[Acute acalculous cholecystitis]

A previously healthy 32-year-old man presented with fever, upper abdominal pain and leukocytosis of 5 days duration. Ultrasonography and CT-scan of the abdomen were not diagnostic. On laparotomy acute gangrenous acalculous cholecystitis was found and was successfully treated by cholecystectomy. This condition is a well-known complication in critically ill patients. However, physicians should be aware of its possible occurrence even in previously healthy ambulatory patients, since a delayed diagnosis carries a significant risk of perforation and death.