Friday November 25, 2005
Acute acalculous cholecystitis in ICU

Diagnosis of acute acalculous cholecystitis (AAC) remains one of the most life saving skill in ICU as mortality from gallbladder rupture within 48 hours is high. Data of 39 patients published from Finland provide pretty good idea of patients prone to develop AAC. 1

1. Infection was the most common admission diagnosis, followed by cardiovascular surgery.
2. The mean APACHE II score on admission was 25.
3. The mean length of ICU stay before cholecystectomy was 8 days.
4. 85% of the patients received norepinephrine infusion.
5. 90% of the patients suffered respiratory failure before cholecystectomy.

Champagne Sign in acute acalculous cholecystitis: (On ultrasound) emphysematous cholecystitis with gas bubbles arising in the fundus of the gallbladder.

See nice review article on acalculous cholecystitis from emedicine.com (please register - free).

References: click to get abstract/article
1. Acute acalculous cholecystitis in critically ill patients - Acta Anaesthesiologica Scandinavica, 2004 Sep;48(8):986-91 - from pubmed -. Acta Anaesthesiologica Scandinavica is an official publication of The Scandinavian Society of Anaesthesiology and Intensive Care Medicine.