Chapter 53: Biliary Tract- Acute Acalculous Cholecystitis Flashcards

1
Q

What is it?

A

Acute cholecystitis without evidence of stones

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2
Q

What is the pathogenesis?

A

It is believed to result from sludge and gallbladder disuse and biliary stasis, perhaps secondary to absence of cholecystokinin stimulation (decreased contraction of gallbladder)

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3
Q

What are the risk factors?

A
  • Prolonged fasting
  • TPN
  • Trauma
  • Multiple transfusions
  • Dehydration
  • Often occurs in prolonged postoperative or ICU setting
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4
Q

What are the diagnostic tests of choice?

A
  1. Ultrasound
    • sludge and inflammation usually present with acute acalculouscholecystitis
  2. HIDA scan
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5
Q

What are the findings on HIDA scan?

A

Nonfilling of the gallbladder

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6
Q

What is the management of acute acalculous cholecystitis?

A

Cholecystectomy, or cholecystostomy tube if the patient is unstable (placed percutaneously by radiology or open surgery)

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