is always associated with obstruction of gall bladder neck or cystic duct with a stone. Sometimes it can happen due to mucosa, worm or a tumour. In 10% of the cases no obstruction is observed it is called acute acalculous cholecystitis.
The main feature is pain in the right upper abdomen and also pain in epigastrium, right shoulder tip or between the blades. The pain lasts more than an hr.
Its difficult to differentiate gallstone induced gall bladder pain and acute cholecystitis, in cholecystitis pain, fever and leucocytosis may be present.
Jaundice occurs in 20 to 25% even though there are no stones in common bile duct.
If the patient is untreated the inflammation may resolve to recur and on the other hand the it may progress to an empyema or perforation and peritonitis.
This condition might be very severe in old people as there are few signs and high rate of empyema and perforation.

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