Differential Diagnoses for Cholecystitis
Single Most Likely Diagnosis
- Cholelithiasis: This is the most common cause of cholecystitis, where gallstones obstruct the cystic duct, leading to inflammation of the gallbladder. The presence of gallstones is a significant risk factor for developing cholecystitis.
Other Likely Diagnoses
- Acalculous Cholecystitis: This condition occurs in the absence of gallstones and is often seen in critically ill patients, those with severe trauma, or after major surgery. It has a high mortality rate if not promptly treated.
- Biliary Dyskinesia: A motility disorder of the gallbladder that can cause symptoms similar to cholecystitis, including biliary colic and inflammation.
- Chronic Cholecystitis: A condition where the gallbladder is inflamed over a long period, often due to recurrent gallstone obstruction. It can present with chronic or intermittent symptoms.
Do Not Miss Diagnoses
- Gallbladder Perforation: A serious complication of cholecystitis where the gallbladder ruptures, potentially leading to peritonitis and sepsis. Early recognition and surgical intervention are crucial.
- Mirizzi Syndrome: A rare condition where a gallstone becomes impacted in the cystic duct, causing obstruction of the common bile duct and potentially leading to jaundice and cholangitis.
- Sphincter of Oddi Dysfunction: A condition that affects the sphincter at the junction of the bile and pancreatic ducts, causing biliary-type pain and potentially mimicking cholecystitis.
Rare Diagnoses
- Xanthogranulomatous Cholecystitis: A rare form of chronic cholecystitis characterized by the presence of xanthoma cells in the gallbladder wall, often mimicking gallbladder cancer.
- Gallbladder Cancer: Although rare, gallbladder cancer can present with symptoms similar to cholecystitis, making it an important differential diagnosis, especially in older patients with a history of gallstones.
- Porcelain Gallbladder: A condition where the gallbladder wall becomes calcified, potentially increasing the risk of gallbladder cancer. It can be asymptomatic or present with symptoms similar to cholecystitis.