Symptoms of acute cholecystitis

Written by Xie Zheng Yuan
Gastroenterology
Updated on February 27, 2025
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Acute cholecystitis is a relatively common digestive system disease in clinical practice, often triggered by the presence of gallstones, leading to acute inflammation of the gallbladder. When an acute cholecystitis attack occurs, it typically presents as pain in the upper right abdomen, accompanied by fever, and sometimes nausea and vomiting, similar to symptoms of gastric discomfort. Additionally, if a gallstone falls and lodges in the cystic duct, or even in the common bile duct, it can cause jaundice, as indicated by the yellowing of the skin and sclera. During a physical examination, it might be possible to detect tenderness in the upper right abdomen, or even rebound tenderness. Another possible positive sign could be Murphy's sign, which are all common manifestations of acute cholecystitis.

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Is hot compress effective for cholecystitis?

The main symptoms of cholecystitis include pain in the upper right abdomen and fever. If this occurs, applying heat to the painful area may temporarily relieve the pain, but it is merely a symptomatic treatment and not a cure, as cholecystitis is caused by an infection and requires antibiotic treatment. Therefore, the fundamental treatment is to reduce inflammation. Merely using heat for relief does not address the root of the disease. Thus, it is essential to receive treatment in a hospital, where a doctor can prescribe medication, which is the most effective and fundamental method.

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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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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.

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How to relieve gallblitis pain?

Gallbladder inflammation generally presents as sudden severe pain in the upper right abdomen, typically occurring after consuming a large amount of fatty foods or most frequently at night. The pain may radiate to the right shoulder or back, indicating gallbladder inflammation. For treatment, antispasmodic pain relief medications can be used. If these are ineffective, opiates like pethidine may be employed to alleviate symptoms. Additionally, it is necessary to perform routine blood tests and imaging, such as an abdominal CT scan or ultrasound, to confirm the diagnosis. Once the diagnosis is confirmed, aggressive anti-inflammatory treatment should be pursued. (Medication should be used under the guidance of a physician.)

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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.