Inflammation of the gallbladder most commonly caused by obstruction of the cystic duct by a gallstone

Aetiology

• See Gallstones

Clinical features

Symptoms

• Constant pain in RUQ

Signs

• Tenderness in RUQ +/- Murphy’s sign (place hand firmly at costal margin in RUQ, sign is positive if patient has pain on inspiration)
• Inflammatory response e.g. fever

Investigations

• Imaging:
  • USS
  • MRCP and/or ERCP if further clarification needed
• Bloods:
  • LFTs: ALP > ALT/AST, ↑ bilirubin
  • FBC and CRP: raised (inflammatory response)
  • Amylase: to check for pancreatitis

Management

• Initial management - IV antibiotics, fluids, nil by mouth
• Once confirmed - cholecystectomy (urgent or interval)