Acute cholecystitis in neutropenic patients

Area of Science:

• Hepatology
• Gastroenterology
• Oncology

Background:

• Acute cholecystitis (AC) occurs in 0.4-1.65% of neutropenic patients.
• Clinical presentation, diagnosis, and treatment of AC in neutropenic patients differ significantly from the general population.
• Hematologic diseases are a key consideration in neutropenic patients presenting with AC.

Purpose of the Study:

• To characterize the clinical presentation of AC in neutropenic patients with hematologic diseases.
• To describe the diagnostic approaches and patient outcomes.
• To evaluate the effectiveness of different treatment strategies for AC in this specific patient cohort.

Main Methods:

• Retrospective analysis of patients diagnosed with neutropenia and fever associated with AC between January 2000 and January 2017.
• Analysis of quantitative variables using mean and standard deviation.
• Analysis of qualitative variables using frequency and percentage.

Main Results:

• Twelve out of 2007 (0.59%) neutropenic patients with fever had AC.
• Lymphoblastic leukemia was the most common hematologic malignancy.
• Acute acalculous cholecystitis occurred in 50% of cases; 91.6% presented severely, with 75% undergoing cholecystostomy. Septic shock was the leading cause of mortality (33.3%).

Conclusions:

• Individualized treatment is essential for AC in neutropenic patients.
• Cholecystostomy can serve as a bridge therapy to interval cholecystectomy.
• Prompt diagnosis and management are critical for improving outcomes in this high-risk group.