The Internet Book of Critical Care Podcast IBCC Episode 63 - Acalculus Cholecystitis
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Nov 12, 2019 Dive into the sneaky world of acalculus cholecystitis, a critical condition lurking in severely ill patients. Discover the key risk factors and signs that all healthcare providers should recognize. Learn about the diagnostic power of ultrasound versus traditional lab tests. Explore tailored antibiotic strategies for calculus cholecystitis, especially when bacteria aren’t present. Finally, uncover essential management strategies, including drainage and surgery, to tackle this life-threatening issue in critical care.
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Pathophysiology of Acalculous Cholecystitis
- Acalculous cholecystitis often complicates long-term critical illness with gallbladder dysfunction and distension.
- This leads to progressive necrotizing cholecystitis which is potentially dangerous if not recognized early.
Recognize Key Risk Factors
- Consider risk factors like trauma, burn, sepsis, multi-organ failure, prolonged fasting, opioids, and hypoperfusion for acalculous cholecystitis.
- These factors contribute to gallbladder distension and poor perfusion, creating the perfect storm for disease.
Suspect Acalculous Cholecystitis Early
- In ventilated or sedated patients with sepsis of unknown origin, suspect acalculous cholecystitis even without classic symptoms.
- Always include it in your differential for unexplained right upper quadrant signs or persistent sepsis.