Chapter 53: Biliary Tract- Acute Acalculous Cholecystitis Flashcards
1
Q
What is it?
A
Acute cholecystitis without evidence of stones
2
Q
What is the pathogenesis?
A
It is believed to result from sludge and gallbladder disuse and biliary stasis, perhaps secondary to absence of cholecystokinin stimulation (decreased contraction of gallbladder)
3
Q
What are the risk factors?
A
- Prolonged fasting
- TPN
- Trauma
- Multiple transfusions
- Dehydration
- Often occurs in prolonged postoperative or ICU setting
4
Q
What are the diagnostic tests of choice?
A
-
Ultrasound
- sludge and inflammation usually present with acute acalculouscholecystitis
- HIDA scan
5
Q
What are the findings on HIDA scan?
A
Nonfilling of the gallbladder
6
Q
What is the management of acute acalculous cholecystitis?
A
Cholecystectomy, or cholecystostomy tube if the patient is unstable (placed percutaneously by radiology or open surgery)
