Causes and Risk Factors of Acute Cholecystitis
The primary cause of acute cholecystitis is the blockage of the cystic duct by a gallstone, which prevents bile from leaving the gallbladder. The bile builds up, causing irritation and swelling. In some cases, bacterial infection follows.
Main Causes
- Gallstones (Cholelithiasis)
- 90–95% of acute cases are due to gallstones
- Gallstones form when bile contains too much cholesterol or bilirubin
- Acalculous Cholecystitis
- Occurs without gallstones, usually after major surgery, trauma, or critical illness
- Less common but more dangerous
- Infections
- E. coli, Klebsiella, and other bacteria may infect trapped bile
- E. coli, Klebsiella, and other bacteria may infect trapped bile
- Tumours or bile duct abnormalities
- Rare, but may also block bile flow
Causes and Risk Factors of Acute Cholecystitis
Risk Factors
- Obesity or rapid weight loss
- Female sex and age over 40
- High-fat, low-fibre diet
- Diabetes or insulin resistance
- Pregnancy
- Use of hormone replacement therapy or oral contraceptives
- Family history of gallstones
In South Africa, the condition is often underdiagnosed in rural communities due to limited access to imaging like ultrasound. Urban diets high in processed fats have also increased gallstone prevalence.
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