Acalculous cholecystitis – Signs and Symptoms
Acalculous cholecystitis is inflammation of the gallbladder in the absence of gallstones. It most commonly occurs in the setting of a severe illness or injury – burns, major trauma, sepsis, and major surgery. It is particularly associated with the use of parenteral nutrition in patients who are not being fed by mouth.
The diagnosis is based on having a high index of suspicion. If the patient is awake they usually complain of abdominal pain either diffusely or in the right upper quadrant. They also usually complain of tenderness on palpation. If the patients or obtunded or sedated they may present with unexplained fever or an elevated white blood cell count on laboratory testing. Additonal lab tests that are commonly elevated are serum bilirubin, aspartate aminotransferase (AST), and alkaline phosphatase.
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