[Reactive acalculous cholecystitis: a bland and asymptomatic course--incidence of a classical stress disease]

A systematic search for reactive acalculous cholecystitis (RAC) performed from 11/85 until 11/87 rendered an incidence of 9 in 1272 patients recovering from surgery and 1 in 930 patients treated conservatively for various diseases. 8 patients presented with typical but discrete clinical symptoms whereas 2 remained asymptomatic. Abdominal sonography proved to be the most useful diagnostic procedure. The ratio of classic fulminant disease to cases presenting with lesser severity was calculated to be 1:50. All patients in this series were managed nonoperatively in respect to RAC. The pathoanatomic and pathogenetic context is reviewed and the author's impression corroborated that relevant cases may frequently go by unnoticed by clinicians.