Upper abdominal pain with vomiting and fever signals acute cholecystitis…why regular ultrasound matters
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Gangnam St. Peter's Hospital 26-01-15 07:29Main content
Obesity, diabetes and hyperlipidemia raise the risk↑…rapid dieting is also a ‘cause’
Park Kwan-tae, Chief at St. Peter's Hospital: “See a specialist as soon as symptoms begin”
(Seoul = News1) Reporter Kim Gyu-bin = The gallbladder, commonly known in Korean as 'sseulgae', is a small organ that nonetheless plays an important part in digestion, and the risk of inflammation and gallstones rises with age. Cholecystitis patients increase notably after the 40s and 50s and are most numerous after the 60s, so regular check-ups are needed.
Park, Kwan Tae, Chief of General Surgery at St. Peter's Hospital, said on the 15th, "If pain you have not had before appears in the upper abdomen, you should not brush it off lightly even if the symptom disappears for a time," adding, "It is important to see a specialist early who can examine the gallbladder, pancreas and bile ducts together."
According to the Health Insurance Review and Assessment Service, among patients with cholecystitis (K81) in 2024, those in their 40s were about 1.4 times as numerous as those in their 30s, while those in their 60s numbered about twice as many as those in their 30s, the largest patient group of any age band. The risk of cholecystitis clearly increases with age.
The gallbladder is located near the liver, where it stores bile and sends it through the bile duct to the duodenum to aid digestion. If the bile duct becomes blocked in this process or bacteria enter the bile, cholecystitis can result. This is why the liver, gallbladder, bile ducts and pancreas are often examined together in clinical practice.
The most common cause of cholecystitis is gallstones. Gallstones form when the components of bile become imbalanced and harden; when they block the cystic duct, pressure inside the gallbladder rises and inflammation develops. Most acute cholecystitis is caused by gallstones, and in chronic cholecystitis, too, gallstones often continuously irritate the gallbladder, causing tissue changes and inflammation.
Metabolic conditions such as obesity, diabetes and lipid disorders are major factors that raise the risk of gallstones. When overeating and high-calorie diets are repeated, changes in the composition of bile make gallstones easier to form and also increase the likelihood of inflammation. Continuing poor eating habits after middle age can place a cumulative burden on the gallbladder. Conversely, rapid weight loss is also known to affect the development of gallstones; some reports indicate that gallstones developed in about 25% of people who followed severe diets.
Cholecystitis differs markedly in its symptoms between the acute and chronic forms. Acute cholecystitis is often accompanied by severe right upper abdominal pain together with nausea, vomiting and fever, and pressing on the right upper abdomen may intensify the pain. Chronic cholecystitis, by contrast, causes almost no symptoms or presents only as bloating, discomfort and fullness in the upper abdomen, and is easily mistaken for a gastrointestinal disorder.
Diagnosis is made mainly by abdominal ultrasound. About 90-95% of gallstones can be identified on ultrasound, and where cholecystitis is present, a thickened gallbladder wall or inflammatory findings are observed. In acute cholecystitis, blood tests may show a rising white blood cell count, or fluid may collect around the gallbladder. Additional tests are carried out as needed to confirm the diagnosis.
Treatment varies with the patient's condition. For acute cholecystitis, surgery to remove the gallbladder is performed as the standard treatment. Even after the gallbladder is removed, bile is secreted directly from the liver, so digestive function is largely unaffected. If symptoms are mild, oral dissolution therapy using medication to dissolve gallstones may be tried, but the complete dissolution rate is under 30% and the long-term risk of recurrence is high.
For chronic cholecystitis, the principle is observation if there are no symptoms. However, because it can progress to acute cholecystitis, regular abdominal ultrasound is recommended to monitor changes where gallstones have been identified. If acute symptoms such as sudden abdominal pain then appear, the patient should seek care promptly.
Chief Park, Kwan Tae advised, "If cholecystitis is suspected, it is best to seek a medical institution with a hepatobiliary-pancreatic specialist who can provide comprehensive care of the gallbladder together with the pancreas and bile ducts," adding, "Complications can occur in about 10% of patients with acute cholecystitis, and chronic cholecystitis can also turn acute depending on its course."
