Gallbladder Dysfunction: Cholecystitis, Choledocholithiasis, Cholangitis, and Biliary Dyskinesia

Prim Care. 2017 Dec;44(4):575-597. doi: 10.1016/j.pop.2017.07.002. Epub 2017 Oct 5.

Abstract

The prevalence of gallstones is 10% to 15% in adults. Individuals with acute cholecystitis present with right upper quadrant pain, fever, and leukocytosis. Management includes supportive care and cholecystectomy. The prevalence of choledocholithiasis is 10% to 20%, and serious complications include cholangitis and gallstone pancreatitis. The goal of management in individuals with choledocholithiasis consists of clearing common bile duct stones. Acute ascending cholangitis is a life-threatening condition involving acute inflammation and infection of the common bile duct. Treatment includes intravenous fluids, analgesia, intravenous antibiotics, and biliary drainage and decompression. Biliary dyskinesia includes motility disorders resulting in biliary colic in the absence of gallstones.

Keywords: Acute cholecystitis; Ascending cholangitis; Biliary dyskinesia; Choledocholithiasis; Cholelithiasis; Functional gallbladder disorder; Sphincter of Oddi disorders.

Publication types

  • Review

MeSH terms

  • Bile Duct Diseases / diagnosis*
  • Bile Duct Diseases / diagnostic imaging
  • Bile Duct Diseases / physiopathology*
  • Biliary Dyskinesia / diagnosis
  • Biliary Dyskinesia / physiopathology
  • Cholangitis / diagnosis
  • Cholangitis / physiopathology
  • Cholecystitis / diagnosis
  • Cholecystitis / physiopathology
  • Choledocholithiasis / diagnosis
  • Choledocholithiasis / physiopathology
  • Diagnosis, Differential
  • Gallbladder Diseases / diagnosis*
  • Gallbladder Diseases / diagnostic imaging
  • Gallbladder Diseases / physiopathology*
  • Gallstones / diagnosis
  • Gallstones / physiopathology
  • Humans
  • Primary Health Care
  • Risk Factors
  • Severity of Illness Index