Written and medically reviewed by: Assoc. Prof. Cengiz Dibekoğlu, MD, General SurgeryLast updated:
Gallbladder Disease — Acute Cholecystitis
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.”
Educational schematic. Some structures may be simplified or emphasized for clarity; not an exact anatomical depiction.
© Cengiz Dibekoğlu — illustrative; not for unauthorized use
Figure summary
- This educational figure shows: Acute cholecystitis.
- Related figures on this page: Stone-related inflammation, Early surgery option.
Related educational figures
Tap a figure to enlarge.
Stone-related inflammation Educational schematic. Some structures may be simplified or emphasized for clarity; not an exact anatomical depiction.
© Cengiz Dibekoğlu — illustrative; not for unauthorized use
Figure summary
Stone-related inflammation
Early surgery option Educational schematic. Some structures may be simplified or emphasized for clarity; not an exact anatomical depiction.
© Cengiz Dibekoğlu — illustrative; not for unauthorized use
Figure summary
Early surgery option
Key points
What is acute cholecystitis?
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.
- Key note inside
Symptoms
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
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
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.
- Key note inside
Complications of delay
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?
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.
More chapters in this hub
Gallstones
Biliary colic, silent stones, and when cholecystectomy is appropriate
Bile-Duct Stones
Jaundice and cholangitis risk — ERCP then gallbladder removal
Gallbladder Polyps
Size, growth, and when surveillance becomes surgery
Gallbladder Cancer
Rare cancer — staging and tumor-board planning
Laparoscopic Cholecystectomy
Laparoscopic cholecystectomy: what the procedure aims to do and who it fits
Robotic Gallbladder Surgery
Robotic surgery: what the procedure aims to do and who it fits
Gallbladder Surgery Methods
Open, laparoscopic, robotic
Appointment / info
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.