Does acute cholecystitis require hospitalization?

Written by Zhang Tao

Hepatobiliary Surgery

Updated on September 26, 2024

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Patients with acute cholecystitis often have a history of gallstones or gallbladder polyps. An acute attack of cholecystitis can be triggered by inattention to diet or other reasons, such as unclean food. If the patient's abdominal pain is not severe, they can be advised to rest in bed and take oral anti-inflammatory and bile-promoting medications. If the patient experiences significant upper abdominal pain, accompanied by fever and other discomforts, and the abdominal pain persists and radiates to the back, it is recommended that the patient be hospitalized. During the hospital stay, it is essential to ensure the patient eats and receives clinical infusions, as well as complete relevant examinations.

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Written by Huang Ya Juan

Gastroenterology

3min 8sec

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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 Zhao Xin Lan

Endocrinology

38sec

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Does cholecystitis hurt?

Whether cholecystitis is painful depends on the nature of the inflammation. If it is acute cholecystitis, it often causes severe pain in the gallbladder area, which is persistent and accompanied by chills, fever, poor spirit, loss of appetite, and even jaundice. If it is chronic cholecystitis, there may not be obvious symptoms of gallbladder pain. However, it can lead to an acute attack of chronic cholecystitis under the conditions of chills, high-fat diet, or other causes, which then causes pain in the gallbladder area.

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Written by Wu Hai Wu

Gastroenterology

49sec

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Why is there nothing wrong with the B-ultrasound for cholecystitis?

As for why cholecystitis appears normal in an ultrasound, there are two possible reasons. One possibility is that the medical practitioner conducting the ultrasound may lack sufficient clinical experience to identify an inflamed gallbladder. Another reason could be limitations in the ultrasound equipment itself, which might fail to detect an inflamed gallbladder. There are very few cases where cholecystitis appears normal under ultrasound. The main ultrasound features of cholecystitis include gallbladder wall edema, roughness, and an enlarged gallbladder among other radiological changes. Once cholecystitis is diagnosed, it is crucial to undertake active treatment measures, such as aggressive anti-infection treatment, spasmodic pain relief, etc.

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Written by Zhao Xin Lan

Endocrinology

49sec

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Gallblitis Symptoms

The symptoms of cholecystitis are divided into chronic cholecystitis and acute cholecystitis, and they present differently clinically. During acute cholecystitis, there is pain in the right upper abdomen in the gallbladder area, accompanied by fever, fatigue, decreased appetite, and even jaundice. Physical examination can reveal obvious tenderness and rebound pain in the right upper abdomen at the gallbladder. In contrast, chronic cholecystitis may not have obvious symptoms. Occasional pain may occur in the gallbladder area, but it is bearable. Typically, there is no obvious tenderness in the area, and the condition usually requires diagnosis through examinations such as an ultrasound.

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Written by Wu Hai Wu

Gastroenterology

44sec

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Where to massage for symptoms of gallblitis pain?

Gallbladder inflammation pain requires massaging the upper right abdomen, also known as the Murphy's point. The symptoms of gallbladder inflammation primarily include chills, fever, jaundice, pain, etc. Once a gallbladder inflammation attack occurs, it is necessary to promptly complete the relevant auxiliary examinations to determine the cause of the disease. Treatment should be based on the cause, and surgical treatment may be necessary when needed. The main causes of gallbladder inflammation include biliary infection, bile stasis, and biliary stones, etc. Patients with gallbladder inflammation should have a light diet and avoid greasy food.