[Acute acalculous cholecystitis]

Abstract

Acute acalculous cholecystitis (AC) is an inflammatory process of the gallbladder, often caused by other severe diseases. The etiology is multifactorial, but the pathogenesis is in all cases a reduction in the gallbladder's emptying capacity. The mortality of AC reaches 85% without treatment. This fact makes it important to consider AC as a possible complication to major surgery, multi-trauma, and artificial ventilation. Symptoms resemble "normal" cholecystitis, but may be masked by the underlying severe disease. Fever without known focus may be the only symptom. Ultrasound, CT-scanning or cholangiography are used to verify the diagnosis, supplemented by laboratory investigations. Treatment is cholecystectomy. Percutaneous ultrasonic guided cholecystotomy is a good alternative if the diagnosis made in an early stage. The mortality is considerably reduced by early intervention.