What is the Difference Between Biliary Colic and Cholecystitis?

Biliary colic and cholecystitis are both conditions related to the biliary tract, but they have distinct differences:

Biliary Colic:

• Caused by obstruction of a bile duct by a gallstone, leading to right upper quadrant pain.
• Occurs when the gallbladder neck becomes impacted by a gallstone, resulting in painful contractions of the gallbladder.
• Typically presents as constant pain lasting 1-5 hours, most commonly in the epigastrium or right upper quadrant.
• Patients are usually not systemically unwell and may not have fever, nausea, or vomiting.

Cholecystitis:

• Inflammation of the gallbladder wall, usually caused by obstruction of the bile ducts by gallstones.
• Occurs when obstruction at the cystic duct is prolonged (usually several hours), resulting in inflammation of the gallbladder wall.
• Patients tend to be systemically unwell and may have fever, nausea, and vomiting.
• Inflammatory markers (such as white cell count and C-reactive protein) are usually raised, and liver function tests may show a raised bilirubin, ALP, ALT, and gamma-GT.

In summary, biliary colic is characterized by intermittent pain due to temporary obstruction of the bile duct by a gallstone, while cholecystitis is characterized by inflammation of the gallbladder wall due to prolonged obstruction of the bile ducts. Patients with biliary colic are typically not systemically unwell, whereas patients with cholecystitis often present with fever, nausea, and vomiting.

Comparative Table: Biliary Colic vs Cholecystitis

Biliary colic and cholecystitis are both conditions related to the biliary system, usually due to gallstones, but they have distinct differences in their presentation and management. Here is a table summarizing the differences between biliary colic and cholecystitis:

Differentiating between biliary colic and cholecystitis can be challenging due to their overlapping features, but it is crucial for appropriate management and treatment.