Definition and Epidemiology of Acute Cholecystitis with Ascending Cholingitis

Cholecyctitis

• Inflammation of gallbladder
• Gall stones common - 10-20% of population
  
• Difficult to determine exact incidence, though patients with gallstones have 1% per year incidence of severe events (e.g. cholecystitis, obstructive jaundice or biliary pancreatitis)

Acute

• Sudden inflammation of gallbladder
• Causes severe abdominal pain
• Caused by gallstones in bladder
• Severe illness, and rarely, tumours of gallbladders
• Main symptom: abdominal pain located on right hypochondral/epigastrium

Chronic

• Long standing swelling and irritation of gallbladder
• Caused by repeated attacks of acute cholecystitis
• Epigastric pain, nausea/vomiting

Ascending Cholingitis

• Bacterial infection caused by bacteria descending from its junction with duodenum
• Tends to occur if bile duct is already partially obstructed by gallstones
• May be associated with neoplasm or stricture
• Relatively uncommon
• Occurs in association with other diseases that cause biliary obstruction and bactibilia (e.g. after endoscopic retrograde cholangiopancreatography [ERCP], 1-3% develop)
• Risk is increased if dye is injected retrograde