Cholecystitis
Overview
The gallbladder is a pear-shaped organ located on the upper right side of your abdomen (belly), under your liver. The gallbladder holds bile (a fluid that helps with digestion) that it releases into your small intestine. Cholecystitis occurs when the gallbladder becomes inflamed (swollen).
There are two types of cholecystitis:
Acute cholecystitis. This occurs when the gallbladder becomes suddenly inflamed.
Chronic cholecystitis. This occurs when the gallbladder is inflamed for a long period of time, such as weeks or months. Long-term inflammation of the gallbladder can cause scarring and damage to the organ.
Symptoms of Cholecystitis
Signs and symptoms of acute cholecystitis can include:
Fever
Jaundice (yellowing of the skin and whites of the eyes)
Nausea
Pain that radiates to your child’s right shoulder or back
Sharp pain in your child’s upper right or middle area of the abdomen
Tenderness when your child’s abdomen is touched
Vomiting
The main symptom of chronic cholecystitis is mild to moderate pain in the upper right or middle area of the abdomen that comes and goes (intermittent pain). Some people with chronic cholecystitis won’t experience any symptoms.
When to see a doctor
If your child’s abdominal pain is so bad that they cannot stand up straight or if they are vomiting and unable to keep food down, you should contact their doctor right away or go to the nearest emergency room.
Causes of Cholecystitis
Inflammation of the gallbladder – or cholecystitis – can be caused by:
Gallstones. The most common cause of cholecystitis is when gallstones (hard particles of wastes and minerals that form in the gallbladder) block the bile duct and cause inflammation.
Bile duct block. Scarring of a bile duct (tubes that go from the liver to the small intestines) can lead to blockages that cause cholecystitis. Scarring can result from a bile duct stone (hard mineral deposit), prior bile duct surgery, or infection or inflammation of the bile duct.
Blood vessel problems. If your child has blood vessel damage, it can decrease blood flow to the gallbladder. This can lead to cholecystitis.
Tumor. If your child has a tumor near their gallbladder, it may be preventing bile from properly draining out of the gallbladder.
Who’s at risk
Having a history of the following factors can increase your child’s risk for developing cholecystitis:
Gallstones
Infection or inflammation of the bile ducts
Bile duct stones
Bile duct surgery
Blood vessel damage
A tumor near the gallbladder
The following factors can increase your risk of developing gallstones:
High-fat diet
Obesity (having a body mass index, or BMI, of over 30)
Pregnancy
Quick weight loss
Birth control medication (“the pill”)
Diagnosis of Cholecystitis
Your child will undergo one or more of the following tests to diagnose cholecystitis:
Blood test. Your child’s doctor may use blood tests to check for signs of infection or issues with the gallbladder.
Imaging tests. Your child’s doctor may order imaging tests – such as an abdominal ultrasound, endoscopic ultrasound, magnetic resonance cholangiopancreatography (MRCP) or computerized tomography (CT) scan – to obtain detailed images of your child’s gallbladder and surrounding structures.
Hepatobiliary iminodiacetic acid (HIDA) scan. This test checks how bile moves through your child’s body. A HIDA scan can locate any blockages or issues with the bile ducts (tubes that go from the liver to the small intestines) or gallbladder.
Treatments for Bronchopulmonary Sequestration
If your child is diagnosed with acute cholecystitis, they may need to stay in the hospital for treatment. If they have been diagnosed with chronic cholecystitis, and their pain is only occasional and well-controlled at home, they may be treated as an outpatient with planned surgery. If your child is admitted to the hospital, they receive one or more of the following treatments:
Avoiding food or drink for a period of time. This helps the inflamed (swollen) gallbladder rest.
Receiving intravenous (IV) fluids. This helps prevent dehydration.
Receiving medications. Pain medications help control pain. Antibiotic medications help fight infection.
Undergoing endoscopic retrograde cholangiopancreatography (ERCP). This minimally invasive procedure removes gallstones from the gallbladder and bile ducts using X-ray images and a tube down the throat. The surgeon uses specialized tools to break up the gallstones into small pieces, and then removes them through the tube.
If your child has cholecystitis, the doctor may recommend a surgical procedure to remove the gallbladder, which is not a vital organ. This procedure is known as a cholecystectomy. Removing the gallbladder will avoid future cases of cholecystitis. Once a person has their gallbladder removed, there is no place for bile to collect in the body. Instead, the liver releases bile straight into the small intestine.
Laparoscopic Cholecystectomy
Your child’s surgeon will likely use minimally invasive laparoscopic surgery to remove the gallbladder. Your child will be under general anesthesia for the surgery (fully asleep). During this procedure, your child’s surgeon makes two to four small cuts (incisions) in your child’s abdomen that allow the surgeon to access the gallbladder. During surgery, the surgeon uses a specialized camera inserted through one of the incisions to guide the surgery. (If there is too much infection surrounding the gallbladder or it is difficult to access, your child’s surgeon may need to remove the gallbladder using an open-surgery technique). Once the gallbladder is removed, the surgeon removes the surgical tools and camera, and uses stitches and either surgical glue or bandages to close the incisions.
Your child will spend a few hours in a recovery area while the effects of anesthesia wear off. In most cases of laparoscopic cholecystectomy, your child will only need to stay in the hospital for one night for close monitoring and pain control.
After Surgery
Once at home following surgery, you will need to help keep your child’s wounds dry and clean. Your child should be seen by their surgeon for follow-up appointments to ensure proper healing. Your child should rest and avoid heavy lifting for at least one week, or when cleared by the surgeon.
Because the gallbladder is not essential to digestion, most people who have their gallbladder removed will not have any significant long-term complications. In some cases, your child may experience loose stool for a short time after surgery. If your child experiences this, speak with their doctor about possible temporary diet modifications, such as avoiding fatty or fried foods.
Contact Us
If you suspect that your child may have Cholecystectomy, make an appointment with an Orlando Health pediatrician today so your child can start on the road to improved health.
