Acute Cholecystitis

Acute Cholecystitis is almost always associated with obstruction of the gall bladder neck or cystic duct by a gallstone. Occasionally, obstruction may be by mucus, parasitic worms or a tumour. The pathogenesis is unclear, but the initial inflammation is chemical included. At the time of surgery approximately 50% of cultures of the gallbladder contents are sterile. The cardinal feature is pain in the right upper quadrant but also in the right shoulder tip or interscapular region. This disease can be managed by taking bed rest, antibiotics and maintain fluid balance. A cephalosporin is the antibiotic of choice and metronidazole is usually added in severely ill patients.