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Acalculous Cholecystitis

Signs & Symptoms

 Lasts several hours
Ref: Uptodate [ Pathogenesis, clinical features, and diagnosis of acute cholecystitis] Harrison [ 2426] Harrison [ 76] Cecil [ 472]
Significant vascular disease
Ref: Uptodate [ Acalculous cholecystitis]
Recurrent episodes of typical Right Upper Quadrant pain #criteria
Ref: Harrison [ 2428]
relieved by Vomiting (negative symptom)
Ref: Harrison [ 255]

Physical Examination

 Acute
Ref: Uptodate [ Pathogenesis, clinical features, and diagnosis of acute cholecystitis] Cecil [ 473]
Critically ill patient
Ref: Uptodate [ Pathogenesis, clinical features, and diagnosis of acute cholecystitis] Cecil [ 473] Epocrates [ https://online.epocrates.com/diseases/7831/Acute-cholecystitis/Diagnostic-Approach]
Right upper quadrant tenderness
Ref: Uptodate [ Pathogenesis, clinical features, and diagnosis of acute cholecystitis] Harrison [ 279]

Lab / Serology

 Leukocytosis
Ref: Uptodate [ Acalculous cholecystitis] Cecil [ 473]
Left shift
Ref: Uptodate [ Acalculous cholecystitis]
Hyperbilirubinemia
Note: much more common in acalculous than calculous cholecystitis
Ref: Uptodate [ Acalculous cholecystitis]

Imagin Study

 HIDA scan show Leakage into pericholecystic space
Note: due to perforation
Ref: Uptodate [ Acalculous cholecystitis]
HIDA scan show Failure to opacify the gallbladder
Ref: Uptodate [ Acalculous cholecystitis]
HIDA scan show perforation
Ref: Uptodate [ Acalculous cholecystitis]

Complication

 Sepsis
Ref: Uptodate [ Acalculous cholecystitis]
Peritonitis
Ref: Uptodate [ Acalculous cholecystitis]
Shock
Ref: Uptodate [ Acalculous cholecystitis]

Risk Factors

 Trauma
Ref: Unknown [ 0]
Burns
Ref: Unknown [ 0]
Postpartum period
Ref: Unknown [ 0]

Cause

 Caused by Gallbladder ischemia
Ref: Cecil [ 473]
Caused by Gallbladder stasis
Ref: Cecil [ 473]

Other