Acute acalculous cholecystitis

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 5 February 2018, last major update September 2012

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Acute acalculous cholecystitis[TI] gallbladder full text[sb]

See also: Acute cholecystitis, Acute calculous cholecystitis
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Cite this page: Gulwani, H. Acute acalculous cholecystitis. website. Accessed June 19th, 2019.
Definition / general
  • 10% of cases
  • 2/3 male, mean age 50+ years
  • Often only fever or hyperamylasemia
  • Patients usually severely debilitated, due to severe trauma, sepsis, shock, burns, cancer, diabetes, multiple blood transfusions, surgery, torsion, cystic duct obstruction from various causes
  • May be associated with infection by CMV, cryptosporidia or microsporidia in AIDS patients
  • 10 - 50% mortality
  • Raised prostaglandin E levels (cause damage), tissue anoxia, bacterial contamination, stasis and changes in bile salt concentration
Microscopic (histologic) description
  • Bile infiltration is more prominent and extends deep to muscle layer, WBC margination of blood vessels and lymphatic dilation
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