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__NOTOC__
__NOTOC__
{{CMG}}
{{Cholecystitis}}
{{Cholecystitis}}
{{CMG}}; {{AE}} {{VR}}
==Overview==
Cholecystitis is often caused by [[cholelithiasis]] which blocks the cystic duct directly, predisposing the gallbladder to secondary infections by gut organisms, especially [[escherichia coli]] and [[bacteroides]].  Less commonly, in debilitated and trauma patients, the [[gall bladder]] may become inflamed and infected in the absence of [[cholelithiasis]], which is known as acalculous cholecystitis.


==Causes==
==Causes==
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.  Acute cholecystitis may become complicated as [[abscess]], [[gangrene]] or [[perforation]] in patients who are older, with [[diabetes]] or who delay seeking treatment.  This complicated acute cholecystitis should be considered as a life threatening condition. 
===Common Causes===
===Common Causes===
Cholecystitis is often caused by [[cholelithiasis]] (the presence of [[cholelith]]s, or [[gallstone]]s, in the [[gall bladder]]), with [[cholelith]]s most commonly blocking the cystic duct directly. This leads to to [[inspissation]] of [[bile]], bile [[stasis (medicine)|stasis]] and secondary infection by gut organisms, predominantly ''E coli'' and Bacteroides species.
*[[Bacteroides]]
 
*[[Cholelithiasis]]<ref name="Gouma-1992">{{Cite journal  | last1 = Gouma | first1 = DJ. | last2 = Obertop | first2 = H. | title = Acute calculous cholecystitis. What is new in diagnosis and therapy? | journal = HPB Surg | volume = 6 | issue = 2 | pages = 69-78 | month =  | year = 1992 | doi =  | PMID = 1292590 }}</ref>
The [[gall bladder]]'s wall becomes inflamed. Extreme cases may result in [[necrosis]] and [[rupture]]. Inflammation often spreads to its outer covering, thus irritating surrounding structures such as the [[diaphragm]] and [[bowel]].
*[[Escherichia coli]]
 
Less commonly, in debilitated and trauma patients, the [[gall bladder]] may become inflamed and infected in the absence of [[cholelithiasis]], and is known as acute acalculous cholecystitis.


Stones in the [[gall bladder]] may not cause obstruction and the accompanying acute attack. The patient might develop a chronic, low-level inflammation which leads to a [[chronic cholecystitis]], where the gall bladder is fibrotic and calcified.
===Causes by Organ System===
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Cardiac events, including myocardial infarction]]
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Cholesterol emboli]], [[Ischemia|gall bladder ischemia]],  [[hemobilia]],  [[vasculitis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| No underlying causes
|-
|-
Line 27: Line 34:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Ceftriaxone]],  [[clofibrate]],  [[cryptosporidium]],  [[cytomegalovirus]],  [[estrogen]],  [[octreotide]],  [[opiates]],  [[oral contraceptives]],  [[sunitinib]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| No underlying causes
|-  
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| [[Diabetes mellitus]]
|bgcolor="Beige"| No underlying causes
|-  
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
Line 43: Line 50:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Acalculous cholecystitis]], [[Bile duct blockage]], [[Bile stasis]], [[Cholelithiasis]], [[Crohn's disease]], [[Gall bladder ischemia]], [[Gallbladder empyema]], [[Liver abscess]], [[Peritonitis]]
|bgcolor="Beige"| [[Acalculous cholecystitis]], [[Ampulla of Vater#Related disorders|ampullary stenosis]], [[calculous cholecystitis]], [[cholelithiasis]], [[cirrhosis]],  [[Crohn's disease]], [[Ischemia|gall bladder ischemia]], [[gallbladder carcinoma]],  [[gallstones]],  [[hemobilia]],  [[hepatocellular carcinoma]], [[liver abscess]], [[pancreatic tumor]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| [[Familial hyperlipoproteinemia]]
|bgcolor="Beige"| [[Choledochal cyst]],  [[sickle cell disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| [[Sickle cell disease]]
|bgcolor="Beige"| [[Hemolysis]],  [[sickle cell disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| [[Abdominal surgery]], [[Harmonal therapy in women]], [[Long-term total parenteral nutrition]]
|bgcolor="Beige"| [[Percutaneous transhepatic cholangiography]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[Bacteriodes]], [[Cryptosporidiosis]], [[Cytomegalovirus]], [[E.coli]], [[Edwardsiella tarda]], [[Klebsiella]], [[Microsporidiosis]], [[Opisthorchiasis]], [[Salmonella infections]], [[Secondary infection from gut organisms]], [[Typhoid fever]],[[Gallbladder empyema]], [[Liver abscess]]
|bgcolor="Beige"| [[Ascaris lumbricoides]], [[bacteroides]], [[brucella]], [[campylobacter jejuni]],  [[candida]],  [[choledochal cyst]],  [[coxiella burnetii]],  [[echinococcus granulosus]],  [[Enterobacteriaceae|edwardsiella tarda]],  [[epstein-barr virus]],  [[escherichia coli]], [[flavivirus]], [[hepatitis A]], [[hepatitis B]], [[HIV]], [[infections]], [[isospora]], [[klebsiella]], [[leptospira]], [[liver abscess]],  [[microsporidiosis]],  [[mycobacterium tuberculosis]],  [[opisthorchiasis]],  [[plasmodium]],  [[salmonella enterica]],  [[salmonella infections]],  [[salmonella typhi]],  [[typhoid fever]],  [[vibrio cholerae]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| No underlying causes
|-
|-
Line 70: Line 77:
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Familial hyperlipoproteinemia]]
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Long labor]], [[Pregnancy]]
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| [[Malignancy]]
|bgcolor="Beige"| [[Acute myelogenous leukemia]],  [[gallbladder carcinoma]],  [[hepatocellular carcinoma]],  [[malignancy]],  [[pancreatic tumor]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| [[Anorexia nervosa]]
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 98: Line 105:
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Sjogren's syndrome]], [[SLE]]
|bgcolor="Beige"| [[Crohn's disease]],  [[Sjogren's syndrome]], [[SLE]],  [[vasculitis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 111: Line 118:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| [[Abdominal trauma]]
|bgcolor="Beige"| [[Cholesterol emboli]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Urologic'''
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| [[Critically ill patients]], [[Elderly]], [[Idiopathic]], [[Losing weight rapidly]], [[Prolonged fasting]]
|bgcolor="Beige"| [[Idiopathic]]
|-
|-
|}
|}


