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In this video, we explore Cholecystitis, an inflammation of the gallbladder commonly resulting from gallstone obstruction. This topic is essential for medical students and graduates preparing for exams like USMLE, UKMLA, NEET PG, and others.

Pathophysiology and Causes
Cholecystitis usually occurs due to blockage of the cystic duct by gallstones (calculous cholecystitis). This blockage leads to bile stasis, irritation, and secondary bacterial infection, typically by organisms such as Escherichia coli or Klebsiella species. Other, less common forms include acalculous cholecystitis, which may be seen in critically ill patients or due to trauma.

Symptoms
Right Upper Quadrant Pain: Often severe, radiating to the right shoulder or back, and worsened after meals.
Fever and Chills: Systemic symptoms indicating infection.
Nausea and Vomiting: Commonly accompanies the pain.
Murphy’s Sign: A clinical sign where there is inspiratory arrest upon palpation of the RUQ, indicating gallbladder inflammation.
Diagnosis
Ultrasound: First-line imaging that may show gallstones, thickened gallbladder wall, or fluid around the gallbladder.
Blood Tests: Elevated WBC, liver enzymes, and sometimes bilirubin if there is bile duct obstruction.
HIDA Scan: Used if ultrasound findings are inconclusive, as it assesses gallbladder function.
Treatment
Supportive Care: Includes fasting (NPO), IV fluids, and pain control.
Antibiotics: Broad-spectrum antibiotics targeting Gram-negative organisms and anaerobes, such as ceftriaxone with metronidazole.
Surgery: Cholecystectomy (removal of the gallbladder) is the definitive treatment, typically performed laparoscopically within 24-48 hours of diagnosis in most cases of acute cholecystitis.
Percutaneous Cholecystostomy: For high-risk surgical patients, a tube may be placed to drain the gallbladder.
This video provides an in-depth overview of cholecystitis to help you understand its pathophysiology, causes, presentation, diagnosis, and management options—crucial knowledge for exams and clinical practice.

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