The gallbladder is an organ that sits below the liver. It stores bile, which your body uses to digest fats in the small intestine.
Acute cholecystitis occurs when bile becomes trapped in the gallbladder. This often happens because a gallstone blocks the cystic duct. This is the tube that bile travels into and out of the gallbladder. When a stone blocks this duct, bile builds up, causing irritation and pressure in the gallbladder. This can lead to swelling and infection.
Other causes include:
Serious illnesses such as HIV or diabetes
Tumors of the gallbladder (rare)
Some people are more at risk for gallstones. Risk factors include:
Being Native American or Hispanic
Losing or gaining weight rapidly
Sometimes the bile duct becomes blocked temporarily. When this occurs repeatedly, it can lead to chronic cholecystitis. This is swelling and irritation that continues over time. Eventually, the gallbladder becomes thick and hard. It also does not store and release bile as well.
The main symptom is pain in the upper right side or upper middle of your belly that usually lasts at least 30 minutes. You may feel:
Sharp, cramping, or dull pain
Pain that spreads to your back or below your right shoulder blade
Other symptoms that may occur include:
Nausea and vomiting
Yellowing of skin and whites of the eyes (jaundice)
Exams and Tests
A physical exam will show that it hurts to touch your belly.
Injury to the bile ducts draining the liver (may occur after gallbladder surgery)
Peritonitis (inflammation of the lining of the abdomen)
When to Contact a Medical Professional
Call your health care provider if:
Severe belly pain does not go away
Symptoms of cholecystitis return
Removing the gallbladder and gallstones will prevent further attacks.
Glasgow RE, Mulvihill SJ. Treatment of gallstone disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 66.
Jackson P, Evans S. Biliary system. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap. 55.
Siddiqui T. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials. Am J Surg. 2008;195:40-47.
Wang DQH, Afdhal NH. Gallstone disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 65.
George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.