Cholecystitis is acute or chronic inflammation of the gallbladder wall; 95 % of cases follow stone obstruction of the cystic duct. Core symptoms escalate over time:
- Colicky or persistent dull right-upper-quadrant pain, often sudden after a fatty meal, radiating to the right scapula or back
- Nausea and repeated vomiting that does not relieve the pain
- Fever ≥38 °C with chills, marking advancing inflammation
- Classic Murphy sign: inspiratory arrest when the examiner presses below the right costal margin
- Pain persisting >6 h suggests acute cholecystitis
- In severe cases jaundice, tachycardia or hypotension signals risk of suppuration or perforation
- Chronic cholecystitis presents as intermittent bloating, eructation and fatty-food intolerance, often mistaken for “gastritis”
Seek immediate care if right-upper pain >6 h is accompanied by fever or jaundice; early surgery (within 72 h) markedly reduces complications.
| Symptom group | Typical features | Time/sign clues |
|---|---|---|
| RUQ pain | Colic→dull ache, refers to shoulder/back | Sudden after fat meal, >6 h unrelieved |
| GI | Nausea, repeated vomiting, no pain relief | Appears almost with biliary colic |
| Fever | ≥38 °C with chills | Marker of advancing inflammation |
| Murphy sign | Inspiratory arrest on RUQ palpation | Classic physical finding |
| Jaundice | Yellow skin/sclera | Impacted stone or CBD compression |
| Systemic | Tachycardia, hypotension | Warn of pus, gangrene or perforation |