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Acalculous Cholecystitis

Gustavo Adolfo Martin Small, MD, Maria Lidón Serrano Barragan, MD and Noelia Fernandez, RN Reviewed 06/2019
 


BASICS

DESCRIPTION

Acalculous cholecystitis, also known as acute alithiasic cholecystitis (AAC), is an acute necroinflammatory disease of the gallbladder occurring in the absence of cholelithiasis (1) ...

DIAGNOSIS

  • The diagnosis of AAC can be challenging and relies on accurate history, physical examination, laboratory, and imaging (1).

  • Early diagnosis improves outcomes (4).

HISTORY

  • Right upper quadrant pa...

TREATMENT

MEDICATION

  • Early treatment is essential for patients with AAC due to the risk of gangrene and perforation (4).

  • Early empiric antibiotic therapy should be initiated to cover gram-negative bacte...

ONGOING CARE

PROGNOSIS

  • Acalculous cholecystitis is associated with several complications and a high mortality rate.

  • If treatment is delayed, mortality rates may be as high as 75%.

  • Gallbladder gangrene de...

REFERENCES

1
Gomes MM, Antunes H, Lobo AL, et al. Acute alithiasic cholecystitis and human herpes virus type-6 infection: first case. Case Rep Pediatr.  2016;2016:9130673. [View Abstract on OvidMe...

ADDITIONAL READING

Barie PS, Fischer E. Acute acalculous cholecystitis. J Am Coll Surg.  1995;180(2):232–244. [View Abstract on OvidMedline] 

CODES

ICD10

  • K81 Cholecystitis
  • K81.0 Acute cholecystitis
  • K81.1 Chronic cholecystitis
  • K81.2 Acute cholecystitis with chronic cholecystitis
  • K81.9 Cholecystitis

ICD9

  • 575.1 Other cholecystitis
  • 575.10 Cholecystitis
  • ...

CLINICAL PEARLS

  • Acute acalculous cholecystitis is a progressive inflammatory disease of the gallbladder presenting mostly in hospitalized patients. It has a high morbidity and mortality if not address...

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