Pathogenesis (development of disease)
Cholecystitis occurs in the majority of cases as a complication of cholecystolithiasis (gallstone disease). The stone obstructs the ductus cysticus (gallbladder duct). In up to 85% of cases, bacteria are found in the gallbladder in cholecystitis. The most common pathogens include Escherichia coli, Streptococcus faecalis (enterococci), Klebsiellen, Enterobacter, and Clostridium perfringens. Other causes of cholecystitis include bacterial inflammatory colonization of the gallbladder by the following routes: ascending (ascending), descending (descending), hematogenous (by the blood route), and lymphogenous (by the lymphatic route).
Acalculous cholecystitis is when there is acute cholecystitis without stones.
A special form of cholecystitis is present in permanent Salmonella excretors.
In addition, there is also the possibility of chemical inflammation caused by the release of various enzymes or mechanical inflammation caused by increased pressure in the gallbladder (= abacterial cholecystitis).
Etiology (causes)
Biographic causes
- Genetic burden from parents, grandparents.
- Hormonal factors
Behavioral causes
- Hyperalimentation (overeating)
- Overweight (BMI ≥ 25; obesity).
Disease-related causes
- Actinomycosis – chronic infectious disease caused by a fungus.
- Bacterial colonization of the gallbladder
- Cholecystolithiasis (gallstone disease); 95% of acute cholecystitis results from cholecystolithiasis.
- Diabetes mellitus (diabetes).
- Gallbladder carcinoma (gallbladder cancer)
- Gallbladder torsion – twisting of the gallbladder.
- Coronary artery disease (CAD) – atherosclerosis (arteriosclerosis, hardening of the arteries) of the coronary arteries.
- Parasitic infestation of the gallbladder
- Sarcoidosis – inflammatory systemic disease affecting mainly the lymph nodes, lungs and joints.
- Syphilis (Lues) – sexually transmitted infectious disease.
- Tuberculosis (consumption)
- Vasculitis (vascular inflammation)
- Condition after major surgery
- Condition after severe trauma (injuries)
- Condition after burns
Other causes
- Protracted birth – birth duration of more than 18 hours for first-time mothers and more than 12 hours for multiparous mothers.
