What Is Chronic Cholecystitis?
Chronic cholecystitis is abnormal gallbladder function caused by repeated episodes of acute or subacute cholecystitis, or chronic gallbladder stones. About 25% of patients have a bacterial infection, and the pathogenesis is based on obstruction of the gallbladder or common bile duct. According to the presence of stones in the gallbladder, it is divided into calculus cholecystitis and non-calculus cholecystitis. Noncalculus cholecystitis is chronic cholecystitis caused by bacteria, viral infections, or bile salts and pancreatin.
- English name
- chronic cholecystitis
- Visiting department
- Gastroenterology
- Multiple groups
- Obese, high-fat dieters
- Common locations
- gallbladder
- Common causes
- Repeated episodes of acute or subacute cholecystitis, or gallstones
- Common symptoms
- Persistent dullness or discomfort in the right upper quadrant, nausea, belching, acid reflux, abdominal distension, etc.
- Contagious
- no
Basic Information
Causes of chronic cholecystitis
- 1. Chronic calculus cholecystitis is the same as acute cholecystitis. Gallstones can cause repeated small episodes of acute cholecystitis, that is, chronic cholecystitis and acute cholecystitis are at different stages of the same disease.
- 2. Chronic noncalculus cholecystitis is found at autopsy or surgery, accounting for 2% to 10% of all gallbladder lesions.
- 3. Chronic atrophic cholecystitis with stones is also known as porcelain bottle-like gallbladder. The inflammatory stimulus caused by stones leads to the formation of calcification of the gallbladder wall. Calcification can be limited to the mucosa, muscularis, or both. Female patient.
- 4. Yellow granulomatous cholecystitis is rare, and is caused by inflammatory reactions caused by bile lipids entering the connective tissue of the gallbladder cavity.
Clinical manifestations of chronic cholecystitis
- There are no specific symptoms and signs of chronic cholecystitis, and the clinical manifestations are as follows:
- Acute cholecystitis
- The patient had a history of cholecystitis, which was consistent with acute cholecystitis during an acute attack.
- 2. Painful cholecystitis
- Long-term pain in the right upper quadrant appears.
- 3. Stomach fullness and belching after a meal.
- 4. Asymptomatic
- Found only during surgery or autopsy.
Chronic cholecystitis examination
- Collecting duodenal drainage fluid for bile examination, it can be found that there are pus cells, cholesterol crystals, bilirubin calcium precipitation, parasite eggs, etc. in bile culture. Bile culture can find pathogenic bacteria.
- 1.B-ultrasound
- The most diagnostic value can show the size of the gallbladder, the thickness of the capsule wall, the stones in the capsule and the contraction of the gallbladder.
- 2. Plain radiograph of abdomen
- Can show signs of positive stones, gallbladder calcification and gallbladder expansion; Cholecystography can show signs of stones, gallbladder size, shape, gallbladder contraction and concentration.
- 3. Oral and intravenous cholangiography
- In addition to showing signs of stones, gallbladder size, gallbladder calcification, and gallbladder swelling, common bile duct morphology and signs of stones, tapeworms, and tumors in the common bile duct can be observed, which has diagnostic value for this disease.
Diagnosis of chronic cholecystitis
- Diagnosis can be made based on the patient's medical history, clinical manifestations (mostly atypical), and B-ultrasound.
Chronic cholecystitis treatment
- Focus on conservative treatment. For patients with mild symptoms that do not affect normal life, non-surgical treatment, low-fat diet, and long-term oral choleretic drugs such as Xiaoyan Lidan Tablets, Xiongdan Capsules, Choline, etc. can be used. Symptomatic treatment of drugs, anti-infective treatment if necessary.
- Patients with severe symptoms or recurrent biliary colic, accompanied by gallstones, can choose surgery.