$Unique_ID{BRK03594} $Pretitle{} $Title{Cholecystitis} $Subject{Cholecystitis Gall Bladder Disease Gallstone Cholecystitis Acalculous Cholecystitis Hiatal Hernia Pancreatitis Gastroenteritis Angina Pectoris Pyelonephritis Acute Appendicitis Alcoholic Hepatitis Gastric Ulcer} $Volume{} $Log{} Copyright (C) 1989 National Organization for Rare Disorders, Inc. 701: Cholecystitis ** IMPORTANT ** It is possible that the main title of the article (Cholecystitis) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Gall Bladder Disease Disorder Subdivisions: Gallstone Cholecystitis Acalculous Cholecystitis Information on the following diseases can be found in the Related Disorders section of this report: Hiatal Hernia Pancreatitis Gastroenteritis Angina Pectoris Pyelonephritis Acute Appendicitis Alcoholic Hepatitis Gastric Ulcer General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Cholecystitis is the inflammation of the gallbladder. It is usually caused by gallstones. This can be an acute or chronic condition. Symptoms Cholecystitis is an acute or chronic inflammation of the gallbladder. It is characterized by abdominal pain which can be chronic or severe, chills, nausea and vomiting, indigestion, heartburn, gassiness, fever, and referred pain in the chest, shoulder and back. There may also be some discomfort and pain after eating (especially at night), an intolerance to fatty foods and a yellow discoloration of the skin (jaundice). In severe cases there may be a bacterial infection and eventual perforation of the gallbladder. Acalulous Cholecystitis is a rare form of Cholecystitis. It is usually associated with long-term fasting, previous surgeries, injuries, severe burns, or immobility in disabled people. Gallstones are not present in Acalulous Cholecystitis. Since the symptoms of Cholecystitis are similar to many other diseases, it is important to have a complete history and physical exam before a clear diagnosis of Cholecystitis can be made. In some cases, specific diagnostic tests such as ultrasonography, cholescintigraphy, tomography or oral cholecystography may be necessary. Causes The exact cause of Cholecystitis is unknown. It usually results from the formation of gallstones that can block the gallbladder's, cystic duct or the common bile duct. These gallstones are usually composed of cholesterol. Affected Population Cholecystitis is a common disorder. It is more prevalent in females than males. High blood cholesterol, advancing age and being overweight increases the chance of developing gallbladder disease. Related Disorders Symptoms of the following disorders can be similar to those of Cholecystitis. Comparisons may be useful for a differential diagnosis: Angina Pectoris is a disorder that causes pain in the heart muscle. It is characterized by a tight feeling in the chest, shoulders, jaw, one or both arms spreading down to the hands and occasionally the upper abdomen. Pancreatitis is an inflammation of the pancreas associated with a buildup of digestive enzymes. The pancreas produces these enzymes to help break down carbohydrates and proteins during digestion. It is characterized by nausea and vomiting, fever, chills, severe abdominal pain and distention. Pancreatitis can be caused by alcoholism, trauma, duodenal ulcer or gallstones. Gastroenteritis is usually due to a bacterial or viral infection that causes an inflammation of the intestinal tract and stomach. It is characterized by abdominal cramps and sometimes dehydration caused by a loss of fluid due to vomiting and diarrhea. Hiatal Hernia is due to a weakening of the muscle wall (diaphragm) that divides the abdominal and chest cavity. This weakening causes the stomach to bulge into the chest cavity. It is characterized by heartburn, belching and a tightness or pain in the chest that may radiate to the neck, back, upper chest and arm. Pyelonephritis is a bacterial infection of the kidneys and pelvis. It is characterized by a sudden onset of fever and chills associated with back and kidney (flank) pain, frequent and painful urination, nausea and vomiting. Acute Appendicitis is a serious inflammation of the appendix. It is characterized by severe abdominal pain and tenderness localizing in the right lower abdomen, fever, chills, nausea and vomiting. Alcoholic Hepatitis is an inflammation of the liver caused by a long history of drinking. It is characterized by abdominal swelling, an enlarged liver and spleen, loss of weight, fever, dehydration, nausea with or without vomiting, and a yellow discoloration of the skin (jaundice). Gastric Ulcer is the erosion of a part of the stomach lining. It is characterized by severe abdominal pain and nausea. Therapies: Standard The treatment of Cholecystitis depends on the cause of the inflammation. When the inflammation occurs without gallstones, bed rest, weight loss and a fat free diet may be helpful in relieving the symptoms. If there are gallstones, then early surgical removal of the diseased gallbladder (cholecystectomy) may be necessary. Patients with this disease who are a high surgical risk treated have been treated successfully with the gallstone dissolving drugs chenodiol and monooctanoin. Other treatment is symptomatic and supportive. Therapies: Investigational At the present time studies are being conducted on the use of the gallstone dissolution drug ursodeoxycholic acid, and extracorporeal ultrasound shock waves (lithotripsy) as possible treatments for Cholecystitis. More research will be needed to assure the long-term effectiveness and safety of these treatments. This disease entry is based upon medical information available through December 1989. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Cholecystitis, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 National Digestive Diseases Information Clearinghouse Box NDIC Bethesda, MD 20892 (301) 468-2162 References INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 256. THE MERCK MANUAL, Volume 2, 14th Ed.: Robert Berkow, M.D., ed.-in-chief; Merck Sharp & Dohme Laboratories., 1982. Pp. 569. HOW TO IMAGE THE GALLBLADDER IN SUSPECTED CHOLECYSTITIS. K. Martin et al.; ANN INTERN MED, (November 1; issue 109 (9)). Pp. 722-729. ACUTE ACALCULOUS CHOLECYSTITIS AFTER RADICAL CYSTECTOMY. T. Bauer et al.; J UROL (January 1988; issue 139 (1)). Pp. 128-129. USE OF ULTRASONOGRAPHY RISK SCORE IN THE TIMING OF OPERATIVE INTERVENTION FOR ACUTE CHOLECYSTITIS. K. Miyazaki et al.; ARCH SURG, (April 1988; issue 123 (4)). Pp. 487-489. CHOLECYSTITIS AND CHOLELITHIASIS. E. Taylor et al.; PRIM CARE, (March 1988; issue 15 (1)). Pp. 147-156.