Cholecystitis
Cholecystitis is inflammation of the gallbladder, most commonly caused by a gallstone blocking the cystic duct. This blockage leads to swelling, pain, and sometimes infection of the gallbladder. Less commonly, cholecystitis can occur without gallstones (acalculous cholecystitis), typically in people who are very ill or have certain medical conditions. Imaging is essential for diagnosing the condition and assessing its severity.
What is it?
Cholecystitis occurs when the gallbladder becomes inflamed, most often due to a gallstone obstructing the cystic duct. This prevents bile from leaving the gallbladder, causing it to swell and resulting in pain and inflammation. If the blockage persists, infection may develop. Acalculous cholecystitis can occur without stones and is usually associated with critical illness, trauma, or prolonged fasting.
Imaging plays a key role in diagnosis. Ultrasound commonly shows gallbladder wall thickening, stones, fluid around the gallbladder, or a positive “sonographic Murphy sign” (pain when the ultrasound probe presses over the gallbladder). CT and MRI can help identify complications such as perforation or tissue death (gangrenous cholecystitis).
Important to Know
Cholecystitis can range from mild to severe. Prompt treatment helps prevent complications such as spreading infection, abscess formation, or gallbladder rupture. Patients may require antibiotics, IV fluids, and pain management. In many cases, surgical removal of the gallbladder is recommended to prevent recurrence.
Red flags include high fever, severe abdominal pain, jaundice, or confusion—these may indicate a worsening infection or complications requiring urgent medical attention. Follow-up imaging may be needed if symptoms do not improve or if complications are suspected.