Patients with chronic cholecystitis may have systemic symptoms such as lethargy and fatigue, or no systemic symptoms. For example, in acute attack, there may be right upper abdominal pain, nausea, anorexia, fever and other symptoms. Most patients with chronic cholecystitis have no systemic symptoms. Some patients may suffer from recurrent episodes of cholecystitis, resulting in indigestion and causing systemic symptoms such as lethargy and fatigue. Acute attack may have typical right upper abdominal pain, accompanied by right shoulder radiating pain, nausea, vomiting, fever and other symptoms, mostly with a history of eating a greasy diet or stimulating diet. Symptoms alone cannot confirm the diagnosis of chronic cholecystitis, and the diagnosis needs to be based on history, physical signs, and ultrasound of the gallbladder.