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. 1989 Jul;210(1):52–55. doi: 10.1097/00000658-198907000-00008

Acute acalculous cholecystitis in critically injured patients. Preoperative diagnostic imaging.

E E Cornwell 3rd 1, A Rodriguez 1, S E Mirvis 1, R M Shorr 1
PMCID: PMC1357765  PMID: 2662924

Abstract

The potential lethality and predisposing factors of acute acalculous cholecystitis (AAC) are well established; however, preoperative diagnosis remains a challenge. This update of a previous report of 30 cases of AAC at a Level I trauma center describes 14 multiply injured patients who developed AAC and underwent cholecystectomy. All 14 patients had acutely inflamed gallbladders; 6 (42.8%) had areas of necrosis or gangrene. The mortality rate was 7% (1 patient). While the percentage of patients receiving prolonged intensive care (100%), narcotic analgesics (100%), and TPN (93%) correlates with the experience cited previously, the percentage undergoing preoperative diagnostic imaging is unusually high, reflecting a heightened suspicion for AAC. Computed tomographic or sonographic evidence of gallbladder wall thickness greater than or equal to 4 mm, pericholecystic fluid or subserosal edema without ascites, intramural gas, or a sloughed mucosal membrane was considered diagnostic criteria for AAC. We conclude that preoperative computed tomogram or ultrasound imaging leads to earlier recognition of this life-threatening problem.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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