Right Upper Abdominal Pain After Eating? It Could Be a Sign of Gallbladder Inflammation!
Understanding the Condition Through a Real Case
This article is intended for educational purposes only. Patient privacy has been protected through appropriate editing. A 68-year-old male patient visited our hospital with recurring right upper abdominal pain, often worsening after meals. Initially, he mistook it for indigestion and delayed medical attention. However, after experiencing fever and chills the night before his visit, he took fever-reducing medication which temporarily lowered his temperature. Despite this, his symptoms persisted and fluctuated, prompting him to seek professional medical help. He was later diagnosed with acute cholecystitis, underwent laparoscopic cholecystectomy, and recovered well with no lingering discomfort.
Key Details of the Case
- Age & Gender: Male, 68 years old
- Medical History: Hypertension (5–6 years), COPD (5 years), smoking and alcohol use (40+ years)
- Diagnosis: Acute calculous cholecystitis
- Hospital: First Affiliated Hospital of Xi'an Jiaotong University
- Date of Admission: February 2021
- Treatment: Laparoscopic gallbladder removal
- Hospital Stay: 5 days
- Outcome: Full recovery with no recurrence of symptoms
Initial Consultation and Symptoms
The patient had a long history of smoking and alcohol consumption, along with chronic conditions such as hypertension and COPD. He experienced intermittent right upper quadrant pain, especially at night and after eating. Mistaking it for a stomach issue, he ignored the symptoms until the night before admission, when he developed a fever (up to 38.3°C) and chills. Although he took an unspecified fever reducer, his temperature continued to fluctuate. Upon physical examination at the clinic, abdominal tenderness and a positive Murphy's sign were noted, leading to a suspected diagnosis of acute cholecystitis and subsequent hospitalization.
Diagnostic Process and Surgical Intervention
After admission, blood tests revealed elevated white blood cell counts. An abdominal ultrasound confirmed gallbladder wall thickening and the presence of gallstones, confirming acute calculous cholecystitis. Given the patient's age and overall condition, a minimally invasive laparoscopic cholecystectomy was recommended. After obtaining informed consent from the patient and family, the surgery was performed under general anesthesia. Postoperative care included close monitoring of vital signs and wound healing to prevent infection or complications.
Postoperative Recovery and Follow-Up
Within five days of surgery, the patient showed significant improvement, with no pain or discomfort and was cleared for discharge. One month later, during a follow-up visit, his surgical wound had healed well, and both blood tests and ultrasound scans were normal. The patient was encouraged to maintain a healthy lifestyle and continue light physical activity to support long-term recovery.
Recommendations for Recovery and Prevention
While the patient responded well to surgery without complications, it's important for caregivers to monitor elderly patients closely during the healing phase. Preventing wound infection and ensuring proper nutrition are crucial. Light daily exercise like walking or gentle stretching can aid recovery. Most importantly, a low-fat diet is essential post-surgery—not only to manage hypertension and cholesterol levels, but also to ease digestion now that the gallbladder is removed.
Why Early Diagnosis Matters
Acute cholecystitis often presents with right upper quadrant pain after eating, especially following fatty meals. If left untreated, it can lead to life-threatening complications like gallbladder perforation. This case highlights the importance of timely medical evaluation when abdominal pain persists. Self-medication should be avoided, and professional diagnosis and treatment are strongly recommended to prevent serious outcomes.