Acute Acalculous Cholecystitis

Acute acalculous cholecystitis (ACC) can develop with or without gallstones after surgery and in critically ill or injured patients. Diabetes mellitus, malignant disease, abdominal vasculitis, congestive heart failure, cholesterol embolization, shock, and cardiac arrest also have been associated with AAC. The pathogenesis of MC is complex and multifactorial. Ultrasound of the gallbladder is most accurate for the diagnosis of MC in the critically ill patient. CT is probably of comparable accuracy, but carries both advantages and disadvantages. Rapid improvement may be expected when MC is diagnosed correctly and cholecystostomy is performed timely.