Asymptomatic patients with sludge or microlithiasis require no therapy. When patients are symptomatic or if complications arise, cholecystectomy is indicated.
For the elderly or those at risk from the surgery, endoscopic sphincterotomy can prevent recurrent episodes of pancreatitis. Gallbladder sludge is more frequently diagnosed in people with gallbladder and liver issues because people with these types of conditions are more likely to undergo diagnostic imaging tests. Not all people with gallbladder sludge develop symptoms. When gallbladder sludge is caused by a risk factor, such as pregnancy, it usually goes away when the risk factor disappears.
Gallbladder sludge follows one of 3 different courses. It may disappear entirely and never come back; it may go away then recur later, or it may persist, usually leading to the development of gallstones.
Pregnancy, which can stress the gallbladder, may also cause gallbladder sludge. Gallbladder sludge caused by pregnancy usually resolves when the pregnancy ends.
Many people with gallbladder sludge experience no symptoms. Even when gallbladder sludge causes gallstones, 80 percent of people will not have symptoms. Some people only discover they have gallbladder sludge when they experience symptoms of a condition related to the sludge, such as acute pancreatitis. These symptoms can also be signs of many other conditions, so it is essential to get an accurate diagnosis.
It may not always be necessary to monitor the condition, since gallbladder sludge may resolve on its own. Other treatments include:. In some cases, it may be possible to dissolve gallstones related to gallbladder sludge with medication. Treating underlying medical conditions can also help with gallbladder sludge since being in generally poor health can be a risk factor for this problem. Those who have pain associated with gallbladder sludge, or who have gallstones or other symptoms, may need to have their gallbladders removed.
People can function well without a gallbladder, and people who are reasonably healthy are good candidates for gallbladder removal. The surgery requires general anesthesia, meaning the person will be fully asleep during the operation.
Another option is endoscopic retrograde cholangiopancreatography ERCP. But if your cholecystitis is caused by gallstones in your gallbladder, your gallbladder will need to be removed. Gallbladder removal called cholecystectomy is a common surgery. Your body will work well without your gallbladder. It is not essential for a healthy life. You may have surgery done right away. If you are too sick to have surgery, a small tube may be put through your skin and into your gallbladder. This will drain the bile and ease your symptoms until you can have surgery.
If your gallbladder has not been removed and you have more attacks of cholecystitis, you may develop long-term chronic cholecystitis.
Chronic cholecystitis may not cause any symptoms. But it can damage the walls of your gallbladder. The walls can become scarred and get thicker. Your gallbladder will start to get smaller. Over time, it will be less able to store and release bile. You will need surgery to remove your gallbladder.
Health Home Conditions and Diseases. The gallbladder is a small organ under your liver. It stores bile which is made in the liver. Cholecystitis can be sudden acute or long-term chronic. What causes cholecystitis?
Cholecystitis happens when a digestive juice called bile gets trapped in your gallbladder. The gallbladder stores bile. Gallstones are formed in your gallbladder. They are made from bile. Other causes of cholecystitis include: Bacterial infection in the bile duct system.
The bile duct system is the drainage system that carries bile from your liver and gallbladder into the first part of your small intestine the duodenum. Tumors of the pancreas or liver. A tumor can stop bile from draining out of your gallbladder.
Reduced blood supply to the gallbladder. Gallstones do not cause belching or bloating. Nausea occurs only when biliary colic occurs. Between episodes, people feel well. If the blockage persists, the gallbladder becomes inflamed a condition called acute cholecystitis Symptoms Gallstones are collections of solid material predominantly crystals of cholesterol in the gallbladder. The liver can secrete too much cholesterol, which is carried with bile to the gallbladder When the gallbladder is inflamed, bacteria flourish, and infection may develop.
The inflammation usually causes fever. Blockage of the common bile duct or the ampulla of Vater is more serious than blockage of the cystic duct. Blockage of a bile duct can cause the ducts to widen dilate.
It can also cause fever, chills, and jaundice Jaundice in Adults In jaundice, the skin and whites of the eyes look yellow. Jaundice occurs when there is too much bilirubin a yellow pigment in the blood—a condition called hyperbilirubinemia.
See also Overview This combination of symptoms indicates that a serious infection called acute cholangitis has developed. Bacteria can spread to the bloodstream and cause serious infections elsewhere in the body sepsis Sepsis and Septic Shock Sepsis is a serious bodywide response to bacteremia or another infection plus malfunction or failure of an essential system in the body. Septic shock is life-threatening low blood pressure Also, pockets of pus abscesses Symptoms An abscess is a pocket of pus, usually caused by a bacterial infection.
Most people have constant abdominal pain and a fever. Computed tomography or another imaging test can distinguish an abscess Stones that block the ampulla of Vater also can block the pancreatic duct, causing inflammation of the pancreas pancreatitis Overview of Pancreatitis Pancreatitis is inflammation of the pancreas. The pancreas is a leaf-shaped organ about 5 inches about 13 centimeters long.
It is surrounded by the lower edge of the stomach and the first Inflammation of the gallbladder caused by gallstones can erode the gallbladder wall, sometimes resulting in a hole perforation. Perforation results in leakage of the gallbladder contents throughout the abdominal cavity, causing severe inflammation peritonitis. A large gallstone that enters the small intestine can cause intestinal blockage, called a gallstone ileus.
This rare complication is more likely to occur in older people. Doctors suspect gallstones in people with the characteristic pain in the upper abdomen caused by a swollen gallbladder. Sometimes gallstones are detected when an imaging test such as ultrasonography is done for other reasons. Ultrasonography Ultrasonography Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, radionuclide scanning, computed tomography CT , magnetic resonance imaging MRI , endoscopic retrograde cholangiopancreatography It is less accurate in detecting stones in the bile ducts, but it may show that the blockage has caused the ducts to dilate.
Other diagnostic tests may be necessary. They include. Alcohol use and cigarette smoking In endoscopic ultrasonography EUS , an endoscope that contains a tiny ultrasound device at its tip is passed through the mouth into the stomach and the small intestine.
It is positioned near the gallbladder and bile ducts and can show images of the structures there better than standard ultrasonography. For ERCP, a flexible viewing tube endoscope with surgical attachments is passed through the mouth, down the esophagus, through the stomach, and into the small intestine see figure Understanding Endoscopic Retrograde Cholangiopancreatography Understanding Endoscopic Retrograde Cholangiopancreatography Chronic pancreatitis is long-standing inflammation of the pancreas that results in irreversible deterioration of the structure and function of the pancreas.
A thin catheter is passed through the endoscope, into the opening between the small intestine and the common bile and pancreatic ducts and up into the common bile duct.
A radiopaque contrast agent, which is visible on x-rays, is then injected through the catheter into the bile ducts, and x-rays are taken to detect any abnormalities. Blood tests to evaluate how well the liver is functioning and whether it is damaged liver tests Liver Blood Tests Liver tests are blood tests that represent a noninvasive way to screen for the presence of liver disease for example, hepatitis in donated blood and to measure the severity and progress of Results are usually normal unless stones block the bile ducts.
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