Chronic cholecystitis

00:00 / 00:00



Chronic cholecystitis



Chronic cholecystitis


0 / 9 complete

USMLE® Step 1 questions

0 / 2 complete

High Yield Notes

13 pages


Chronic cholecystitis

of complete


USMLE® Step 1 style questions USMLE

of 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:  

Reproduced from: Wikimedia Commons

This patient is at risk of developing which of the following complications?    

External References

First Aid








Acalculous cholecystitis p. 405

Calculous cholecystitis p. 405

Cholecystitis p. 405

Cytomegalovirus (CMV)

cholecystitis and p. 405

Referred pain

cholecystitis p. 405


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.


  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)

Copyright © 2023 Elsevier, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.