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Gallstones in the cystic duct typically cause abdominal pain.
Gallstones form in the gallbladder when bile, a fluid manufactured in the liver, hardens into pebble-like deposits. Bile is stored in the gallbladder until the body needs it for digestion. Then the gallbladder contracts and pushes bile through a tube called the cystic duct into the common bile duct. From there, bile flows into the small intestine. Most gallstones are "silent" or asymptomatic, but they can cause problems if they block a bile duct.
When the cystic duct is blocked by a gallstone, the gallbladder becomes inflamed, a condition called cholecystitis. A sudden attack of cholecystitis causes severe abdominal pain, nausea, vomiting and tenderness over the gallbladder that typically lasts more than 6 hours. People with cholecystitis commonly have a low-grade fever unless they are elderly. Within a few hours, people with acute cholecystitis develop Murphy's sign, an increase in pain when the person breathes in while the health care provider is pressing on the right upper region of the abdomen. Gallstones associated with acute cholecystitis are usually diagnosed with abdominal ultrasound testing.
After an acute attack of cholecystitis, you may develop chronic cholecystitis, a long-term form of gallbladder inflammation. The gallstones block the cystic duct intermittently, causing episodes of pain, nausea and vomiting alternating with periods of feeling well. Unlike acute cholecystitis, fever typically does not occur with chronic cholecystitis. Rarely, the gallbladder may become hardened with calcium deposits, a condition called porcelain gallbladder. This condition is associated with an increased risk for gallbladder cancer.
Untreated cholecystitis can cause complications such as a hole in the gallbladder (perforation) and pus in the gallbladder (empyema). These complications are potentially life-threatening if gangrene or tissue death occurs. If a cystic duct stone moves and blocks the common bile duct, jaundice may develop with yellowing of the skin and the whites of the eyes.
Cholecystectomy, surgical removal of the gallbladder, is the treatment of choice for symptomatic gallstones. If a person with acute cholecystitis has mild symptoms or feels better after a short time, surgery is usually considered within a few weeks. In most cases, the individual is able to go home the same day after surgery. A severe attack of cholecystitis may require hospitalization for fluids and pain control. Surgery is commonly performed within a few days. Approximately 95 percent of people find that their symptoms are relieved by cholecystectomy. The few who continue to have pain, nausea or vomiting after surgery may have another disease process causing their symptoms.