Hepatabiliary
Acalculous Cholecystitis

Acalculous Cholecystitis

Note

Bile stasis in critically ill patients can lead to inflammation and secondary infection.

Relatively common cause of fever, leukocytosis +/- abdominal tenderness in critically ill patients (M > F).

Palpable gallbladder and jaundice more common than calculous cholecystitis.

Pathogens similar to calculous cholecystitis, but can also be caused by opportunistic pathogens in immunosuppressed patients.

Dx by U/S.

Treatment requires prompt source control - cholecystectomy vs. cholecystostomy - Send anaerobic cultures and STAT gram stain.

Reassess Therapy on Day 3