The liver produces bile to aid in the digestion of fats, cholesterol and certain vitamins. This bile is delivered to the gallbladder, which dispenses small amounts in response to food entering the small intestine. The gallbladder is a small, pear shaped sac that sits just below the liver. Bile is dispensed through a series of ducts or small tubes to the small intestine. When these ducts are blocked, symptoms will appear (Reference 1).
Acute Cholecystitis
Cholecystitis is inflammation of the gallbladder. According to Penn Medicine, 20 percent of patients experiencing gallbladder symptoms have acute cholecystitis and they are typically women between the ages of 20 and 40. There are several reasons why the gallbladder may become inflamed; a gallstone blocking the bile duct is the most common reason (Reference 1). It is not really clear why gallstones develop. A sudden onset of severe right upper abdominal pain, nausea, vomiting and loss of appetite are the symptoms of acute cholecystitis. The pain mayalso be felt under the right shoulder blade. Fever will follow when the gallbladder becomes inflamed (Reference 1). The pain can last for greater than six hours and can be excruciating.
Acalculous Cholecystitis
Acalculous cholecystitis is a more serious form of gallbladder disease. Acalculous literally means "without stones," which describes this type of gallbladder disease that develops without gallstones. Patients develop a sudden onset of severe right upper abdominal pain suddenly with no history of prior gallbladder disease. Acalculous cholecystitis can develop after major surgery, critical illnesses or sepsis, or prolonged fasting (Rference 1). The inflammation of acalculous cholecystitis can be very severe and cause the gallbladder to rupture or become gangrenous. Acalculous cholecystitis if left untreated causes death in 65 percent of patients, according to the Merck Manual.
Chronic Cholecystitis
Chronic cholecystitis is almost always associated with gallstones, according to the Merck Manual. This disease is heralded by chronic attacks of right upper abdominal pain called biliary colic. The pain is caused by a stone that is wedged between the gallbladder and bile duct or stuck in the bile duct itself. The pain is caused by the strong contractions of the gallbladder and duct in an effort to dislodge the stone (Reference 2). In chronic cholecystitis the gallbladder has repeated bouts of inflammation that cause the walls to become thickened and scarred. Fever does not usually occur in people with chronic cholecystitis (Reference 1).
