Cholecystitis Linked to Liver Cirrhosis – The Connection Between Liver and Gallbladder is Real!
Understanding the Case
This article presents a medical case involving a 59-year-old female patient who experienced persistent upper abdominal pain for one week, accompanied by nausea, vomiting, and a significant loss of appetite. Self-administered digestive medications failed to provide relief, prompting her to seek professional medical attention. Upon admission to the First Affiliated Hospital of Xi'an Jiaotong University in April 2022, she was diagnosed with cholecystitis secondary to liver cirrhosis. After a two-week inpatient treatment regimen, her condition improved significantly, though continued outpatient follow-up and medication were advised.
Patient Profile and Treatment Overview
- Age and Gender: 59-year-old female
- Diagnosis: Hepatogenic (liver-origin) cholecystitis
- Hospital: First Affiliated Hospital of Xi'an Jiaotong University
- Treatment Period: April 2022
- Therapeutic Approach: Combination drug therapy including Compound Glycyrrhizin Tablets, Entecavir Dispersible Tablets, Furosemide Injection, Thymopeptide Enteric-coated Tablets, and Anti-inflammatory and Cholagogic Tablets
- Duration: Two weeks of hospitalization
- Outcome: Symptoms largely resolved, improved liver function, and reduced ascites
Initial Assessment and Symptoms
The patient initially reported continuous upper abdominal discomfort without progressive worsening or radiation to the back. She also experienced fatigue, aversion to fatty foods, dark yellow urine resembling strong tea, and non-projectile vomiting occurring 2–3 times daily. Despite taking domperidone externally, her symptoms persisted. An outpatient ultrasound revealed liver cirrhosis, ascites, and multiple hyperechoic liver lesions, leading to a diagnosis of hepatogenic cholecystitis.
Medical Intervention and Strategy
Following admission, blood tests and liver function assessments confirmed elevated levels of ALT, AST, and ALP, with an AST/ALT ratio greater than 1—indicative of liver and biliary system involvement. A comprehensive treatment plan was initiated to address both liver and gallbladder health. Liver-protective agents, antiviral drugs, diuretics, immune boosters, and anti-inflammatory cholagogues were administered to manage cirrhosis and reduce gallbladder inflammation.
Positive Response to Treatment
After two weeks of inpatient care, the patient's nausea and vomiting ceased, and abdominal pain subsided. Her appetite improved, and liver function tests showed declining enzyme levels. Ascites had nearly resolved, indicating a successful therapeutic response. However, continued medication and regular monitoring were recommended to prevent disease recurrence.
Post-Discharge Care and Lifestyle Adjustments
To maintain long-term health, the patient was advised to continue liver-protective medication and adopt a low-fat, high-protein diet including dairy, fish, and skinless poultry. Regular follow-ups every three months were emphasized to monitor gallbladder and liver status and prevent future complications.
Medical Insight on Hepatogenic Cholecystitis
Hepatogenic cholecystitis is a known complication of chronic liver disease such as viral hepatitis and cirrhosis. Managing both liver and gallbladder health is essential in such cases. Early and aggressive treatment helps prevent the progression to chronic inflammation, reduces patient discomfort, and improves long-term outcomes. This case underscores the critical interplay between liver function and gallbladder health, reinforcing the importance of a comprehensive, integrated treatment strategy.