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Acute and chronic acalculous cholecystitis associated with aortic dissection

Fuyuki F Inagaki1, Yoshiaki Hara2, Masako Kamei2

  • 1Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan Hepato-Biliary-Pancreatic Surgery Division, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan inagaki-tky@umin.ac.jp.

Journal of Surgical Case Reports
|August 2, 2015
PubMed

Insights

Acalculous cholecystitis, a rare gallbladder disease, can be linked to aortic dissection. This study presents two cases, highlighting acute and chronic ischemic forms potentially caused by reduced blood flow.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Pathology

Background:

  • Acalculous cholecystitis (AC) is a severe condition with unclear pathogenesis.
  • Aortic dissection is a critical cardiovascular emergency.

Observation:

  • Two patients with aortic dissection developed acalculous cholecystitis.
  • Case 1 presented with acute ischemic cholecystitis post-aortic dissection exacerbation.
  • Case 2 showed chronic ischemic cholecystitis with gallbladder perforation after prolonged aortic dissection management.

Findings:

  • Histological examination revealed distinct acute (necrotized cholecystitis, thrombi) and chronic (fibrosis, hemosiderosis) ischemic changes in the gallbladder.
  • Chronic acalculous cholecystitis (CAC) is documented here for the first time in association with aortic dissection.
  • Aortic dissection may be an underlying risk factor for both acute and chronic AC.

Implications:

  • Reduced splanchnic blood flow secondary to aortic dissection is a potential mechanism for AC.
  • This association broadens the understanding of AC etiology.
  • Recognition of this link may improve diagnosis and management of AC in patients with aortic dissection.

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