The first symptom of cholecystitis is usually pain in the upper right-hand quadrant of your abdomen.  It can start out spasmodic but is most of the time severe and consistent pain. Referred pain is if it is felt in your right shoulder or below your shoulder blade.

The gallbladder area may be swollen and tender, and is most often accompanied by a slightly increased temperature, vomiting, nausea, and watery stools.

As the condition gets worse, life-threating conditions supervene including greatly increased temperatures, jaundice – which is an indication of liver problems, or shock.

A perforation of the gallbladder would cause the bile to leak into the abdominal cavity, and in essence, cause a digesting of your other organs.  If it forms a fistula or an opening with the small bowel it can lead to intestinal obstruction, which can also be life-threatening.

Diagnosis of cholecystitis is found with physical examination, history of any of these symptoms, laboratory findings, and imaging tests. Ultrasound would be elicited upon a positive Murphy’s sign. This is a part of an abdominal examination in which the physician will ask the patient to breathe in and out while the physician places a hand below the ribs on the right side.

If the gallbladder is inflamed the patient will stop breathing and exhibit pain when the gallbladder comes in contact with the doctor’s fingers.

Another radiology test used to diagnose cholecystitis is a CT scan. Either CT scan or ultrasound would show a thickening of the gallbladder wall, extra fluid and the positive Murphy’s sign. Blood tests would show elevated hydrolase enzyme responsible for removing phosphates, increased bilirubin which is a compound of the bile, and maybe increased white blood count which is consistent with infection.

Complications of cholecystitis include rupturing of the gallbladder, or ascending cholangitis, which is an infection caused by bacteria of the bile duct. Rokitansky-Aschoff sinuses, pockets or out-pouch in the wall of the gallbladder, are formed as a result of increased pressure and recurrent damage to the wall of the gallbladder.

Cholecystitis is a serious illness and the signs and symptoms of it should not be ignored. Talk with your doctors if you notice any cholecystitis symptoms.

1)     gallstones

2)     sludge

3)     polyps

4)     rupture

Gallstones

One of the most common gallbladder problems is gallstones. This is often caused by gallstones in the bile duct and it can cause pain in the abdominal area. Gallstones are small pebble-like structures in the gallbladder. The size of these stones can range from tiny grains of sand to the size of golf balls. They can get stuck in the bile duct when large, and can either slow or block the flow of the bile in the duct that connects the liver and small intestine, resulting in either a dull ache or sharp pain in the area. This may also lead to jaundice, a condition where the flow of bile is blocked, backed up into the liver, and is released into the bloodstream. It can cause the skin and whites of the eyes to turn yellow. If you notice that you have this condition, you should see your doctor immediately.

Sludge

Bile helps your body digest dietary fats when it is released into the small intestine. Bile can attach to other particles found in the gallbladder, such as salts and minerals. Gallbladder sludge forms when bile particles, cholesterol crystals, and calcium salts combine. Biliary sludge may progress to form cholesterol gallstones. The good news is that in most cases, biliary sludge don’t develop into gallstones. Instead they dissolve and pass out harmlessly through the gallbladder.

Polyps

Gallbladder polyps range from 1 to 10 mm long and are usually benign (non-cancerous). They are small projections that emerge from the walls of the gallbladder. They usually don’t require treatment. Often, doctors will request follow up examinations to see if the polyps change in size. A change in the size of the polyp may be a malignant (cancerous) polyp. These follow-ups often require an ultrasound examination.

When polyps are larger than one centimetre, there is a greater chance that it may be cancerous. The greater the size of the polyps, the higher the chance that the polyps are malignant. If this is the case, doctors often will suggest cholecystectomy, a term used to describe the surgical removal of the gallbladder. When polyps are in combination with gallstones, there is an even greater risk of cancer, and it is more likely that your doctor will recommend cholecystectomy.

Rupture

Rupture is another one of the common gallbladder problems. Some gallbladder symptoms can lead to rupture. Cholecystitis the term for the inflammation of the gallbladder. This condition is often caused by gallstones or choleliths in the gallbladder, known as cholelithiasis. Choleliths or gallstones can block the cystic duct, which causes the bile to thicken as well as increases the chances of a secondary infection. This leads the gallbladder to become inflamed. An extreme gallbladder symptom is rupture, a serious injury.

If the gallbladder ruptures, one may get an infection called peritonitis, an infection of the abdominal membranes. Some symptoms of this infection include nausea, bloating, fatigue, diarrhea, vomiting, appetite loss, abnormal bowel movement, and flatulence. A ruptured gallbladder can be fatal if you do not seek medical treatment immediately. It will need to be removed, and antibiotic treatment will likely be prescribed.