[Acute acalculous cholecystitis: apropos of 6 cases]

Authors relate their experience of six cases of acute acalculous cholecystitis (4 postoperative, 2 posttraumatic and postoperative). Five cases were correctly diagnosed preoperatively and another case was operated on the basis of a high index of suspicion. Acute acalculous cholecystitis is often misdiagnosed and its frequency is probably higher than suspected. Associated diseases, the natural history of the disease as well as delayed diagnosis explain its poor prognosis. The diagnosis of acute acalculous cholecystitis should be routinely ruled out in high risk patients (polyoperated, polytraumatised) in order to improve the mortality rate. Ultrasonography and biliary scintigraphy are useful for the diagnosis in high risk patients. Emergency cholecystectomy is still the best long term treatment.