| Topic: | Digestive Diseases (DD) |
| Title: | Acalculus Cholecystitis. |
| Author: | Reece-Smith, H. |
| Source: | Care of the Critically Ill. 17(2): 44-47. April 2001. |
| Availability: | Available from Stockton Press. Houndmills, Basingstoke, Hampshire RG21 6XS, UK. 44(0) 1256 329242. Fax: 44(0) 1256 810526. Website: www.stockton-press.co.uk/cci/. |
| Abstract: | This article discusses the etiology (causes), diagnosis, and treatment of acalculus cholecystitis (gallbladder inflammation not due to gallstones). In patients with a typical history of biliary colic (abdominal pain related to the gallbladder) in whom ultrasound examination for stones is negative, oral cholecystogram will occasionally reveal small stones missed on ultrasound and will give some information as to gall bladder function. Absent gallbladder function or lack of concentration of the test dye with typical symptoms probably justifies cholecystectomy (removal of the gallbladder). In some patients in whom all diagnostic tests are negative but the diagnosis of chronic acalculus cholecystitis is strongly suspected, cholecystectomy may be both diagnostic and therapeutic, but the patient must be adequately counseled about all aspects of the procedure, including the possibility of still having symptoms after surgery. A laparoscopic procedure is usually used for cholecystectomy. Acute acalculus cholecystitis is an uncommon condition, probably due to ischemia (lack of blood flow) in the gallbladder, perhaps during episodes of acute hypotension (low blood pressure). Diagnosis of acute acalculus cholecystitis depends primarily upon a high level of clinical suspicion of the condition in patients who are at risk by virtue of their underlying pathology. Laparoscopic cholecystectomy is both effect and safe in experienced hands. Overall mortality is thought to be in the range of 6 to 9 percent. Perforation significantly increases mortality and should be prevented wherever possible by early operative intervention. 3 figures. 1 table. 20 references. |
| Format: | Journal Article |
| Language: | English. |
| Major Keywords: | Digestive System Diseases. Cholecystitis. Acute Disease. Gallbladder. Diagnosis. Cholecystectomy. Patient Care Management. |
| Minor Keywords: | Diagnostic Tests. Patient Selection. Risk Factors. Symptoms. Abdominal Pain. Etiology. Surgical Techniques. Laparoscopy. Acute Cholecystitis. Chronic Cholecystitis. |
| Publication Number: | DDJA08380 |
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