Complications of Cholecystitis
The complications of acute cholecystitis are very dire and can quickly lead to the death of the patient. Most of the complications of acute cholecystitis are caused by the spreading infection which leads to septicemia (spread of infection throughout the bloodstream). Usual symptoms include rapid heartbeat, fast shallow breathing, fever, and mental confusion.
Septicemia can lead to the following conditions:
- Abscesses or gangrene. If the acute cholecystitis is left untreated, the infection and inflammation can lead to the formation of an abscess. If the body cannot contain the inflammation the abscess turns into gangrene. This complication occurs in 2-30% of the cases of untreated acute cholecystitis.
- Perforated gallbladder. It is estimated that 10 % of the cases of acute cholecystitis result in perforation, which happens to be a life-threatening condition. Usually, this complication happens in people that wait too long to get treated. The risk of perforation is increased if gas is formed in the gallbladder (emphysematous cholecystitis). Once the perforation occurs, the pain may temporarily subside, which is very dangerous and misleading, since peritonitis will develop afterwards.
- Empyema. About 2-3 % of the patients develop a pus-filled gallbladder (empyema). The usual symptoms include severe abdominal pain and high fever. This condition is life-threatening if the infection spreads to the nearby organs or if the wall of the gallbladder becomes perforated.
- Fistula. In some cases the inflammation may cause the gallbladder to adhere to the nearby organ (small intestine, liver, pancreas, etc.) and create a passage between the two. This is a very serious condition which should be treated immediately.
- Gallstone ileus. The condition when the gallstones block the passage through the small intestine is called the gallstone ileus. It usually occurs in people that are over the age of 65, and in some cases can be fatal. Depending on the location of the stone, a surgery may be necessary to remove it.
- Pancreatitis. When the stones get lodged at the very end of the common bile duct, they can obstruct the flow of the pancreatic enzymes, which can lead to acute pancreatitis. This condition is life-threatening and should be treated using endoscopic retrograde cholangiopancreatography in order to remove the stones.
- Gallbladder cancer. Statistics show that 80 % of the patients with gallbladder cancer also have gallstones. The symptoms of gallbladder cancer are usually not apparent until it’s too late for the treatment and include anemia, substantial weight loss, recurrent vomiting, and a feeling of a lump in the abdomen. When the cancer is discovered at an early stage and the gallbladder is removed, the 5-year survival rate is 68 %.
Asymptomatic gallstones very rarely cause complications. The most common complication happens when the gallbladder is surgically removed and some stones get logged in the common bile duct, causing post-hepatic jaundice.
Prognosis after surgical removal of the gallbladder is very good. Very few people experience side effects from this procedure, while the rest do not need to make any changes to their lifestyle after this procedure.