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Acalculous CholecystitisAka: Biliary Dyskinesia

Epidemiology
1. Incidence: 5-10% of patients with Acute Cholecystitis
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)
Symptoms and Signs
1. Indistinguishable from calculous Acute Cholecystitis
2. Patient ill on initial presentation
Diagnostics
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%
Management
1. Cholecystectomy
  1. Offers satisfactory symptom relief in 96% of cases
  2. Brosseuk (2003) Am J Surg 186:1

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This page was written by Scott Moses, MD, and was last revised 1/27/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.