Basic laparoscopy: Cholecystectomy 04.3 Acute cholecystitis.

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A stone becomes lodged in the neck of the gallbladder or Hartmann's pouch.

There is distension of the galladder due to obstruction

+ Superadded inflammatory oedema, triggered by a chemical irritation

+ The growth of organisms (usually bowel organisms).

There is an inflammatory oedema of the wall of the gallbladder and surrounding tissues extending into the cystic duct, and bile duct.

In an uncomplicated case:

The stone is thought to fall back into the gallbladder

The gallbladder fluid escapes down the biliary tree into the duodenum.

The inflammatory process resolves.

The pain and fever usually settle down in 10 days or so.

The inflammatory process may a take a month or two to resolve sufficiently for the tissue planes to be restored.

Sometimes no stones are found at operation. They may have passed, or the condition may be caused by a stricture in the cystic duct.

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