The difference between acute cholecystitis and chronic cholecystitis

Written by Zhang Tao
Hepatobiliary Surgery
Updated on September 29, 2024
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Chronic cholecystitis clinically manifests as recurrent dull pain in the upper abdomen and biliary colic, which the patient can quickly relieve on their own; acute cholecystitis involves more severe pain that cannot be relieved without intervention, and is usually accompanied by fever, nausea, and vomiting. In chronic cholecystitis, pressing on the right upper abdomen elicits no special reaction; in acute cholecystitis, pressing on the right upper abdomen causes obvious pain, known as a positive Murphy's sign. Acute cholecystitis is accompanied by a significant increase in white blood cells, and an ultrasound can reveal a marked enlargement and thickening of the gallbladder wall; chronic cholecystitis does not show these specific characteristics.

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Written by Wu Hai Wu
Gastroenterology
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Does a woman's back hurt after gallblitis?

Women with cholecystitis generally do not experience back pain. Pain associated with cholecystitis may cause pain in the right shoulder. In addition to shoulder pain, patients with cholecystitis may also experience pain under the right ribs. Severe cases may also be accompanied by chills, fever, jaundice, dark urine, etc. It is necessary to promptly complete abdominal imaging studies, such as ultrasound, CT, MRI, etc., to clarify the diagnosis. Active anti-infection treatment is required, which may include third-generation cephalosporin antibiotics or fluoroquinolone antibiotics. If necessary, surgical treatment may also be required. (The use of medications should be under the guidance of a physician)

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Written by Zhang Tao
Hepatobiliary Surgery
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Can you drink alcohol with acute cholecystitis?

Acute cholecystitis, clinically divided into calculous cholecystitis and acalculous cholecystitis, is closely related to diet regardless of the type. Therefore, patients with acute cholecystitis should not consume alcohol, as drinking can lead to another attack of acute cholecystitis. Most episodes of acute cholecystitis are directly related to diet and excessive drinking, so not only during an acute attack but also in everyday life, it is important to avoid greasy, fried foods, spicy and irritating foods, and excessive alcohol consumption, in order to prevent stimulating the swelling of the gallbladder mucosa and triggering an attack of acute cholecystitis.

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Written by Wu Hai Wu
Gastroenterology
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What are the symptoms when there are problems with the gallbladder?

Gallbladder issues, specifically symptoms of cholecystitis, mainly include chills, fever, persistent dull pain in the upper right quadrant of the abdomen, episodic colic pain that radiates to the right shoulder and back, and may also be accompanied by jaundice, dark urine, nausea, vomiting, and constipation. Patients with cholecystitis often experience sudden pain at night, typically due to overeating or consuming greasy foods. Once cholecystitis occurs, it is advised to seek medical attention at a regular hospital as soon as possible, complete the relevant diagnostic tests, such as imaging studies of the abdomen, consider surgical treatment, and engage in active anti-infection treatment.

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Written by Huang Ya Juan
Gastroenterology
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Symptoms and Treatment of Cholecystitis

Cholecystitis is divided into acute cholecystitis and chronic cholecystitis. Acute cholecystitis typically presents very typical and obvious clinical symptoms, primarily manifesting as acute abdominal pain. Acute cholecystitis often occurs after eating greasy food, mainly presenting as severe colicky pain in the upper right abdomen, which is episodic and worsens. The pain may radiate to the right shoulder or back, followed by nausea, vomiting, and in severe cases, fever. Some severe cases may also present with jaundice and symptoms of systemic infection and toxicity. Acute simple cholecystitis is often treated non-surgically, and most cases can be cured. If the patient has a history of multiple attacks or the presence of stones, elective cholecystectomy is usually performed later. For suppurative or gangrenous cholecystitis, surgery should be performed promptly after appropriate preparation to remove the diseased gallbladder, typically within three days of onset. If the patient's condition is critical at the time of surgery, or if there is severe local infection and the anatomy is unclear, the doctor will not forcibly remove the gallbladder to avoid major bleeding and damage. Instead, a cholecystostomy may be performed first, followed by cholecystectomy after three months. Chronic cholecystitis, besides occasional upper abdominal discomfort and indigestion, usually shows no prominent symptoms, and most patients only learn about their condition through ultrasound examination. However, for recurrent acute attacks or symptomatic chronic cholecystitis, especially those with stones larger than 1 cm or multiple stones, cholecystectomy should be performed. Elderly or frail individuals with other serious illnesses, such as cardiovascular disease, diabetes, kidney disease, or liver disease, may receive medical treatment, including general digestive aids and antispasmodic medications. Bile preparations have choleretic effects, can increase the secretion of bile, promote the digestion and absorption of fats, and facilitate the excretion from the gallbladder, which can alleviate symptoms and stabilize the condition. Considering that acute attacks of chronic cholecystitis in elderly people progress rapidly and that emergency surgery has a much higher mortality rate than elective surgery, it is advisable to perform surgery during a remission period. Whether treated with medication or surgery, it is important to follow medical advice.

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Written by Guan Yu Hua
Orthopedic Surgery
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Is rib pain gallblitis?

The gallbladder is located in the upper right abdomen, at the intersection of the midpoint of the right costal margin and the costal arch, near the midclavicular line. If there is tenderness in this area, it indicates a positive Murphy's sign. Usually, an ultrasound can reveal whether there is gallbladder wall thickening or a rough surface. Additionally, the ultrasound can detect gallstones or bile duct stones. Furthermore, a complete blood count should be performed to check for elevated white blood cells, which could indicate acute suppurative cholangitis. This condition may present with fever, positive Murphy's sign, Charcot's triad or pentad, and all require ultrasound for differentiation. Rib pain is mostly related to trauma, strain, or localized pressure during sleep, such as from a pillow corner, ashtray, or remote control. It can also be associated with costochondritis or intercostal neuralgia, and breathing heavily or coughing may cause pain. To confirm a diagnosis of cholecystitis, an ultrasound and a complete blood count should be performed.