Which department should I go to for cholecystitis?

Written by Zhang Jun Jun
Endocrinology
Updated on September 25, 2024
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Firstly, it is necessary to determine the cause of the cholecystitis. The most common type of cholecystitis is caused by gallstones. If the cholecystitis is an acute episode caused by gallstones, leading to pain, nausea, vomiting, or even high fever, surgical intervention is usually indicated. It is generally recommended to consult with departments such as general surgery or hepatobiliary surgery, as emergency surgery may be needed. The second scenario involves cases where cholecystitis is detected during routine physical examinations without symptoms. Ultrasound may show gallstones or gallbladder polyps. In symptom-free situations, it is possible to consult general departments like gastroenterology, and regular follow-ups and checks of inflammation indicators, as well as abdominal ultrasonography, can be performed to monitor the dynamic changes of the cholecystitis. The third scenario pertains to cholecystitis where new techniques such as MRCP are available. With this technology, gallstones can be removed under endoscopic guidance. Generally, these procedures are performed in the gastroenterology department. Thus, for acute cholecystitis with choledocholithiasis and concurrent biliary pancreatitis, it may be treated with endoscopic techniques under gastroenterology, avoiding the need for traditional or minimally invasive surgery. Therefore, patients with cholecystitis may visit either the hepatobiliary surgery or gastroenterology departments.

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Written by Zhu Dan Hua
Gastroenterology
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What are the symptoms of cholelithiasis cholecystitis?

Cholecystitis due to gallstones is relatively common in clinical practice, with abdominal pain being a frequent reason for seeking medical attention. The pain usually manifests in the upper abdomen or right side, occurring in intermittent or continuous episodes. Typically, the nature of the pain is described as distension, colic, or dull pain. Patients may also experience radiating pain in the lower back, typically extending to the right side of the abdomen. Additionally, a small number of patients may experience nausea, vomiting, and even fever alongside abdominal pain. Fevers are usually mild to moderate, with body temperatures around 38°C (100.4°F). Nausea and vomiting occur as a digestive response following gallbladder contraction and subsequent inflammatory stimulation, with vomitus generally consisting of gastric contents and bile, but not blood. Therefore, if gallstone-induced cholecystitis is suspected, it is recommended for patients to undergo active endoscopic removal, typically via laparoscopic surgery. Of course, older patients might be treated conservatively with medications.

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Written by Si Li Li
Gastroenterology
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Location of pain in female cholecystitis

The main symptoms of cholecystitis include upper abdominal pain. Mild cases generally are limited to the upper abdomen, while severe cases may affect the entire body, and 70% of patients with cholecystitis do not show any symptoms. The early symptoms of cholecystitis can suddenly manifest as severe colicky pain in the upper right abdomen, which can also radiate to the right shoulder and back. These symptoms are generally triggered by consuming a large amount of fatty foods and are more likely to occur at night. If the condition progresses, the pain becomes persistent and progressively worsens, and may also be accompanied by mild to moderate fever. Some patients may experience chills and high fever, indicating that the condition is very severe.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Diet after relief of acute cholecystitis

After the relief of acute cholecystitis, he still needs to pay attention to his diet: First, he should avoid spicy and irritating foods, such as chili peppers, barbecue, garlic, etc., avoid hard-to-digest foods, and avoid foods high in fat to reduce the burden on the gallbladder, such as fatty animal organs. Second, although the symptoms of acute cholecystitis have recovered, it is still necessary to maintain a light diet, eat more fresh vegetables and fruits, which are rich in vitamins and trace elements, to keep the bowels open and prevent other complications. Third, after the symptoms of acute cholecystitis have recovered, it is also appropriate to supplement some foods high in protein, which can enhance the patient's resistance and facilitate the recovery of the condition.

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Written by Zhao Xin Lan
Endocrinology
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Can cholecystitis be cured?

Can cholecystitis be cured? The answer is definitely yes. Cholecystitis can be cured through either medical or surgical means. Firstly, if it is chronic cholecystitis without obvious clinical symptoms, one can prevent acute attacks by paying attention to their daily life, avoiding high-fat and high-calorie diets, and keeping warm. If it is acute cholecystitis, then acute anti-infection treatment is needed. Moreover, if the inflammation is severe and the gallbladder is significantly enlarged, or there is even a risk of perforation, then emergency surgical treatment is necessary at this time.

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Written by Zhang Jun Jun
Endocrinology
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How to Diagnose Cholecystitis

The definitive diagnosis of cholecystitis mainly involves the following aspects: First, clinical manifestations are crucial. The most common symptoms include nausea, vomiting, abdominal distension, and loss of appetite. Regarding physical examination, there is typically pain in the lower right abdomen and mid-lower right abdomen, with tenderness upon palpation. Furthermore, the onset of cholecystitis is characterized by postprandial pain, particularly after consuming fatty foods or feeling overly full. If these symptoms are present, further examination such as gallbladder ultrasound can be conducted to check for thickening of the gallbladder wall. Additionally, blood tests for inflammatory markers like complete blood count and CRP (C-reactive protein) can be performed. The diagnosis of cholecystitis can be confirmed by combining these symptoms and test results.