Acalculous cholecystitis

Acalculous cholecystitis is a form of gallbladder disease that occurs without the presence of gallstones. It is a severe and life-threatening condition that requires immediate medical attention.

Etiology

The exact cause of acalculous cholecystitis is unknown, but it is believed to be due to a combination of factors including biliary stasis, ischemia, and infection. It is often associated with critical illness or trauma, and is more common in patients who are critically ill, such as those in the intensive care unit.

Pathophysiology

In acalculous cholecystitis, the gallbladder becomes inflamed without the presence of gallstones. This inflammation can lead to a decrease in blood flow to the gallbladder, causing necrosis and gangrene. If left untreated, the gallbladder can rupture, leading to a potentially fatal condition known as peritonitis.

Clinical Presentation

Patients with acalculous cholecystitis often present with right upper quadrant pain, fever, and leukocytosis. However, these symptoms may be absent in critically ill patients. Diagnosis is typically made through ultrasound or computed tomography (CT) scan.

Treatment

Treatment for acalculous cholecystitis typically involves antibiotics and cholecystectomy, or removal of the gallbladder. In some cases, percutaneous cholecystostomy may be performed as a temporary measure in patients who are too ill to undergo surgery.

Prognosis

The prognosis for acalculous cholecystitis is generally poor, particularly in critically ill patients. Early diagnosis and treatment can improve outcomes.

See Also

• Cholecystitis
• Gallbladder disease
• Gallstones
• Peritonitis

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