Chronic cholecystitis

Last updated: February 22, 2023

Chronic cholecystitis

Gastrointestinal

Gastrointestinal

Gastrointestinal hormones
Gastric dumping syndrome
Gastrointestinal bleeding: Clinical
Gastrointestinal system anatomy and physiology
Esophageal disorders: Pathology review
Esophageal motility
Esophageal disorders: Clinical
Gastric motility
Small intestine histology
Anatomy of the abdominal viscera: Small intestine
Intestinal malrotation
Anatomy of the abdominal viscera: Large intestine
Pediatric constipation: Clinical
Bowel obstruction
Inflammatory bowel disease: Pathology review
Diverticular disease: Pathology review
Zenker diverticulum
Meckel diverticulum
Crohn disease
Malabsorption syndromes: Pathology review
Food allergy
Colorectal polyps and cancer: Pathology review
Juvenile polyposis syndrome
Familial adenomatous polyposis
Gastrointestinal bleeding: Pathology review
Diarrhea: Clinical
Escherichia coli
Irritable bowel syndrome
Gallbladder disorders: Pathology review
Alcohol-associated liver disease
Non-alcoholic fatty liver disease
Liver anatomy and physiology
Wilson disease
Whipple's disease
Viral hepatitis: Pathology review
Colorectal cancer: Clinical
Jaundice: Pathology review
Appendicitis: Pathology review
Pancreatitis: Pathology review
Small bowel ischemia and infarction
Intussusception
Vitamin B12 deficiency
Gastroesophageal reflux disease (GERD)
Paget disease of bone
Congenital gastrointestinal disorders: Pathology review
Fat-soluble vitamin deficiency and toxicity: Pathology review
Gastroparesis: Clinical
Osteomalacia and rickets
Bone disorders: Pathology review
Chronic cholecystitis
Childhood nutrition and obesity: Information for patients and families (The Primary School)
Anatomy clinical correlates: Viscera of the gastrointestinal tract

Flashcards

Chronic cholecystitis

0 of 9 complete

Questions

USMLE® Step 1 style questions USMLE

0 of 2 complete

A 65-year-old woman comes to a follow-up appointment following hospitalization due to diverticulitis. Since then, she has been recovering well and has no complaints. Medical history is significant for cholelithiasis, hypercholesterolemia, diverticulitis and constipation. Medications include statins, multivitamins, and supplemental fiber. She does not smoke, drink alcohol, or use illicit drugs. On physical examination, the abdomen is soft and nontender, and bowel sounds are present. A CT obtained at the recent hospitalization is shown below and reveals extensive, encrusting calcification of the gallbladder:  


 Reproduced from: ">Wikimedia Commons 
This patient is at risk of developing which of the following complications?  

Transcript

Watch video only

Content Reviewers

With acute cholecystitis, a gallstone gets lodged in the cystic duct, or maybe in the common bile duct, and then causes acute inflammation, pain, and possibly, but not usually, infection; almost all cases of acute cholecystitis though, about 90%, clear up after about a month and the gallstone dislodges.

It’s possible though, that gallstones get stuck again, and then dislodge, and then get stuck again, and dislodge, and so on.

So over time, you can imagine the gall bladder walls taking a serious beating, and as those epithelial cells go through this cycle of inflammation over and over again, patients are essentially in this constant state of inflammation, also known as chronic cholecystitis.

After a while, they can begin to show signs of cellular damage and the epithelial cells can possibly even die off.

Some patients might not even have had cases of acute cholecystitis where the gallstone gets lodged in the ducts, and sometimes they just have gallstones that cause this constant state of irritation and mild inflammation just by being in the gallbladder.

Gallstones can be made up of bilirubin, called pigment gallstones, or cholesterol, called cholesterol stones, or maybe they’re made up of both both, and when they roll around and are in contact with the epithelial cells, they can cause inflammation.

One study found that cholesterol stones in particular might have a more potent ability to stimulate inflammation of the gallbladder epithelial cells.

Whatever the case, chronic inflammation can take its toll, and changes in the gallbladder wall structure can start to take place.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Acute Calculous Cholecystitis" New England Journal of Medicine (2008)
  6. "Diffuse Gallbladder Wall Thickening: Differential Diagnosis" American Journal of Roentgenology (2007)