The gallbladder, a small, pear-shaped organ located beneath the liver, stores and concentrates bile, a digestive fluid that helps break down fats. Gallstones, hardened deposits of digestive fluid, are common, affecting 10-15% of adults. While most gallstones do not cause symptoms, some can lead to discomfort or severe pain, often referred to as a “gallbladder attack.” Understanding when these symptoms signal a medical emergency is important for preventing serious health complications.
Recognizing Emergency Symptoms
A gallbladder attack can manifest with intense, sudden pain, typically felt in the upper right or center of the abdomen. This pain may radiate to the back or the right shoulder blade and can persist for several hours, often worsening and not improving with changes in position or over-the-counter pain relievers. Such severe and unremitting pain is a key indicator that immediate medical attention is necessary.
Additional symptoms that signal an emergency include fever and chills, which can suggest an infection, such as acute cholecystitis (gallbladder inflammation). Jaundice, characterized by yellowing of the skin or the whites of the eyes, along with dark, tea-colored urine and light-colored or clay-colored stools, points to a potential blockage in the bile ducts. Persistent nausea and vomiting, especially if it prevents fluid intake, also warrant emergency care. A rapid heart rate or low blood pressure, along with confusion or disorientation, are signs that the body may be experiencing a severe infection or shock, requiring urgent evaluation.
Potential Complications of Delayed Care
Ignoring severe gallbladder symptoms or delaying medical attention can lead to serious health risks. A significant complication is gallbladder rupture or perforation, where inflammation causes a hole in the gallbladder, potentially spreading infection throughout the abdominal cavity, a condition known as peritonitis. Peritonitis is a severe abdominal infection that can be life-threatening and often requires surgical intervention.
Untreated infections can also lead to sepsis, a life-threatening response to infection that impacts the entire body and demands immediate treatment. Another serious issue is pancreatitis, which is inflammation of the pancreas that can occur if a gallstone obstructs the bile duct where it joins the pancreatic duct. This condition causes severe upper abdominal pain and often necessitates hospitalization. Furthermore, a severe infection of the bile ducts, known as cholangitis, can arise from blockages and may also lead to sepsis. In rare instances, large gallstones can cause gallstone ileus, a form of bowel obstruction.
What to Expect at the Emergency Room
Upon arrival at the emergency room for suspected gallbladder issues, medical staff will begin with an initial assessment, including checking vital signs, reviewing your medical history, and conducting a physical examination, often involving gentle pressure on the upper right abdomen. Diagnostic tests are typically ordered to confirm a gallbladder issue and rule out other conditions. These tests often include blood work, such as a complete blood count (for infection), liver function tests (for liver health), and amylase/lipase levels (for pancreatitis).
Imaging tests are a standard part of the diagnostic process. An abdominal ultrasound is commonly the first imaging tool used to visualize gallstones and signs of inflammation. In some cases, a CT scan or a HIDA scan (hepatobiliary iminodiacetic acid scan) may be performed to further evaluate gallbladder function and bile duct obstruction. Pain management and intravenous fluids are often administered to alleviate discomfort and prevent dehydration. Depending on the diagnosis and severity, admission to the hospital may be necessary, and a consultation with a surgeon for potential cholecystectomy (surgical removal of the gallbladder) is common for managing symptomatic gallstone disease.
When to See Your Doctor (Non-Emergency Situations)
Not all gallbladder symptoms indicate an emergency, but they still warrant evaluation by a healthcare provider. Mild or intermittent pain in the upper right abdomen, especially after fatty meals, is a common gallstone symptom that may not require an emergency visit. This pain, often called biliary colic, can last minutes to a few hours.
Other non-emergency symptoms include chronic indigestion, bloating, or gas. Heartburn-like sensations or general abdominal discomfort without fever, jaundice, or severe, unremitting pain also suggest a non-emergency. Consulting a doctor is important to prevent future complications and develop a management plan for the underlying condition.