How to diagnose cholecystitis?

Written by Zhao Xin Lan
Endocrinology
Updated on September 29, 2024
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Firstly, we can use physical examination to check. Acute cholecystitis will show tenderness in the upper right abdomen. If pressing below the right ribs causes significant pain, it is likely to be acute cholecystitis. Secondly, instrument examination can be utilized, with the most common and cost-effective being an ultrasound examination. When examining cholecystitis, fasting is required; no food should be consumed for at least eight hours. Additionally, modern CT scans or MRI can be used to help determine whether there is inflammation in the gallbladder. Blood tests can also be conducted; an increase in white blood cells in a routine blood test can indicate the presence of inflammation.

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Gastroenterology
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Methods to alleviate gallbladder inflammation pain

The primary symptoms of cholecystitis include sudden, severe pain in the upper right abdomen, which typically radiates to the right shoulder, scapula, and back. The pain often occurs more frequently at night and can be exacerbated by consuming a large amount of fatty foods, which may lead to acute cholecystitis. In terms of treatment, if severe abdominal pain occurs, timely pain relief is necessary. Spasmolytic painkillers and analgesics, such as opioids, can be used for pain relief. Additionally, treatment should address the underlying cause, including the use of antibiotics. Aminoglycoside antibiotics or cephalosporin antibiotics can be effective in treating the infection, and controlling the infection will also help alleviate the pain.

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Does acute cholecystitis require hospitalization?

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 Wu Hai Wu
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Do you need to fast and hold your urine for a gallbladder inflammation B-ultrasound?

When undergoing an ultrasound for cholecystitis, fasting is required, but there is no need to hold urine. However, if the examination involves the adnexa of the uterus, bladder, prostate, and other areas, it requires holding urine to perform the test, allowing the prostate, adnexa, etc., to sufficiently distend. This helps in more clearly observing pathological changes. Patients with cholecystitis need to fast before an ultrasound. If food is consumed before the scan, the gallbladder contracts more quickly, making it difficult to accurately identify lesions. Patients with cholecystitis may experience chills, fever, right upper abdominal pain, jaundice, yellowing skin, dark urine, etc. In severe cases, patients may develop septic shock and require active treatment measures.

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Endocrinology
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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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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.