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Posttraumatic acalculous cholecystitis

J Rice, H C Williams, L M Flint

    Southern Medical Journal
    |January 1, 1980
    PubMed
    Summary
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    Acalculous cholecystitis, a gallbladder inflammation without stones, can occur after trauma or burns. Early cholecystectomy is recommended for better outcomes in these critical surgical patients.

    Area of Science:

    • Surgical pathology
    • Gastroenterology
    • Trauma surgery

    Background:

    • Acalculous cholecystitis is a severe gallbladder inflammation often seen in critically ill patients.
    • It can present with symptoms mimicking gallstones, complicating diagnosis.
    • Occurs in approximately 0.5% of trauma and burn patients.

    Observation:

    • Six patients experiencing trauma and burns developed acalculous cholecystitis.
    • Symptoms were similar to acute calculous cholecystitis.
    • Conservative management failed in all cases, necessitating surgical intervention.

    Findings:

    • All patients underwent cholecystectomy due to failed conservative treatment.
    • Histopathological examination revealed gangrenous changes or focal necrosis in the gallbladder.

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  • Uniformly successful postoperative recovery was observed after surgery.

    • Implications:

    • Delayed diagnosis of acalculous cholecystitis in trauma/burn patients is associated with high mortality (24% overall, 10% related to gallbladder disease).
    • While cholecystostomy is an option, cholecystectomy offers superior results when surgically feasible.
    • Highlights the importance of prompt recognition and surgical management for acalculous cholecystitis in post-trauma and burn patients.