Park Kwan-tae, Chief at St. Peter's Hospital: “See a specialist as soon as symptoms begin”
(Seoul = News1) Reporter Kim Gyu-bin = The gallbladder, commonly known in Korean as 'sseulgae', is a small organ that nonetheless plays an important part in digestion, and the risk of inflammation and gallstones rises with age. Cholecystitis patients increase notably after the 40s and 50s and are most numerous after the 60s, so regular check-ups are needed.
Park, Kwan Tae, Chief of General Surgery at St. Peter's Hospital, said on the 15th, "If pain you have not had before appears in the upper abdomen, you should not brush it off lightly even if the symptom disappears for a time," adding, "It is important to see a specialist early who can examine the gallbladder, pancreas and bile ducts together."
According to the Health Insurance Review and Assessment Service, among patients with cholecystitis (K81) in 2024, those in their 40s were about 1.4 times as numerous as those in their 30s, while those in their 60s numbered about twice as many as those in their 30s, the largest patient group of any age band. The risk of cholecystitis clearly increases with age.
The gallbladder is located near the liver, where it stores bile and sends it through the bile duct to the duodenum to aid digestion. If the bile duct becomes blocked in this process or bacteria enter the bile, cholecystitis can result. This is why the liver, gallbladder, bile ducts and pancreas are often examined together in clinical practice.
The most common cause of cholecystitis is gallstones. Gallstones form when the components of bile become imbalanced and harden; when they block the cystic duct, pressure inside the gallbladder rises and inflammation develops. Most acute cholecystitis is caused by gallstones, and in chronic cholecystitis, too, gallstones often continuously irritate the gallbladder, causing tissue changes and inflammation.
Metabolic conditions such as obesity, diabetes and lipid disorders are major factors that raise the risk of gallstones. When overeating and high-calorie diets are repeated, changes in the composition of bile make gallstones easier to form and also increase the likelihood of inflammation. Continuing poor eating habits after middle age can place a cumulative burden on the gallbladder. Conversely, rapid weight loss is also known to affect the development of gallstones; some reports indicate that gallstones developed in about 25% of people who followed severe diets.
Cholecystitis differs markedly in its symptoms between the acute and chronic forms. Acute cholecystitis is often accompanied by severe right upper abdominal pain together with nausea, vomiting and fever, and pressing on the right upper abdomen may intensify the pain. Chronic cholecystitis, by contrast, causes almost no symptoms or presents only as bloating, discomfort and fullness in the upper abdomen, and is easily mistaken for a gastrointestinal disorder.
Diagnosis is made mainly by abdominal ultrasound. About 90-95% of gallstones can be identified on ultrasound, and where cholecystitis is present, a thickened gallbladder wall or inflammatory findings are observed. In acute cholecystitis, blood tests may show a rising white blood cell count, or fluid may collect around the gallbladder. Additional tests are carried out as needed to confirm the diagnosis.
Treatment varies with the patient's condition. For acute cholecystitis, surgery to remove the gallbladder is performed as the standard treatment. Even after the gallbladder is removed, bile is secreted directly from the liver, so digestive function is largely unaffected. If symptoms are mild, oral dissolution therapy using medication to dissolve gallstones may be tried, but the complete dissolution rate is under 30% and the long-term risk of recurrence is high.
For chronic cholecystitis, the principle is observation if there are no symptoms. However, because it can progress to acute cholecystitis, regular abdominal ultrasound is recommended to monitor changes where gallstones have been identified. If acute symptoms such as sudden abdominal pain then appear, the patient should seek care promptly.
Chief Park, Kwan Tae advised, "If cholecystitis is suspected, it is best to seek a medical institution with a hepatobiliary-pancreatic specialist who can provide comprehensive care of the gallbladder together with the pancreas and bile ducts," adding, "Complications can occur in about 10% of patients with acute cholecystitis, and chronic cholecystitis can also turn acute depending on its course."