How to Diagnose Cholecystitis

Cholecystitis is an inflammation of the gallbladder, usually caused by a gallstone obstructing the cystic duct. The gallbladder becomes distended and loses blood flow and drainage to the lymphatic system, which can lead to anemia of the gallbladder or even tissue death. Bile cultures are usually positive but this may be the result, not the cause, of cholecystitis. The following steps will show how to diagnose cholecystitis.

Instructions

1. Observe the presenting symptoms of cholecystitis. This is most commonly upper abdominal pain that frequently radiates to the tip of the right scapula. Most patients will have a history of pain caused by the gallbladder.

2. Find fever, rapid heart rate and tenderness of the epigastric region or right upper quadrant (RUQ) upon a physical examination of the patient. A feeling of fullness in the RUQ also exists and the gallbladder may be palpable in 30 to 40 percent of cholecystitis cases. Jaundice may also be found in 15 percent of these cases.

3. Consider the risk factors for cholecystitis caused by gallstones. These include female gender, hormone supplements, Pima Indian or Scandinavian ethnicity, obesity, pregnancy and elderly patients.

4. Look at the risk factors of cholecystitis not associated with gallstones. The gallbladder most commonly reduces or ceases its production of bile from injury, major surgery or prolonged fasting.

5. Use ultrasound to detect findings suggestive of cholecystitis. These include an accumulation of pericholecystic fluid, and a thickening of the gallbladder wall to greater than 4 mm and gallstones.