Acute cholecystitis is sudden swelling and irritation of the gallbladder. It causes severe belly pain.
Cholecystitis - acute
The gallbladder is an organ that sits below the liver. It stores bile, which your body uses to digest fats in the small intestine.
Acute cholecystitis occurs when bile becomes trapped in the gallbladder. This often happens because a gallstone blocks the cystic duct, the tube through which bile travels into and out of the gallbladder. When a stone blocks this duct, bile builds up, causing irritation and pressure in the gallbladder. This can lead to swelling and infection.
Other causes include:
Serious illnesses, such as HIV or diabetes
Tumors of the gallbladder (rare)
Some people are more at risk for gallstones. Risk factors include:
Being Native American or Hispanic
Losing or gaining weight rapidly
Sometimes the bile duct becomes blocked temporarily. When this occurs repeatedly, it can lead to chronic cholecystitis. This is swelling and irritation that continues over time. Eventually, the gallbladder becomes thick and hard. It does not store and release bile as well as it did.
The main symptom is pain in the upper right side or upper middle of your belly that usually lasts at least 30 minutes. You may feel:
Sharp, cramping, or dull pain
Pain that spreads to your back or below your right shoulder blade
Other symptoms that may occur include:
Nausea and vomiting
Yellowing of skin and whites of the eyes (jaundice)
Exams and Tests
Your health care provider will perform a physical exam and ask about your symptoms. During the physical exam, you will likely have pain when the provider touches your belly.
Your provider may order the following blood tests:
Injury to the bile ducts draining the liver (may occur after gallbladder surgery)
Peritonitis (inflammation of the lining of the abdomen)
When to Contact a Medical Professional
Call your health care provider if:
Severe belly pain does not go away
Symptoms of cholecystitis return
Removing the gallbladder and gallstones will prevent further attacks.
Glasgow RE, Mulvihill SJ. Treatment of gallstone disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease:Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 66.
Jackson P, Evans S. Biliary system. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap. 55.
Wang DQH, Afdhal NH. Gallstone disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease:Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 65.
Subodh K. Lal, MD, Gastroenterologist at Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.