Acute alithiasic cholecystitis

Abstract

Acute alithiasic aholecystitis or also called acalculous manifested by the presence of an inflammation of the gallbladder in the absence of stones inside, is a rare but emerging entity and in many cases secondary to other clinical conditions such as; infectious processes of viral or bacterial strain, major surgery, drugs, traumatisms, mechanical ventilation, parenteral nutrition, burns, among others. It is characterized by presenting clinical manifestations that do not differ greatly from those of lithiasic cholecystitis, among them; fever, jaundice, localized pain in the right hypochondrium, nausea, vomiting and anorexia, positive or doubtful Murphy sign, hypersensitivity of the area and presence of mass in upper quadrant, corresponding to this, should be considered among the diagnostic possibilities for every patient critically ill or injured with a clinical presentation of sepsis or jaundice with no known origin, with vesicular ultrasound being the study of choice and thus allowing the establishment of medical treatment, which includes hemodynamic stabilization, suppression of drugs capable of hindering vesicular emptying and the administration of antibiotics that act on gram negative aerobes, enterococci and anaerobes, while interval cholecystectomy is not indicated after a true episode of CAA and is reserved only for patients with gangrene, vesicular perforation or when percutaneous drainage fails.