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Complications of acute cholecystitis
Gangrenous cholecystitis is a common complication of acute cholecystitis that occurs in up to 30% of cases. Gallbladder perforation is a less common but more serious complication that occurs in around 1 in 100 cases.
Gangrenous cholecystitis develops when severe inflammation (swelling) interrupts the blood supply to your gallbladder.
Without a constant supply of blood, the tissue of the gallbladder will begin to die. This is potentially serious because the dead tissue is vulnerable to serious infection, which can quickly spread throughout the body.
Known risk factors for gangrenous cholecystitis include:
- being male
- being 45 years of age or over
- having a history of diabetes
- having a history of heart disease
It is unclear why these risk factors make a person more vulnerable to gangrenous cholecystitis.
Other than a very rapid heartbeat (more than 90 beats a minute), gangrenous cholecystitis does not usually cause noticeable symptoms, so is usually diagnosed on the basis of test results.
Gangrenous cholecystitis would be strongly suspected if:
- your heart rate is more than 90 beats a minute
- you have a very high white blood cell count
- the ultrasound scan shows the wall of your gallbladder is thicker than 4.5mm
If gangrenous cholecystitis if suspected, a cholecystectomy will usually be carried out to remove the gallbladder as soon as possible.
In cases of severe inflammation, the wall of the gallbladder can tear and infected bile can leak out. This can cause an infection of the lining of the abdomen (tummy), known as peritonitis.
Symptoms of peritonitis include:
- a sudden and very severe abdominal pain
- a high temperature (fever) of 38ºC (100.4ºF) or above
- rapid heartbeat (tachycardia)
- feeling thirsty
- not passing urine or passing much less urine than normal
Peritonitis is treated using a combination of antibiotic injections and surgery to remove the gallbladder and drain away infected bile.
Read more information about peritonitis.