II. Epidemiology

  1. Incidence: 5-10% of patients with Acute Cholecystitis
  2. Most common in critically ill Intensive Care patients

III. Risk factors

  1. Elderly
  2. Diabetes Mellitus
  3. Multiple Trauma
  4. Extensive Burn Injury
  5. Prolonged labor
  6. Major surgery
  7. Gallbladder torsion
  8. Systemic Vasculitis
  9. Biliary tract infection (Bacterial or parasitic)

IV. Findings: Symptoms and Signs

  1. Indistinguishable from calculous Acute Cholecystitis
  2. Patient ill on initial presentation
  3. Presentation may be subtle in already ill ICU patients
    1. May present as Fever Without Source

V. Imaging

  1. RUQ Ultrasound or CT Abdomen
    1. Large, tense, static gallbladder
    2. No evidence of Gallstones
  2. Radionuclide Cholescintography (HIDA Scan)
    1. Poor gallbladder filling
    2. Gallbladder ejection fraction <50%

VI. Management

VII. Prognosis

  1. Intensive Care patient
    1. Delayed diagnosis is common, often with gall bladded gangrene or perforation at time of diagnosis
    2. Mortality 10-50%
  2. Outpatient diagnosis in an otherwise healthy patient
    1. Follows a typical course as those with typical Cholecystitis

VIII. References

  1. Aldeen and Rosenbaum (2017) 1200 Questions Emergency Medicine Boards, 3rd ed, Wolters Kluwer, Baltimore, p. 122

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English Biliary Dyskinesia, Biliary Dyskinesias, Dyskinesias, Biliary, Dyskinesia, Biliary, biliary dyskinesia (diagnosis), biliary dyskinesia, Biliary Dyskinesia [Disease/Finding], biliary dyskinesias, dyskinesia biliary, Biliary dyskinesia, Biliary dyskinesia (disorder), biliary; dyskinesia, dyskinesia; biliary, Biliary dyskinesia (disorder) [Ambiguous]
Swedish Gallgångsdyskinesi
Finnish Biliaarinen dyskinesia
Russian ZHELCHNYKH PUTEI DISKINEZIIA, ЖЕЛЧНЫХ ПУТЕЙ ДИСКИНЕЗИЯ
Czech Biliární dyskineze, žlučové cesty - dyskinéze, biliární dyskineze, dyskineze žlučových cest
Spanish discinesia biliar, discinesia biliar (trastorno), disquinesia biliar, Discinesis biliar, disquinesia biliar (trastorno), disquinesia biliar (concepto no activo), Discinesia Biliar
Polish Zaburzenia czynnościowe dróg żółciowych, Dyskinezy dróg żółciowych
Hungarian Biliaris dyskinesis
Norwegian Biliær dyskinesi, Gallegangsdyskinesi
Japanese タンドウジスキネジア, 胆道ジスキネジア
Dutch dyskinesie; gal, gal; dyskinesie, galblaasdyskinesie, Biliaire dyskinesie, Dyskinesie, biliaire
Portuguese Discinésia biliar, Discinesia Biliar
German biliaere Dyskinesie, Gallenwegsdyskinesie, Biliäre Dyskinesie
French Dyskinésie biliaire, Dystonie biliaire
Italian Discinesia biliare

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French Cholécystite acalculeuse, Cholécystite alithiasique, Cholécystite non lithiasique, Cholécystite sans calcul
German Cholezystitis ohne Stein, Cholezystitis, steinlose, Gallenblasenentzündung, steinlose, Steinlose Cholezystitis, Streß-Cholezystitis
Italian Colecistite alitiasica, Infiammazione non calcolotica della cistifellea, Colicistite non calcolotica
Portuguese Colecistite não litiásica, Colecistite Alitiásica, Colecistite Acalculosa, Inflamação da Vesícula Biliar Acalculosa
Spanish Colecistitis acalculosa, colecistitis alitiásica (trastorno), colecistitis alitiásica, colecistitis sin cálculos, Colecistitis Acalculosa, Colecistitis Alitiásica, Inflamación de la Vesícula Acalculosa
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Finnish Kivetön sappirakkotulehdus
Russian KHOLETSISTIT NEKAL'KULEZNYI, NEKAL'KULEZNYI KHOLETSISTIT, НЕКАЛЬКУЛЕЗНЫЙ ХОЛЕЦИСТИТ, ХОЛЕЦИСТИТ НЕКАЛЬКУЛЕЗНЫЙ
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Hungarian Acalculosus cholecystitis
Norwegian Akalkuløs kolecystitt, Akalkuløs galleblærebetennelse, Kolecystitt uten stein, Galleblærebetennelse uten stein