Gall bladder: what are the symptoms of acute cholecystitis?

A short lesson in express medicine: the gall bladderit is a "small reservoir" connected to the liver that fills with bile (a substance produced by the liver) between meals.

When eating, the gallbladder contracts to send bile into the duodenum, which is a segment of the small intestine: this mechanism participates in the phenomenon of digestion, especially fat.

Acute cholecystitis, what is it?

Acute cholecystitis is an infection of the gall bladder. This is the "final stage" of a process that starts with simple gallbladder stones. "Bile is mainly composed of cholesterol and bile salts"explains Patrick Pessaux, president of the French Association of Surgery (AFC).

"When there is an imbalance in the composition of the bile (an excess of cholesterol in 80% of cases) and this is in addition to a problem of motricity of the gallbladder (the "emptying" is done less well ), stones can form inside the reservoir: this disease is called the cholelithiasis"Similar to" pebbles ", these calculations can be more or less large, and more or less numerous.

Good to know : usually, gallbladder stones are asymptomatic. It is estimated that 25% of adults aged 50 and over have, without knowing it!

Things get tough when a calculation will come to "block" the gall bladder duct, the one that delivers bile to the duodenum via the main bile duct. "This causes sharp pains (located under the ribs, right) between 20 and 30 minutes after meals, which last for about 2 hours: this is hepatic colic", says Prof. Pessaux.

Acute cholecystitis occurs when the calculation remains "stuck" in the channel: "the bile accumulates and the pressure inside the "reservoir" increases; germs in the digestive tract can enter the gallbladder, causing an infection"develops the specialist.

What are the symptoms of acute cholecystitis?

First thing to know: some risk factors promote the appearance of stones in the gall bladder:

• obesity and overweight,
• surgery of the small intestine,
• age (from age 50, the risk is significant),
• certain drugs: oestroprogestatifs, anti-cholesterol ...
• women are, on average, more affected than men,
• Asian populations are also more concerned.

Acute cholecystitis is characterized by symptoms following:

• Permanent pain under the ribs, right. It can go up to the right shoulder - way "shoulder strap".
• In a third of cases, there is also a stomach pain (in the upper belly),
• A fever that can rise to 39 ° C (often 38.5 ° C),
• A desire to vomit, nausea,

"These symptoms should not be ignored: Acute cholecystitis is an infection that can degenerate into peritonitis or septicemia if we do not treat it", warns Professor Pessaux.

From the onset of pain, it is necessary to make an appointment with his doctor: a blood test will confirm the infection (there will be an increase in white blood cells) and ultrasound hepatobiliary will reveal the presence of stones and a thickening of the wall of the gallbladder, marking the infection.

Gallbladder surgery: a must

"If acute cholecystitis is detected early (between 2 and 3 days after the onset of the first localized pains), the gall bladder is surgically removedexplains Prof. Pessaux. If you wait longer, an antibiotic treatment will be put in place for a few weeks before cholecystectomy - the scientific name of theremoval of the gall bladder. "

Approximately 120,000 cholecystectomies are performed each year in France. If the operation can be scary, Prof. Pessaux assures us that it does not change the daily life: "in 99% of cases, one can resume a normal life a few days after surgery - and the pain is gone".

Good news : this surgery is now performed by laparoscopy (a minimally invasive way, by small incisions with a camera), and outpatient (we do not sleep in the hospital).

Good to know : if we discover the existence of stones in the gallbladder (thanks to an ultrasound, for example) but no symptoms to report, surgery is not necessary.

Thanks to Prof. Patrick Pessaux, professor of digestive surgery at Strasbourg University Hospitals, and President of the French Association of Surgery (AFC Visceral and digestive surgery).

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