===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
*[[Abdominal surgery]]
{{col-begin|width=80%}}
*[[Abdominal trauma]]
{{col-break|width=33%}}
*[[Acalculous cholecystitis]]
*[[Acalculous cholecystitis]]
*[[Anorexia nervosa]]
*[[Acute myelogenous leukemia]]
*[[Bacteriodes]]
*[[Ampulla of Vater#Related disorders|Ampullary stenosis]]
*[[Bile duct blockage]]
*[[Ascaris lumbricoides]]<ref name="Khuroo-1996">{{Cite journal  | last1 = Khuroo | first1 = MS. | title = Ascariasis. | journal = Gastroenterol Clin North Am | volume = 25 | issue = 3 | pages = 553-77 | month = Sep | year = 1996 | doi =  | PMID = 8863040 }}</ref>
*[[Bile stasis]]
*[[Bacteroides]]
*[[Cardiac events, including myocardial infarction]]
*[[Brucella]]
*[[Calculous cholecystitis]]
*[[Campylobacter jejuni]]
*[[Candida]]<ref name="Araujo-">{{Cite journal  | last1 = Araujo | first1 = PS. | last2 = Medeiros | first2 = Z. | last3 = Melo | first3 = FL. | last4 = Maciel | first4 = MA. | last5 = Melo | first5 = HR. | title = Candida famata-induced fulminating cholecystitis. | journal = Rev Soc Bras Med Trop | volume = 46 | issue = 6 | pages = 795-6 | month =  | year =  | doi = 10.1590/0037-8682-0162-2013 | PMID = 24474028 }}</ref>
*[[Ceftriaxone]]
*[[Choledochal cyst]]
*[[Cholelithiasis]]
*[[Cholelithiasis]]
*[[Cholesterol emboli]]
*[[Cirrhosis]]
*[[Clofibrate]]
*[[Coxiella burnetii]]
*[[Crohn's disease]]
*[[Crohn's disease]]
*[[Critically ill patients]]
*[[Cryptosporidium]]
*[[Cryptosporidiosis]]
*[[Cytomegalovirus]]
*[[Cytomegalovirus]]
*[[Diabetes mellitus]]
*[[Echinococcus granulosus]]
*[[E.coli]]
{{col-break|width=33%}}
*[[Edwardsiella tarda]]
*[[Enterobacteriaceae|Edwardsiella tarda]]
*[[Elderly]]
*[[Epstein-barr virus]]
*[[Familial hyperlipoproteinemia]]
*[[Escherichia coli]]
*[[Gall bladder ischemia]]
*[[Estrogen]]
*[[Gallbladder empyema]]
*[[Flavivirus]]
*[[Harmonal therapy in women]]
*[[Ischemia|Gall bladder ischemia]]
*[[Gallbladder carcinoma]]
*[[Gallstones]]
*[[Hemobilia]]
*[[Hemolysis]]
*[[Hepatitis A]]
*[[Hepatitis B]]
*[[Hepatocellular carcinoma]]
*[[HIV]]<ref name="Cello-1998">{{Cite journal  | last1 = Cello | first1 = JP. | title = AIDS-Related biliary tract disease. | journal = Gastrointest Endosc Clin N Am | volume = 8 | issue = 4 | pages = 963 | month = Oct | year = 1998 | doi =  | PMID = 9730942 }}</ref>
*[[Idiopathic]]
*[[Idiopathic]]
*[[Infections]]
*[[Isospora]]
*[[Klebsiella]]
*[[Klebsiella]]
*[[Leptospira]]
*[[Liver abscess]]
*[[Liver abscess]]
*[[Long labor]]
{{col-break|width=33%}}
*[[Long-term total parenteral nutrition]]
*[[Losing weight rapidly]]
*[[Malignancy]]
*[[Malignancy]]
*[[Microsporidiosis]]
*[[Microsporidiosis]]
*[[Mycobacterium tuberculosis]]
*[[Octreotide]]
*[[Opiates]]
*[[Opisthorchiasis]]
*[[Opisthorchiasis]]
*[[Peritonitis]]
*[[Oral contraceptives]]
*[[Pregnancy]]
*[[Pancreatic tumor]]
*[[Prolonged fasting]]
*[[Percutaneous transhepatic cholangiography]]
*[[Salmonella infections]]
*[[Plasmodium]]
*[[Secondary infection from gut organisms]]
*[[Salmonella enterica]]
*[[Salmonella infections]]<ref name="Yasri-">{{Cite journal  | last1 = Yasri | first1 = S. | last2 = Wiwanitkit | first2 = V. | title = Acute typhic cholecystitis. | journal = Afr J Paediatr Surg | volume = 10 | issue = 4 | pages = 395 | month =  | year =  | doi = 10.4103/0189-6725.125464 | PMID = 24469500 }}</ref>
*[[Salmonella typhi]]
*[[Sickle cell disease]]
*[[Sickle cell disease]]
*[[Sjogren's syndrome]]
*[[Sjogren's syndrome]]
*[[SLE]]
*[[SLE]]
*[[Sunitinib]]
*[[Typhoid fever]]
*[[Typhoid fever]]
*[[Vasculitis]]
*[[Vibrio cholerae]]
{{col-end}}


