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About my Gall Bladder Condition

January 12th, 2005 · 2 Comments · Diabetes

It is called “Acalculous Cholecystitis”. Here is the information on it from EMedicine.com

Synonyms and related keywords: gallbladder inflammation, inflammation of the gallbladder, total parenteral nutrition, TPN, bile stasis, gallbladder stasis, stagnant bile, gallbladder dysmotility, sepsis with biliary tract infection, AIDS cholangiopathy, TPN-associated liver disease, cholecystectomy, percutaneous cholecystostomy

Background: Acalculous cholecystitis is a severe illness that is a complication of various other medical or surgical conditions. Duncan first recognized it in 1844 when a fatal case of acalculous cholecystitis complicating an incarcerated hernia was reported. The condition causes approximately 5-10% of all cases of acute cholecystitis and is usually associated with more serious morbidity and higher mortality rates than calculous cholecystitis. It is most commonly observed in the setting of very ill patients (eg, on mechanical ventilation, with sepsis or severe burn injuries, after severe trauma). In addition, acalculous cholecystitis is associated with a higher incidence of gangrene and perforation compared to calculous disease.

The usual finding on imaging studies is a distended acalculous gallbladder with thickened walls (>3-4 mm) with or without pericholecystic fluid. Acalculous cholecystitis can be observed in patients with human immunodeficiency virus (HIV) infection, although it is a late manifestation of this disease. Acalculous cholecystitis can also be found in patients on total parenteral nutrition (TPN), typically those on TPN for more than 3 months.

Pathophysiology: The main cause of this illness is thought to be due to bile stasis and increased lithogenicity of bile. Critically ill patients are more predisposed because of increased bile viscosity due to fever and dehydration and because of prolonged absence of oral feeding resulting in a decrease or absence of cholecystokinin-induced gallbladder contraction. Gallbladder wall ischemia that occurs because of a low-flow state due to fever, dehydration, or heart failure may also play a role in the pathogenesis of acalculous cholecystitis.

Frequency:

In the US: Acalculous cholecystitis comprises approximately 5-10% of all cases of acute cholecystitis.
Mortality/Morbidity: The mortality and morbidity rates associated with acalculous cholecystitis can be high; the illness is frequently observed in patients with sepsis or other serious conditions.

Sex: Acalculous cholecystitis has a slight male predominance, unlike calculous cholecystitis, which has a female predominance.

Age: The condition can occur in persons of any age, although a higher frequency is reported in persons in their fourth and eighth decades of life.

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