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Acute Care Surgery Handbook pp 171–193Cite as

Acute Cholecystitis and Cholangitis

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Abstract

Although stones in the biliary tree (and especially in the gallbladder) are an extremely common (and many times asymptomatic) disorder, they may even be the cause of insidious infections. Acute cholecystitis (AC) is a bacterial infection (most likely preceded by an inflammation of the gallbladder wall) produced by an obstruction of the cystic duct by gallstones. The obstruction results in gallbladder distension, wall edema, inflammation, ischemia, and ultimately bacterial infection, causing necrosis, gangrene, and eventually perforation of the gallbladder wall, with the development of a local abscess or generalized peritonitis. The obstruction is usually caused by gallstones (>90 %), thereby identifying the acute calculous cholecystitis (ACC), but AC may infrequently be acalculous (acute acalculous cholecystitis, AAC) [1]. Instead acute cholangitis is a bacterial infection caused by an obstruction of the biliary tree most commonly from gallstones, independent of the gallbladder and cystic duct (termed choledocholithiasis, CL), resulting in elevated intraluminal pressure and bile infection. CL in many cases can be even associated to AC.

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Author information

Authors and Affiliations

  1. Unit of General Surgery I, Papa Giovanni XXIII Hospital, Piazza OMS 1, Bergamo, 24127, Italy

    Federico Coccolini, Andrea Allegri, Marco Ceresoli, Giuseppe D’Amico, Asaf Harbi, Giulia Montori, Gabriela Nita, Francesca Rubertà, Michele Pisano & Luca Ansaloni

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  1. Federico Coccolini
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  2. Andrea Allegri
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  3. Marco Ceresoli
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  6. Giulia Montori
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Correspondence to Luca Ansaloni .

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Editors and Affiliations

  1. Emergency and Trauma Surgery Service, C.A. Pizzardi Maggiore Hospital AUSL Bologna, Bologna, Italy

    Salomone Di Saverio

  2. Surgery and Emergency, Maggiore Hospital of Parma, Parma, Italy

    Fausto Catena

  3. General, Emergency and Trauma Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy

    Luca Ansaloni

  4. General, Emergency and Trauma Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy

    Federico Coccolini

  5. Trauma, Emergency Medicine, Harvard Medical School Massachusetts General Hospital, Boston, Massachusetts, USA

    George Velmahos

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Coccolini, F. et al. (2016). Acute Cholecystitis and Cholangitis. In: Di Saverio, S., Catena, F., Ansaloni, L., Coccolini, F., Velmahos, G. (eds) Acute Care Surgery Handbook. Springer, Cham. https://doi.org/10.1007/978-3-319-15362-9_12

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  • DOI: https://doi.org/10.1007/978-3-319-15362-9_12

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