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Causes of acute cholecystitis

The causes of acute cholecystitis can be grouped into two main categories, calculous cholecystitis and acalculous cholecystitis.

Each of these types is discussed in more detail below.

Calculous cholecystitis

Calculous cholecystitis is the most common, and usually less serious, type of acute cholecystitis. It accounts for around 90% of all cases.

Calculous cholecystitis develops when the main opening to the gallbladder, called the cystic duct, gets blocked by a gallstone or by a substance known as biliary sludge. Biliary sludge is a mixture of bile and small crystals of cholesterol and salt.

The blockage in the cystic duct results in a build-up of bile inside the gallbladder, which causes pressure inside the gallbladder to increase. For reasons still unclear, the rise in pressure inside the gallbladder causes the gallbladder to become inflamed and swollen.

In around one in five cases, the inflamed gallbladder becomes infected by bacteria. This can trigger the more serious complications of acute cholecystitis, such as gangrenous cholecystitis (tissue death inside the gallbladder).

Acalculous cholecystitis

Acalculous cholecystitis is usually a more serious type of acute cholecystitis. It often requires admission to an intensive care unit (ICU) for treatment.

Acalculous cholecystitis usually develops as a complication of a serious illness, infection or injury that damages the gallbladder. Possible causes for acalculous cholecystitis include:

Increased risk

Things that increase the risk of getting acute cholecystitis include:

Further information

Cholecystitis, acute
Diet after gallbladder surgery
Gallbladder removal
Gallstones
Facts about fat
Food and diet
Oxford Radcliffe Hospitals: cholecystectomy - a patients' guide (PDF, 161kb)

Last updated : 2012-12-05 by NHS Choices © Crown Copyright 2009