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Acute calculous cholecystitis


Acute calculous cholecystitis

Acute calculous cholecystitis

Cholecystitis is an inflammation of the gallbladder wall. It can be acute or chronic. Acute cholecystitis is one of the most common diseases, and it ranks second in frequency after appendicitis. Chronic inflammation occurs as a result of repeated attacks of acute. It is almost always caused by gallstone disease (calculous cholecystitis).
In the development of acute cholecystitis, the main cause is infection. It can enter the gallbladder in three ways: through the blood, from the intestines through the bladder duct, through the lymphatic vessels. With blood and lymph, the infection enters the gallbladder only if the detoxifying function of the liver is impaired. If the motor function of the bile duct is impaired, bacteria can enter from the intestines.
Inflammation in the gallbladder when an infection enters the gallbladder does not occur, unless its motor function is impaired and there is no bile retention.
Stones, kinks of an elongated or convoluted cystic duct, its narrowing lead to stagnation of bile in the gallbladder. Acute cholecystitis arising on the basis of gallstone disease is 85-90%.
As a result of blockage of the gallbladder duct with a stone, the flow of bile into the intestine stops, and its pressure on the walls of the bladder increases. The walls stretch, blood flow decreases in them, which contributes to the development of inflammation. The cause of chronic cholecystitis is almost always gallstone disease, when stones are exposed to the walls of the gallbladder for a long time.
Acute cholecystitis is more common in people over 50 years of age. The elderly (60-74 years old) and senile (75-89 years old) patients make up 40-50% of the total number of patients with acute cholecystitis. Acute cholecystitis usually begins suddenly. The development of acute inflammation in the gallbladder is often preceded by an attack of biliary colic (sharp pain in the right hypochondrium).

Reasons for the development of acute cholecystitis:
Violation of the outflow of bile from the gallbladder into the bile ducts, contributing to the development of pathogenic secondary microflora, impaired blood supply to the walls of the gallbladder
Blockage of the cystic duct with a stone

What is the danger of acute cholecystitis?
Complications occur in 15-20% of cases of acute cholecystitis. These include a purulent inflammatory process around the gallbladder (abscess), gangrene, perforation of the gallbladder with the development of inflammation in the abdomen and sepsis, biliary fistulas that communicate the gallbladder with the intestines, stomach and even kidney, acute pancreatitis, obstructive jaundice, peritonitis.


- Diet therapy (exclusion of foods that provoke symptoms of the disease: carbonated drinks, fatty foods, alcohol)
- Medications:
- Spasmolytic drugs: buscopan, ditsitel, atropine, platifillin, no-shpa
- Sorbents (activated carbon, enterosgel, smecta)
- Deoxycholic acid preparations (ursofalk, ursosan)
- Gastroenterological collection of herbs
- Antibiotics: metronidazole, cephalosporins, fluoroquinolones

In acute cholecystitis, surgery is required - emergency cholecystectomy.

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