II. Epidemiology
- Incidence: 5-10% of patients with Acute Cholecystitis
- Most common in critically ill Intensive Care patients
III. Risk factors
- Elderly
- Diabetes Mellitus
- Multiple Trauma
- Extensive Burn Injury
- Prolonged labor
- Major surgery
- Gallbladder torsion
- Systemic Vasculitis
- Biliary tract infection (Bacterial or parasitic)
IV. Findings: Symptoms and Signs
- Indistinguishable from calculous Acute Cholecystitis
- Patient ill on initial presentation
- Presentation may be subtle in already ill ICU patients
- May present as Fever Without Source
V. Imaging
-
RUQ Ultrasound or CT Abdomen
- Large, tense, static gallbladder
- No evidence of Gallstones
-
Radionuclide Cholescintography (HIDA Scan)
- Poor gallbladder filling
- Gallbladder ejection fraction <50%
VI. Management
- See Cholecystitis
VII. Prognosis
-
Intensive Care patient
- Delayed diagnosis is common, often with gall bladded gangrene or perforation at time of diagnosis
- Mortality 10-50%
- Outpatient diagnosis in an otherwise healthy patient
- Follows a typical course as those with typical Cholecystitis
VIII. References
- Aldeen and Rosenbaum (2017) 1200 Questions Emergency Medicine Boards, 3rd ed, Wolters Kluwer, Baltimore, p. 122
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Related Studies
Definition (MSH) | A motility disorder characterized by biliary COLIC, absence of GALLSTONES, and an abnormal GALLBLADDER ejection fraction. It is caused by gallbladder dyskinesia and/or SPHINCTER OF ODDI DYSFUNCTION. |
Concepts | Disease or Syndrome (T047) |
MSH | D001657 |
SnomedCT | 43469007, 197432008 |
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 |
Ontology: Acalculous Cholecystitis (C0267841)
Definition (MSH) | Inflammation of the GALLBLADDER wall in the absence of GALLSTONES. |
Concepts | Disease or Syndrome (T047) |
MSH | D042101 |
SnomedCT | 19968009 |
Dutch | acalculeuze cholecystitis, Cholecystitis zonder steenvorming, Galblaasontsteking zonder steenvorming |
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 |
Japanese | 無石性胆嚢炎, ムセキセイタンノウエン, 無石胆嚢炎, 胆嚢炎-無石, 無石胆嚢症 |
Swedish | Akalkulös kolecystit |
English | GALLBLADDER INFLAMM ACALCULOUS, ACALCULOUS GALLBLADDER INFLAMM, acalculous cholecystitis (diagnosis), acalculous cholecystitis, Acalculous Cholecystitis [Disease/Finding], cholecystitis acalculous, Acalculous Gallbladder Inflammation, Cholecystitis, Acalculous, Gallbladder Inflammation, Acalculous, Acalculous Cholecystitis, Acalculous cholecystitis, Cholecystitis without calculus (disorder), Cholecystitis without calculus, Cholecystitis, NOS without calculus |
Czech | akalkulózní cholecystitida, žlučník - zánět akalkulózní, Akalkulózní cholecystitida |
Finnish | Kivetön sappirakkotulehdus |
Russian | KHOLETSISTIT NEKAL'KULEZNYI, NEKAL'KULEZNYI KHOLETSISTIT, НЕКАЛЬКУЛЕЗНЫЙ ХОЛЕЦИСТИТ, ХОЛЕЦИСТИТ НЕКАЛЬКУЛЕЗНЫЙ |
Polish | Zapalenie pęcherzyka żółciowego bez kamicy |
Hungarian | Acalculosus cholecystitis |
Norwegian | Akalkuløs kolecystitt, Akalkuløs galleblærebetennelse, Kolecystitt uten stein, Galleblærebetennelse uten stein |