symptom

Signs and symptoms of cholecystitis include pain in the right upper quadrant, fever, and a high white blood cell count.

The pain usually occurs around the gallbladder, in the upper right quadrant of the abdomen.

In cases of acute cholecystitis, the pain starts suddenly, does not go away, and is intense. If left untreated, it will usually worsen, and breathing deeply will make you feel more intense. Pain may radiate from the abdomen to the right shoulder or back.

Other symptoms may include:

Abdominal distension.
Sensitivity in the upper right side of the abdomen.
Little or no appetite.
Nausea.
Vomiting
Perspiration.

A slight fever and chills may be present with acute cholecystitis.

After a meal, especially one high in fat, the symptoms will worsen. A blood test can reveal a high white blood cell count.

Diagnosis

A doctor will usually ask if a patient has a history of cholecystitis because it often recurs. A physical examination will reveal how sensitive the gallbladder is.

The following tests may also be requested:

Ultrasound: This can highlight any gallstone and show the gallbladder condition.

Blood test: A high white blood cell count may indicate an infection. High levels of bilirubin, alkaline phosphatase, and serum aminotransferase can also help the doctor diagnose.

Computed tomography (CT) or ultrasound: images of the gallbladder may reveal signs of cholecystitis.

Hepatobiliary iminodiacetic acid (HIDA) scanner: Also known as cholescintigraphy, hepatobiliary scintigraphy, or hepatobiliary scintigraphy, this scan creates images of the liver, gallbladder, biliary tract, and small intestine.

This allows the doctor to track the production and flow of bile from the liver to the small intestine and determine if there is a blockage and where the backup is.

Risk factor’s

The following factors may increase the risk of developing gallstones:

Family history of gallstones on the maternal side of the family.
Crohn’s disease.
Diabetes.
Coronary artery disease
End-stage renal disease.
Hyperlipidemia.
Losing weight quickly.
Obesity.
Advanced age.
The pregnancy.

Prolonged labor during delivery can damage the gallbladder, increasing the risk of cholecystitis during the following weeks.

Complications

Untreated acute cholecystitis can lead to:

A fistula, a tube or channel, can develop if a large stone erodes the gallbladder wall. This can link the gallbladder and the duodenum, and the stone can pass.

Gallbladder distention: If the gallbladder is inflamed due to the accumulation of bile, it can stretch and swell, causing pain. There is a much greater risk of perforation or ripping in the gallbladder, infection, and tissue death.

Tissue death: The gallbladder tissue can die, and gangrene develops that can cause a perforation or burst the bladder. Without treatment, 10 percent of patients with acute cholecystitis will experience localized perforation, and 1 percent will develop free perforation and peritonitis.

If a gallstone is affected in the cystic duct, it can compress and block the common bile duct, and this can cause cholestasis. This is rare.

Gallstones can sometimes pass from the gallbladder to the biliary tract, leading to an obstruction of the pancreatic duct. This can cause pancreatitis.

In 3 percent to 19 percent of cases, acute cholecystitis can lead to a pericholecystic abscess. Symptoms include nausea, vomiting, and abdominal pain.

Treatment

A patient with cholecystitis will be hospitalized and probably will not be allowed to consume any solid or liquid food.

They will be given fluids intravenously during fasting. Pain medications and antibiotics can also be provided.

Surgery is recommended for acute cholecystitis because of a high recurrence rate of gallstone-related inflammation. However, if there is a low risk of complications, the surgery can be performed as an outpatient procedure.

If there are complications, such as gangrene or perforation of the gallbladder, the patient will need immediate surgery to remove the gallbladder. If the patient has an infection, a tube can be inserted through the skin to the gallbladder to drain the infection.

Removal of the gallbladder, or cholecystectomy, may be performed by open or laparoscopically abdominal excision.

Laparoscopic cholecystectomy consists of several small incisions in the skin. A camera is inserted into an incision to help the surgeon see inside the abdomen and tools to remove the gallbladder and inserted through the other incisions.

The benefit of laparoscopy is that the incisions are small, so patients generally have less pain after the procedure and fewer scars.

After surgically removing the gallbladder, the bile will flow directly to the small intestine from the liver. This usually does not affect the patient’s general health and digestive system. Some patients may have more frequent episodes of diarrhea.

Diet

When recovering from the condition, it is essential to make adjustments in the diet that help restore bile production to normal.

Eat smaller meals more often and avoid oversized portions or servings. These can disrupt the system and produce a gallbladder or bile duct spasm.

Avoid high-fat and fried foods, including whole-grain dairy products, and adhere to lean proteins.

Live without Gallbladder

As the gallbladder is not an essential organ, a person can lead an everyday life without one. The bile will still reach the small intestine through other passages in the liver instead of being stored in the gallbladder.

Prevention

Some measures may reduce the risk of developing gallstones, and this may decrease the chance of developing cholecystitis:

Avoiding saturated fats.
Maintain a regular breakfast, lunch, and dinner schedule and do not skip meals.
Exercise 5 days a week for at least 30 minutes each time.
Losing weight because of obesity increases the risk of gallstones.
Avoid rapid weight loss as this increases the risk of developing gallstones.

A healthy weight loss is usually around 1 to 2 pounds, or 0.5 to 1 kilogram, of body weight per week.

The closer a person is to his ideal body weight, the lower the risk of developing gallstones. Gallstones are more prevalent in people with obesity than in those with adequate body weight for their age, height, and body structure.

Anyone who has occasional signs or symptoms of gallstones should talk with their doctor. If your symptoms are persistent or severe, you should visit your local emergency room for more urgent evaluation and treatment.