Cholecystitis, a condition also referred to as gallbladder disease, occurs when an individual’s gallbladder becomes inflamed. This inflammation is usually caused by gallstones, which block the tube through which bile is usually released. The buildup is responsible for the inflammation. Gallstones are common, particularly in Western populations. In the United States, gallstones are seen in approximately 6% of men and 9% of women. The incidence in children is not known; however, gallstones/biliary sludge are likely to form in one and five children with hemolytic anemia before their adolescent years. Most patients with an acute attack of cholecystitis have complete remission in 1-5 days; however, approximately 20% require surgical intervention.
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Estrogen usage and hormone replacement therapy has been known to increase stone formation by increasing biliary cholesterol saturation. Other predisposing factors would include bile acid malabsorption, obesity, total parenteral nutrition, status post-bariatric surgery, hemolytic anemia, diabetes, increasing age, pregnancy secondary to elevated progesterone, and genetic predisposition (Native Americans and those of Chinese or Japanese descent). Most individuals with gallstones are asymptomatic throughout their lives. When the stones start causing symptoms the condition is referred to as “gallstone disease.” Uncomplicated gallstone disease refers to stones in the gallbladder that are associated with biliary colic in the absence of complications such as acute cholecystitis, cholangitis, or gallstone pancreatitis. Patients with uncomplicated gallstone disease typically present with biliary colic, normal physical examination findings, and normal laboratory test results. Patients often report associated diaphoresis, nausea, and vomiting. While patients may present with atypical symptoms such as chest pain or nonspecific abdominal discomfort, the absence of biliary colic should prompt an investigation of alternative diagnosis. On the other hand, biliary colic that is associated with fevers, jaundice, or abnormal blood tests (leukocytosis, liver tests, pancreatic tests) suggests the development of a complication of gallstone disease (Family Practice Guidelines,
Estrogen usage and hormone replacement therapy has been known to increase stone formation by increasing biliary cholesterol saturation. Other predisposing factors would include bile acid malabsorption, obesity, total parenteral nutrition, status post-bariatric surgery, hemolytic anemia, diabetes, increasing age, pregnancy secondary to elevated progesterone, and genetic predisposition (Native Americans and those of Chinese or Japanese descent). Most individuals with gallstones are asymptomatic throughout their lives. When the stones start causing symptoms the condition is referred to as “gallstone disease.” Uncomplicated gallstone disease refers to stones in the gallbladder that are associated with biliary colic in the absence of complications such as acute cholecystitis, cholangitis, or gallstone pancreatitis. Patients with uncomplicated gallstone disease typically present with biliary colic, normal physical examination findings, and normal laboratory test results. Patients often report associated diaphoresis, nausea, and vomiting. While patients may present with atypical symptoms such as chest pain or nonspecific abdominal discomfort, the absence of biliary colic should prompt an investigation of alternative diagnosis. On the other hand, biliary colic that is associated with fevers, jaundice, or abnormal blood tests (leukocytosis, liver tests, pancreatic tests) suggests the development of a complication of gallstone disease (Family Practice Guidelines,