The Internet Book of Critical Care Podcast
IBCC Episode 63 - Acalculus Cholecystitis
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.
18:08
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Quick takeaways
- Acalculous cholecystitis primarily affects critically ill patients, often presenting ambiguously amidst other sepsis-related symptoms, complicating diagnosis.
- Ultrasound is essential for diagnosing acalculous cholecystitis, guiding management that may include percutaneous cholecystostomy or surgical intervention.
Deep dives
Understanding Acalculous Cholecystitis
Acalculous cholecystitis primarily affects critically ill patients, often presenting in those who are intubated and sedated. In these patients, gallbladder function deteriorates, leading to fluid accumulation and potential necrotizing cholecystitis. This condition is rare but can account for approximately 5% to 10% of cholecystitis cases. Factors such as hypoperfusion, gallbladder distension, and the critical illness itself contribute significantly to this complication.
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