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Acute acalculous cholecystitis. An increasing entity
Annals of Surgery
|February 1, 1982
Summary
Acute acalculous cholecystitis (AAC) incidence significantly rose from 1950-1979, carrying a mortality rate double that of gallstone-related cholecystitis. Early surgical intervention is crucial for this condition.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Vascular Biology
Background:
- Acute acalculous cholecystitis (AAC) is gallbladder inflammation without stones.
- Historically, AAC has been less common than calculous cholecystitis.
- Understanding AAC's changing epidemiology and pathophysiology is critical.
Observation:
- A statistically significant increase in AAC frequency was observed between 1950 and 1979.
- This rise was most pronounced from 1965 to 1979.
- AAC is associated with severe clinical conditions like sepsis, trauma, and debilitation.
Findings:
- AAC exhibits a mortality rate more than twice that of acute calculous cholecystitis.
- Histologically, AAC involves intense vascular injury in the gallbladder wall.
- This vascular damage resembles experimental findings related to factor XII activation.
Implications:
- The intense vascular injury in AAC can lead to rapid progression to gangrene and perforation.
- Prompt surgical treatment is essential for managing AAC.
- Increased recognition of AAC may be linked to evolving surgical practices over the past 50 years.
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