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Acute acalculous cholecystitis in acute renal failure
P E Stevens1, N A Harrison, D J Rainford
1Department of Renal Medicine, Princess Mary's RAF Hospital, Halton, Aylesbury, Bucks, UK.
Intensive Care Medicine
|January 1, 1988
Summary
Acute acalculous cholecystitis is a significant complication in acute renal failure patients. Early diagnosis and treatment, such as cholecystotomy, improve survival rates and prevent further biliary complications.
Area of Science:
- Nephrology
- Gastroenterology
- Critical Care Medicine
Background:
- Acute renal failure (ARF) patients face increased risks of complications.
- Acute acalculous cholecystitis (AAC) is an emerging concern in intensive care settings.
- Longer survival in ARF patients correlates with higher incidence of AAC.
Purpose of the Study:
- To investigate the incidence and risk factors of AAC in ARF patients.
- To evaluate diagnostic methods for AAC in this population.
- To assess treatment outcomes and survival rates for AAC in ARF.
Main Methods:
- Retrospective analysis of 92 ARF patients without prior biliary disease.
- Identification of risk factors: sepsis, surgery, trauma, TPN, ventilation, sedation, transfusions, hypotension.
- Diagnosis via clinical suspicion, serial ultrasound, WCC, LFTs, and CRP.
Main Results:
- 16 of 92 ARF patients developed AAC.
- Most patients had 6 or more risk factors.
- Conservative treatment (4), cholecystotomy (10), and cholecystectomy (2) were used.
- Survival rate was 69% (11 patients).
- Cholecystotomy led to no further biliary surgery.
Conclusions:
- AAC is a significant complication in high-risk ARF patients.
- Multifactorial risk factors contribute to AAC development.
- Prompt diagnosis and treatment, particularly cholecystotomy, improve outcomes and survival in ARF patients with AAC.