Acute cholecystitis occurring as a complication of other diseases

Acute cholecystitis developed in 17 patients recovering from surgery for nonbiliary disease and in 11 patients receiving treatment for a medical, ie, nonsurgical condition. Certain features of gallbladder disease in these two groups were different from those found in the general population. There was a reversal of the usual sex ratio; men outnumbered women in both groups. In the surgical group, the proportion of acalculous cases (62%) was much higher than in the general population. Prolonged fasting, blood transfusion, mechanical ventilation, and vascular disease seemed to predispose patients to the development of acute cholecystitis. Ultrasonography was the most useful single diagnostic test. Although most patients were treated by early surgery, a small group who had not undergone previous abdominal surgery were treated successfully without operation.