Cholecystitis is the inflammation of the gallbladder.<unk>  may be classified<unk> cording to causes into two major subtypes:<unk> ute calculous cholecystitis and<unk> ute<unk> alculous cholecystitis. Gallstones are found in 3500 years old Egyptian mummies during the autopsies. Common risk factors in the development of<unk> ute calculous cholecystitis include advanced age, female gender, obesity, and positive family history. Long periods of fasting, total parental nutrition (TPN), and weight loss are the common risk factors for the development of<unk> ute<unk> alculous cholecystitis.<unk> ute calculous cholecystitis is usually caused by the mechanical obstruction of the gallbladder due to gallstones.<unk> ute<unk> alculous cholecystitis is caused predominantly by the gallbladder stasis. Gallstones are the most common cause of physical obstruction of the gallbladder usually at the neck or in the cystic duct. Cholesterol gallstones are the most common type of gallstones. The obstruction causes an increased pressure as the gallbladder mucosa continues to produce mucus. This raised pressure may cause the venous congestion which is followed by the arterial congestion. Eventually, the raised pressure and stasis leads to the gallbladder ischemia and necrosis. Mechanical obstruction of the gallbladder as a result of polyps, malignancy, an infestation of the gallbladder with parasites, foreign bodies, and trauma may also lead to the<unk> .<unk>  is more common in siblings and first degree relatives of affected persons. Lith gene is involved in the pathogenesis of cholecystitis.<unk>  is associated with diabetes, insulin resistance, cardiovascular diseases, non-alcoholic fatty liver disease (NAFLD) and gastrointestinal malignancies. Microscopic histopathology shows edematous and hemorrhagic gallbladder wall, mucosal necrosis with neutrophil infiltration. Bile infiltration of the gallbladder wall and bile and leukocyte margination of blood vessels are specific findings for<unk> alculous cholecystitis.<unk>  must be differentiated from other diseases that cause right upper quadrant abdominal pain and nausea/vomiting such as biliary colic,<unk> ute cholangitis, viral hepatitis, alcoholic hepatitis,<unk> ute pancreatitis,<unk> ute appendicitis, and irritable bowel syndrome. The incidence of<unk>  is approximately 6,300 per 100,000 in individuals under 50 years age and 20,900 per 100,000 in individuals over 50 years age worldwide. The prevalence of<unk>  is approximately 369 per 100,000 individuals in the United states. It is estimated from the population-based statistics, based on a comprehensive survey in the U.S.<unk>  is comparatively less prevalent in the developing countries. The mortality rate of<unk>  is approximately 0.6%.<unk>  most commonly occurs as a result of the prolonged obstruction of the cystic duct leading to inflammation of the gallbladder. The obstruction further contributes to the development of the complications associated with<unk>  such as gangrene, empyema, perforation, cholecysto-enteric fistula, emphysematous cholecystitis, and gallstone ileus. Prognosis is generally good if the patient receives treatment.<unk>  occurs as a result of prolonged gallstone obstruction in the bile duct, one to four patients develop biliary colic and about 20% of these patients develop<unk>  annually. The hallmark of<unk>  is biliary colic. A positive history of biliary colic, nausea and vomiting is suggestive of<unk> . Patients with<unk>  usually appear ill. Physical examination of patients with<unk>  is remarkable for right upper quadrant abdominal tenderness, positive murphy's sign, and fever. The presence of murphy's sign on physical examination is highly suggestive of<unk> . Laboratory findings consistent with the diagnosis of<unk>  include leukocytosis and elevated CRP. Transabdominal ultrasound is the initial test of choice for the diagnosis of<unk> . Findings on an ultrasound diagnostic of<unk>  include thickened gallbladder, gallstones or sludge, and pericholecystic fluid. CT scan is usually used for the diagnosis of the complications of<unk> . These complications include emphysematous cholecystitis and gangrenous cholecystitis. Cholescintigraphy is the gold standard for the diagnosis of<unk> . Cholescintigraphy is an alternative method of imaging and uses technetium-labeled hepatic 2,6-dimethyl-iminodiacetic<unk> id (HIDA) in difficult cases or uncertain diagnosis. Findings on a cholescintigraphy diagnostic of<unk>  include lack of visualization of the gallbladder. The mainstay of treatment for<unk>  (calculous and<unk> alculous) is surgery. Laparoscopic cholecystectomy is the gold standard for the treatment of<unk>  and is usually preferred over the open cholecystectomy. Percutaneous cholecystostomy (PC) is an alternative to emergency cholecystectomy in complicated cases of high-risk patients. Pharmacologic medical therapy is recommended for cases of<unk>  in which surgery is delayed. Empiric pharmacologic medical therapies for<unk>  include either amoxicillin-clavulanic<unk> id, cefoxitin, cefotaxime, or ceftriaxone with metronidazole, and ciprofloxacin or levofloxacin with metronidazole. The duration of medical therapy after the cholecystectomy depends on the severity of the disease.
Acute cholecystitis
Chronic cholecystitis
Gallstone pancreatitis
Acute pancreatitis
Gallstone ileus
Ascending cholangitis
Choledocholithiasis
Splenic abscess