Surgery Book

Stomach Disorders


Acalculous Cholecystitis

Aka: Acalculous Cholecystitis, Biliary Dyskinesia
  1. See Also
    1. Gallstone (Cholelithiasis)
    2. Biliary Colic
    3. Acute Cholecystitis
    4. Choledocholithiasis
    5. Acute Gallstone Cholangitis (Ascending Cholangitis)
  2. Epidemiology
    1. Incidence: 5-10% of patients with Acute Cholecystitis
    2. Most common in critically ill Intensive Care patients
  3. 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)
  4. 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
  5. 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%
  6. Management
    1. See Cholecystitis
  7. 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
  8. References
    1. Aldeen and Rosenbaum (2017) 1200 Questions Emergency Medicine Boards, 3rd ed, Wolters Kluwer, Baltimore, p. 122

Biliary Dyskinesia (C0005416)

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
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
Derived from the NIH UMLS (Unified Medical Language System)

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
Polish Zapalenie pęcherzyka żółciowego bez kamicy
Hungarian Acalculosus cholecystitis
Norwegian Akalkuløs kolecystitt, Akalkuløs galleblærebetennelse, Kolecystitt uten stein, Galleblærebetennelse uten stein
Derived from the NIH UMLS (Unified Medical Language System)

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