Is this an elective clinic problem?

No. Fever with continuous RUQ pain belongs in urgent hospital pathways, not home waiting.

Is early surgery always possible?

Often preferred when fitness and anatomy allow. High-risk patients may need bridging drainage first.

Detailed chapter

Acute Cholecystitis

Name: Acute Cholecystitis
Creator: Assoc. Prof. Cengiz Dibekoğlu, MD

Sudden gallbladder inflammation — usually from a stone blocking the cystic duct

Acute cholecystitis is sudden inflammation of the gallbladder, most often when a stone blocks the cystic duct. Severe pain, fever, and local tenderness are typical. Early hospital evaluation and, in suitable patients, early cholecystectomy are preferred over “wait and see.”

Acute cholecystitis — educational figure — Acute cholecystitis · educational illustration · English labels below

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Stone-related inflammation
Early surgery option

Key points

What is acute cholecystitis?
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Inflammation of the gallbladder wall. The usual pathway is cystic-duct obstruction by a stone (calculous). Acalculous cholecystitis is less common, often in critically ill patients, and can progress aggressively.
Symptoms
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Continuous severe right-upper pain lasting hours — unlike short colic attacks — with fever, nausea, vomiting, and Murphy-type tenderness. Advanced cases show guarding and systemic infection signs.
- Continuous right-upper abdominal pain
- Fever and malaise
- Nausea / vomiting
- Local tenderness in the right upper quadrant
Diagnosis
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Exam, blood tests (white cells, CRP, liver enzymes), and ultrasound are the foundation. Ultrasound may show wall thickening, fluid, stones, and a positive sonographic Murphy sign. Unclear cases may need CT or HIDA. Jaundice and high bilirubin also prompt a search for duct stones or cholangitis.
Treatment approach
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Hospital care with fluids, analgesia, and antibiotics is common. Suitable patients are offered early laparoscopic cholecystectomy. Very high-risk or late-presenting selected patients may receive temporary percutaneous cholecystostomy as a bridge — definitive cure is still usually cholecystectomy later.
Complications of delay
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Gangrene, perforation, abscess, peritonitis, and sepsis can follow delayed care. “It will pass” is not a safe plan when pain and fever coexist.

Frequently asked questions

Is this an elective clinic problem?
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No. Fever with continuous RUQ pain belongs in urgent hospital pathways, not home waiting.
Is early surgery always possible?
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Often preferred when fitness and anatomy allow. High-risk patients may need bridging drainage first.

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This page is for education. It is not medical advice and does not replace a visit with your physician.

Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · Last medically reviewed: August 2026 · English patient-education chapter.