Features and presentation of acute cholecystitis: An assessment in a tertiary care hospital in Bangladesh

Background: Acute cholecystitis, caused by gallstone obstruction, presents with right upper quadrant pain, fever, nausea, vomiting, and Murphy's sign. Laboratory findings include leukocytosis and elevated liver enzymes, with imaging showing gallbladder wall thickening and pericholecystic fluid. This study aimed to analyze the clinical features and presentations of acute cholecystitis to improve diagnostic and management strategies. Methods: This study involved 39 patients with acute calculus cholecystitis who were admitted to the Department of Surgery at BIRDEM Hospital between July 2009 and June 2010. Participants, selected randomly without consideration of age or sex, underwent laparoscopic surgery following a confirmed diagnosis. The interval between symptom onset and surgery varied among patients. Data were analyzed using SPSS version 23.0. Results: Among 39 patients with acute cholecystitis, the female-to-male ratio was 1.7:1, with the highest incidence in the fourth decade (46%). Common symptoms included right hypochondrium pain (100%), nausea/vomiting (87%), and fever (79%). Ultrasonography confirmed distended, tense gallbladders with stones in all cases, with 17 patients having single stones. Conclusion: Acute cholecystitis predominantly affects females, with the highest incidence in the fourth decade of life. Key clinical features include right hypochondrium pain, nausea, vomiting, and fever, with ultrasonography reliably confirming the diagnosis through characteristic findings. Early laparoscopic intervention remains a common and effective management approach for these patients.