Acute Acalculous Cholecystitis in Hospitalized Patients With Hematologic Malignancies and Prognostic Importance of Gallbladder Ultrasound Findings

Thampy, Rajesh; Khan, Ahmad; Zaki, Islam; Wei, Wei; Korivi, Brinda Rao; Staerkel, Greg; Bathala, Tharakeswara K.

doi:10.1002/jum.14660

Cited by 13 publications

(7 citation statements)

References 27 publications

(34 reference statements)

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“…On the other hand, the lower complication rate and shorter duration of symptoms may also attribute to early diagnosis and treatment in this group. This is in line with a study by Thampy et al (21), which found that 41% of the patients in the AAC (-) group had positive results for AAC within 1 week of the follow-up ultrasound. Due to the rapid progression of AAC, the role of ultrasound follow-up has been emphasized for the early detection of progressed AAC as well as to prevent misdiagnoses and missed diagnoses (19).…”

Section: Discussionsupporting

confidence: 92%

“…The higher incidence rate observed in our study agrees with previous studies (18)(19)(20). For example, a previous study found that among 94 patients with hematological malignancies and clinical manifestations, the AAC (+) group often presented with a higher rate of complications and mortality (20.9%) than the AAC (-) group (0%; P < 0.001) (21).…”

Section: Discussionsupporting

confidence: 91%

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Prognostic Significance of Ultrasound Findings of Acute Acalculous Cholecystitis for Elderly Long-Term Bedridden Patients

et al. 2021

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Background: Acute acalculous cholecystitis (AAC) is characterized by the development of cholecystitis in the gallbladder without gallstones or with small gallstones unrelated to inflammatory diseases. This disease is not rare in the elderly bedridden patients with co-morbidities and prone to develop life-threatening gangrene or perforation of gallbladder. Early imaging is essential for detecting and effectively treating AAC. This study aimed to evaluate the use of ultrasound diagnostic criteria for the diagnosis and prognosis of elderly long-term bedridden patients with suspected AAC.Methods: We retrospectively studied 374 elderly bedridden patients with clinical manifestations of AC at the acute stage of the disease. Gallbladder anomalies were found in 92 patients by ultrasound examination, which correlated with the duration time of clinical manifestations, complications, as well as therapeutic prognosis. The major and minor ultrasound criteria of AAC were made according to the Tokyo Guidelines 2018. Ultrasound results were thought to be AAC positive when they met two major criteria or one major and two minor criteria.Results: Forty-three (46.7%) of the 92 patients presented with AAC (+) test results based on the ultrasound criteria, with a higher incidence of complications (27.9%) than AAC (–) patients (0%; P < 0.001). The median length of symptoms (8 vs. 4 days, P < 0.001) and duration of antibiotic therapy (13 vs. 5 days, P < 0.001) were longer in the AAC (+) group.Conclusions: The ultrasound-based AAC (+) group often had a worse prognosis than the AAC (–) group. Therefore, patients from the AAC (+) group should receive a follow-up ultrasound examination to detect disease progression early.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Prognostic Significance of Ultrasound Findings of Acute Acalculous Cholecystitis for Elderly Long-Term Bedridden Patients

et al. 2021

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“…Other risk factors that increase the risk of AAC are immunodeficiencies, atherosclerosis, vasculitis, diabetes mellitus, stroke, arterial hypertension, factors reducing vagal tone, bone marrow transplantation, interleukin-2 therapy, and lymphokine-activated killer cell therapy [ 35 , 78 , 79 , 80 , 81 , 82 , 83 ].…”

Section: Aac Pathogenesismentioning

confidence: 99%

Acalculous Cholecystitis in COVID-19 Patients: A Narrative Review

Thomaidou,

Karlafti,

Didagelos

et al. 2024

Viruses

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Acute acalculous cholecystitis (AAC) represents cholecystitis without gallstones, occurring in approximately 5–10% of all cases of acute cholecystitis in adults. Several risk factors have been recognized, while infectious diseases can be a cause of cholecystitis in otherwise healthy people. Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has spread worldwide, leading to an unprecedented pandemic. The virus enters cells through the binding of the spike protein to angiotensin-converting enzyme 2 (ACE2) receptors expressed in many human tissues, including the epithelial cells of the gastrointestinal (GI) tract, and this explains the symptoms emanating from the digestive system. Acute cholecystitis has been reported in patients with COVID-19. The purpose of this review is to provide a detailed analysis of the current literature on the pathogenesis, diagnosis, management, and outcomes of AAC in patients with COVID-19.

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“…Diagnostic evaluation usually includes an US or a cholescintigraphy nuclear scan (HIDA). Another imaging method sometimes used is CT scan [68,69].…”

Section: Acalculous Cholecystitismentioning

confidence: 99%

A scoping review on acute gastrointestinal surgical complications in immunocompromised pediatric patients

et al. 2022

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Background Gastrointestinal complications are becoming increasingly more common and pose a significant risk on the health of children with compromised immunity caused by various etiologies such as chemotherapy and posttransplantation immunosuppression. We aim to review abdominal complications in immunocompromised children and their respective management. Main body This is a scoping review of the literature. PubMed, MEDLINE, Google Scholar, and Scopus libraries were searched for relevant articles. Extracted data included the etiologies of immunocompromised immunity, gastrointestinal and abdominal complications in immunocompromised children, diagnosis, and treatment of these pathologies. Examples of gastrointestinal complications in immunocompromised children include, but not limited to, neutropenic enterocolitis, acute appendicitis, bowel perforation, acalculous cholecystitis, and acute pancreatitis. Our literature review showed that bacterial and fungal infections are the major causes of exacerbation and mortality. The main cause of immunosuppression in children with neutropenic enterocolitis and acute pancreatitis is chemotherapy, and management of these pathologies using intravenous fluids, antibiotic therapy, and granulocyte-stimulating factors is the current standard of care. Surgical intervention is uncommon and reserved for complicated cases. That said, in acute appendicitis and bowel perforation, laparoscopy is the mainstay treatment. However, in systemic infections, nonsurgical interventions such as transfusion and bowel rest are the gold standard. As for acalculous cholecystitis, percutaneous cholecystectomy is superior to laparotomy and other surgical interventions. Conclusion Timely diagnosis and management of gastrointestinal complications in the immunocompromised children is key in reducing mortality and morbidity. Both surgical and nonsurgical interventions are needed and should be further studied in order to improve outcomes.

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Acute Acalculous Cholecystitis in Hospitalized Patients With Hematologic Malignancies and Prognostic Importance of Gallbladder Ultrasound Findings

Abstract: Symptomatic patients who meet the US criteria for the diagnosis of AAC have a poor prognosis. Other patients require a close follow-up US examination within 1 week to detect early progression.

Cited by 13 publications

References 27 publications

Prognostic Significance of Ultrasound Findings of Acute Acalculous Cholecystitis for Elderly Long-Term Bedridden Patients

Prognostic Significance of Ultrasound Findings of Acute Acalculous Cholecystitis for Elderly Long-Term Bedridden Patients

Acalculous Cholecystitis in COVID-19 Patients: A Narrative Review

A scoping review on acute gastrointestinal surgical complications in immunocompromised pediatric patients

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