Acute acalculous cholecystitis

Deitch, Edwin A.; Engel, Juliette M.

doi:10.1016/0002-9610(81)90295-6

Cited by 61 publications

(33 citation statements)

References 4 publications

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“…Both US and CT have similar diagnostic criteria for AAC, which include gall bladder wall thickness greater than 3 mm, periocholecystic fluid, subserosal oedema, intramural gas or sloughed muscosal membrane [20,33]. Diagnostic criteria for HIDA scan include either non-visualisation of the gall bladder 1 h after injection of radiolabeled technetium or 30 min after injection of morphine [34].…”

Section: Discussionmentioning

confidence: 99%

Acalculous Cholecystitis: Is an Elective Interval Cholecystectomy Necessary

et al. 2017

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Background: Acute acalculous cholecystitis (AAC) accounts for 5-10% of cases of acute cholecystitis. The advantage of interval cholecystectomy for patients with AAC is unclear. Therefore, a retrospective analysis of patients diagnosed with AAC at our institution was performed over a 5-year period. Methods: Patients were identified via hospital coding using the keywords “acalculous cholecystitis, cholecystostomy and gall bladder perforation.” Follow-up data was obtained by performing a retrospective review of the patients' hospital records. Results: A total of 33 patients with AAC were identified and followed for a median period of 18 months. The median age at presentation was 70 (10-96) and American Society of Anesthesiologists (ASA) grade was 3 (1-5). Twenty-three patients (70%) were treated with antibiotics alone, 7 patients (21%) with percutaneous cholecystostomy and 3 patients (9%) with laparoscopic cholecystectomy. The 90-day mortality rate was 30% with significant correlation to comorbid status, as all deaths occurred in ASA grade 3-5 individuals (p = 0.020). Two patients (6%) developed recurrent AAC and were managed non-operatively. Conclusion: Antibiotics and cholecystostomy were the mainstay of AAC management, and comorbid status influenced related mortality. Our results suggest that it appears safe to avoid interval cholecystectomy in patients who recover from AAC, as they are typically high-risk surgical candidates.

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Section: Discussionmentioning

confidence: 99%

Acalculous Cholecystitis: Is an Elective Interval Cholecystectomy Necessary

et al. 2017

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“…Deitch's study reported the sensitivity and specificity of a 3.0 mm gallbladder wall thickness to be 90% and 100% respectively, but a gallbladder wall thickness of 3.5mm demonstrated a sensitivity of 98.5% and specificity of 80%. 20 Thickening of the gallbladder wall to > 3.5 mm is the most reliable criterion for the diagnosis of acute cholecystitis whereas 3.0 mm is suggestive but not conclusive evidence of acute cholecystitis. 21,12 Our patient's US and CT findings together demonstrated the diagnostic triad of AAC.…”

Section: Discussionmentioning

confidence: 98%

Acute acalculous cholecystitis after blunt abdominal trauma

et al. 2016

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“…Hydrops and sludge are minor criteria. The triad composed by thickness, hydrops, and sludge is the one preferred for diagnosis [34][35][36][37][38][39].…”

Section: Role Of Ultrasonographymentioning

confidence: 99%

Acute acalculous cholecystitis and cardiovascular disease: a land of confusion

Tana

Cocco

et al. 2015

J Ultrasound

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Acute acalculous cholecystitis (AAC) can be defined as acute inflammatory disease of the gallbladder without evidence of gallstones. The first case was reported in 1844 by Duncan et al.; however, some cases may have been missed previously in view of the complexity of the diagnosis. Several risk factors have been identified, and cardiovascular disease (CVD), in view of its multiple mechanisms of action, seems to play a key role. Atypical clinical onset, paucity of symptoms, overlap with comorbidities, and lack of robust, controlled trials result often in under or misdiagnosed cases. Moreover, laboratory results may be negative or not specific in the late stage of the disease, when a surgical treatment cannot be longer helpful if complications arise. A rapid diagnosis is therefore essential to achieve a prompt treatment and to avoid further clinical deterioration. In this short review, we would present the current evidence regarding epidemiology, pathophysiology, and clinical presentation of the complex relation between AAC and CVD. Then, we fully emphasize the role of ultrasound to achieve an early diagnosis and an appropriate treatment in suspected cases, reducing mortality and complications rates.Keywords Acute acalculous cholecystitis Á Gallbladder Á Cardiovascular disease Á Ultrasonography Á Emergency Department Á Surgery Riassunto La colecistite acuta alitiasica (AAC) può essere definita come una infiammazione acuta della colecisti in assenza di calcoli. Uno dei primi casi clinici riportati in letteratura risale al 1844 (Duncan et al.) ma verosimilmente alcuni di questi sono passati inosservati a causa della complessitá del percorso diagnostico. Numerosi fattori di rischio sono stati identificati e, tra questi, le malattie cardiovascolari, in considerazione di diversi meccanismi d'azione, sembrano assumere una posizione importante e giocare un ruolo chiave. Molti casi possono passare inosservati per varie ragioni che vanno dall'esordio clinico atipico, la povertá di sintomi, la sovrapposizione clinica e strumentale con altre comorbiditá, la carenza di trial controllati. Inoltre i test di laboratorio possono risultare negativi o non specifici anche negli stadi avanzati della malattia, quando la terapia chirurgica può non rivelarsi più utile in caso di complicanze. Una diagnosi rapida é dunque necessaria per instaurare un trattamento mirato e per evitare un ulteriore deterioramento clinico. In questa breve revisione vogliamo mettere in risalto le evidenze attuali che riguardano l'epidemiologia, la fisiopatologia e la presentazione clinica della complessa relazione esistente tra le malattie cardiovascolari e la colecistite acuta alitiasica. Il nostro intento é dunque quello di enfatizzare il ruolo dell'ultrasonografia nel raggiungimento, nei casi sospetti, di una diagnosi precoce e di un trattamento appropriato, al fine di ridurre il tasso di complicanze e la mortalitá.

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Acute acalculous cholecystitis

Cited by 61 publications

References 4 publications

Acalculous Cholecystitis: Is an Elective Interval Cholecystectomy Necessary

Acalculous Cholecystitis: Is an Elective Interval Cholecystectomy Necessary

Acute acalculous cholecystitis after blunt abdominal trauma

Acute acalculous cholecystitis and cardiovascular disease: a land of confusion

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