Archive \ Volume.10 2019 Issue 3

Evaluation of Acalculous Cholecystitis, Diagnosis, and Management

Mohammed J. Addas , Rashmah M. Alshammari , Abdullah M. Alokayli , Abdalatiff K. Bedaiwi , Ahmed M. Ghabban , Ali M. Alasiri , Kalil M. AlKishan , Nawaf A. A. Alhumairi , Rasis K.S. Saber , Ali H.A. Alamri , Amjed N. Alruwaili
Abstract

Background: Around 10% of all cases of cholecystitis are related to the acalculous disease. Acalculous cholecystitis is traditionally known to occur in patients with critical illness and the symptoms may also be vague and intermittent. Therefore, diagnosing and treating such cases can be very difficult and challenging. Objective: In this review, we aimed to assess the published literature that discussed acalculous cholecystitis diagnosis and management. Method: PubMed database was used for articles selection, and the following keys were used in the MeSH (("Acalculous Cholecystitis "[Mesh]) AND (“Acalculous Cholecystitis management"[Mesh])). A total of 30 papers were reviewed and included in the review. Conclusion: An appropriate history, clinical findings, and laboratory data along with high suspicion index are factors needed in order to reach a correct and rapid diagnosis. These factors should be completed by imaging such as computed tomography and ultrasound. The initial step in treating acalculous cholecystitis should be antibiotics and source control. Then, cholecystectomy or drainage by percutaneous cholecystostomy can be done. Percutaneous cholecystostomy has shown a high success rate in controlling the cases of acalculous cholecystitis.