Rapidly developing inflammation of the gallbladder is called acute cholecystitis. This condition most often develops when a gallstone lodges in the duct that permits outflow of bile from the gallbladder. Without a way to release bile, the gallbladder distends and its lining is damaged causing further accumulation of fluid and pressure within the gallbladder. Without medical intervention, the gallbladder wall can die under the pressure and destructive influences of the inflammation. The death of gallbladder tissue is called gallbladder gangrene. This condition is a potentially life-threatening complication of cholecystitis, which requires urgent medical attention.
Pain
The early pain of gallbladder gangrene is similar to that of a gallbladder attack (also known as biliary colic). Sudden, intense pain develops in the right upper abdomen or in the midline above the belly button. However, rather than staying constant and localized as it would with biliary colic, the pain of a gangrenous gallbladder builds in intensity. It becomes less focal over time and spreads over the abdomen. Taking a deep breath intensifies the pain and characteristically causes the inspiration to stop abruptly. The pain persists beyond the timeframe of an attack of biliary colic, which usually eases within six hours. If the gallbladder wall suddenly breaks open through the dead tissue, there is a brief period of decreased pain as the pressure in the gallbladder is relieved. However, generalized abdominal pain returns as the contents of the gallbladder make their way through the abdomen causing inflammation and possibly infection.
High Fever and Racing Heartbeat
A gangrenous gallbladder typically causes high fever and shaking chills. The heart rate is abnormally high. The sufferer may be aware of his heart rate, which typically feels as if the heart is racing. Intense sweating may also occur making the skin feel clammy.
Dizziness, Lightheadedness and Confusion
The blood pressure typically drops, especially if the gangrenous gallbladder is infected. Low blood pressure can cause dizziness, lightheadedness and confusion. Dizziness or lightheadedness is provoked by attempting to stand.
Nausea and Vomiting
Nausea and vomiting can occur with gangrenous gallbladder disease. However, these symptoms also occur with biliary colic and acute cholecystitis without the development of gallbladder gangrene.
Abdominal Rigidity and Distension
Gallbladder gangrene usually causes an intense inflammatory reaction throughout the abdomen--a condition known as peritonitis. Normal activity of the intestines slows causing abdominal distension. When the doctor listens for bowel sounds, they are decreased or absent. The wall of the abdomen is typically rigid.
References
- British Medical Journal: Acute Cholecystitis
- University of Maryland Medical Center: Gallstones and Gallbladder Disease, Prognosis and Complications
- Merck Manual: Cholecystitis
- Mayo Clinic: Cholecystitis Complications
- "Harrison's Principles of Internal Medicine, 16th Edition"; Dennis L. Kasper, M.D., et al, Editors; 2004
