Acute Cholecystitis occurs when a gallstone becomes lodged in the outlet of the gallbladder. This causes the gall bladder to increase secretions, creating distension and inflammation.
Signs and Symptoms
- Progressive epigastric/Right Upper Quadrant pain (referred to the right shoulder tip by the C3,4,5 dermatome)
- Positive Murphy's sign (sharp pain upon inspiration as examiner palpates the right hypochondrium, in the region of the gall bladder).
- Features of obstructive jaundice
- Pale stool
- Dark urine
- LFTs: Bilirubin, ALP, GGT
- If obstructive jaundice is present, bilirubin, ALP and GGT may be raised.
- Abdominal USS
- Thickened gall bladder wall, gallstones visible
- ERCP or MRCP
- Nil by mouth, IV fluids, opioid analgesia
- IV antibiotics-
- Cefalosporins, Piperacillin/Tazobactam