Chronic cholecystitis is a sexually transmitted disease, mostly associated with gallstones, and a minority are non-gallstone chronic cholecystitis. The disease mostly has a chronic onset and can also result from repeated episodes of acute cholecystitis. Clinically, there may be no specific symptoms.

bubble_chart Diagnosis

1. History Taking

Recurrent episodes of upper abdominal pain, often occurring in the right upper quadrant or mid-upper abdomen, and radiating to the subscapular region. Abdominal pain often occurs after meals but can also be unrelated to eating, and the pain is usually persistent. It may be accompanied by reflex nausea, with rare occurrences of vomiting, fever, jaundice, and other symptoms. It may also be accompanied by symptoms of indigestion such as acid reflux and belching, which worsen after consuming greasy foods. During acute episodes or when stones are lodged in the bile duct, typical symptoms of acute cholecystitis or biliary colic may occur. During inquiry, it is important to ask about any history of recurrent biliary colic, the onset (acute or gradual), location, characteristics, radiation, duration, and accompanying symptoms of the pain.

2. Physical Examination Findings

Tenderness in the right upper abdomen, with manifestations similar to acute cholecystitis during acute episodes. Some patients may not show any positive signs.

3. Laboratory Tests

During acute episodes, laboratory findings are similar to those of acute cholecystitis. In the absence of acute episodes, there may be no abnormal changes. Ultrasound can assess the size of the gallbladder, wall thickness, and the presence of stones. Oral cholecystography can evaluate gallbladder contraction function and the presence of stones.

bubble_chart Treatment Measures

1. If chronic cholecystitis is accompanied by gallstones, symptoms recur without relief, and there are no other serious diseases, a hospitalization certificate can be issued for admission and surgical treatment.

2. If the patient disagrees with surgery or has mild symptoms without recurrent episodes, conservative medical treatment can be adopted. Advise the patient to maintain a low-fat diet, take 6 anti-inflammatory and gallbladder-benefiting tablets orally three times daily, or 10ml of 33-50% magnesium sulfate three times daily. Additionally, some Chinese medicinals for dissolving or expelling stones can be taken orally.

3. If the patient experiences an acute episode, manage it as acute cholecystitis (see details in acute cholecystitis).