Acute cholecystitis in patients with stroke.

Area of Science:

• Neurology
• Gastroenterology
• Critical Care Medicine

Background:

• Acute cholecystitis is an uncommon complication following stroke.
• Early diagnosis and intervention are crucial for managing this condition.

Purpose of the Study:

• To investigate the occurrence and characteristics of acute cholecystitis in patients hospitalized for stroke.
• To identify potential risk factors and clinical presentations of acute cholecystitis in the stroke population.

Main Methods:

• A retrospective review of six patients diagnosed with acute cholecystitis during initial stroke hospitalization over five years.
• Analysis of stroke etiology, cholecystitis type (calculous vs. acalculous), and presenting symptoms.

Main Results:

• Six patients with acute cholecystitis post-stroke were identified.
• Common stroke etiologies included cardiac embolism and cerebrovascular hemorrhage.
• Fever was the most frequent symptom; however, many patients were asymptomatic or had atypical presentations, including hemorrhagic cholecystitis in one acalculous case.

Conclusions:

• A strong association exists between acute cholecystitis and stroke.
• Risk factors for stroke patients include atherosclerotic disease, potential medication side effects (anti-thromboembolic drugs leading to hemorrhagic cholecystitis), and stroke-related complications like hemiparesis and fasting.
• Clinical vigilance, including abdominal examination for stroke patients with altered consciousness or aphasia, is essential for timely diagnosis.