Acalculous Cholecystitis

Question 1

what is acute acalculous cholecystitis

Answer 1

acute inflammation of the gallbladder with NO evidence of cholelithiasis

Question 2

what are the risk factors for acute acalculous cholecystitis

Answer 2

prolonged TPN leading to bile stasis
critically ill, recent surgery, decreased perfusion
trauma, burns, sepsis, shock, multi organ failure, immunosuppression, end stage chronic diseases

Question 3

pathogenesis of acalculous cholecystitis

Answer 3

bile stasis and decreased perfusion to the gallbladder that can lead to ischemia and repercussion injury

Question 4

complications of acalculous cholesystitis

Answer 4

necrosis of the gallbladder, bacterial infection, sepsis, gangrenous cholecystitis, emphysematous cholecystitis, gall bladder perforation

Question 5

symptoms of acalculous cholecystitis

Answer 5

RUQ pain, N/V, fever, leukocytosis , Murphy sign (may grimace), elevated bilirubin and ALP

must have a high index of suspicion because these people are usually unable to provide subjective responses

Question 6

uncommon clinical symptoms of acalculous cholecystitis

Answer 6

jaundice, postoperative jaundice, RUQ mass

Question 7

ultrasound findings in acalculous cholecystitis

Answer 7

gallbladder wall thickening greater than 3mm

distended gallbladder

pericholecystic fluid

NO STONES

Question 8

other than ultrasound what else can you use to diagnose acalculous cholecystitis

Answer 8

CT , HIDA

Question 9

supportive treatment of acalculous cholecystitis

Answer 9

IV antibiotics, NPO, IVF, pain control

Question 10

definite treatment of acalculous cholecystitis

Answer 10

immediate intervention

laparoscopic cholecystectomy if patient can undergo surgery

if not

percutaneous cholecystectomy tube then removal once patient is stable