• Gallbladder distention. If your gallbladder becomes inflamed due to bile buildup, it may stretch and swell beyond its normal size (hydrops), which can cause pain and increase the risk of a tear (perforation) in your gallbladder, as well as infection and tissue death.
• Infection (sepsis, cholangitis). If bile builds up within your gallbladder, causing cholecystitis, the bile may become infected (empyema). This infection can increase the risk of a tear in your gallbladder that could allow the infection to spread to your blood or to other parts of your body.
• Perforation. A tear (perforation) in your gallbladder may be caused by gallbladder distention or gangrene that occurs as a result of cholecystitis. When perforation is localized, it may be seen as pericholecystic fluid by ultrasound. Abscess formation is common. Free perforation also can occur, releasing bile and inflammatory matter intraperitoneally, causing peritonitis.
- Gallstone ileus
o When perforation occurs next to a hollow viscus, a gallbladder enteric fistula can be formed.
o Fistulas into the duodenum are most common. When gallstones are passed directly through the fistula into the small bowel, if they are greater than 2.5 cm, they can obstruct the ileocecal valve. This causes gallstone ileus.
• Pancreatitis - The most common cause of acute pancreatitis is the presence of gallstones - small, pebble-like substances made of hardened bile - that cause inflammation in the pancreas as they pass through the common bile duct
• Hepatitis
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