==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[Category:Needs overview]]
[[Category:Needs overview]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
Line 178: Line 208:
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Disease]]
[[Category:Disease]]
{{WH}}
{{WH}}
{{WS}}
{{WS}}

Revision as of 22:33, 11 February 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]

Overview

Cholecystitis is often caused by cholelithiasis which blocks the cystic duct directly, predisposing the gallbladder to secondary infections by gut organisms, especially escherichia coli and bacteroides. Less commonly, in debilitated and trauma patients, the gall bladder may become inflamed and infected in the absence of cholelithiasis, which is known as acalculous cholecystitis.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Acute cholecystitis may become complicated as abscess, gangrene or perforation in patients who are older, with diabetes or who delay seeking treatment. This complicated acute cholecystitis should be considered as a life threatening condition.

Common Causes

Causes by Organ System

Cardiovascular Cholesterol emboli, gall bladder ischemia, hemobilia, vasculitis
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Ceftriaxone, clofibrate, cryptosporidium, cytomegalovirus, estrogen, octreotide, opiates, oral contraceptives, sunitinib
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Acalculous cholecystitis, ampullary stenosis, calculous cholecystitis, cholelithiasis, cirrhosis, Crohn's disease, gall bladder ischemia, gallbladder carcinoma, gallstones, hemobilia, hepatocellular carcinoma, liver abscess, pancreatic tumor
Genetic Choledochal cyst, sickle cell disease
Hematologic Hemolysis, sickle cell disease
Iatrogenic Percutaneous transhepatic cholangiography
Infectious Disease Ascaris lumbricoides, bacteroides, brucella, campylobacter jejuni, candida, choledochal cyst, coxiella burnetii, echinococcus granulosus, edwardsiella tarda, epstein-barr virus, escherichia coli, flavivirus, hepatitis A, hepatitis B, HIV, infections, isospora, klebsiella, leptospira, liver abscess, microsporidiosis, mycobacterium tuberculosis, opisthorchiasis, plasmodium, salmonella enterica, salmonella infections, salmonella typhi, typhoid fever, vibrio cholerae
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Acute myelogenous leukemia, gallbladder carcinoma, hepatocellular carcinoma, malignancy, pancreatic tumor
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Crohn's disease, Sjogren's syndrome, SLE, vasculitis
Sexual No underlying causes
Trauma Cholesterol emboli
Urologic No underlying causes
Miscellaneous Idiopathic

Causes in Alphabetical Order

References

  1. ↑ Gouma, DJ.; Obertop, H. (1992). "Acute calculous cholecystitis. What is new in diagnosis and therapy?". HPB Surg. 6 (2): 69–78. PMID 1292590.
  2. ↑ Khuroo, MS. (1996). "Ascariasis". Gastroenterol Clin North Am. 25 (3): 553–77. PMID 8863040. Unknown parameter |month= ignored (help)
  3. ↑ Araujo, PS.; Medeiros, Z.; Melo, FL.; Maciel, MA.; Melo, HR. "Candida famata-induced fulminating cholecystitis". Rev Soc Bras Med Trop. 46 (6): 795–6. doi:10.1590/0037-8682-0162-2013. PMID 24474028.
  4. ↑ Cello, JP. (1998). "AIDS-Related biliary tract disease". Gastrointest Endosc Clin N Am. 8 (4): 963. PMID 9730942. Unknown parameter |month= ignored (help)
  5. ↑ Yasri, S.; Wiwanitkit, V. "Acute typhic cholecystitis". Afr J Paediatr Surg. 10 (4): 395. doi:10.4103/0189-6725.125464. PMID 24469500.

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