Acute acalculus cholecystitis is a condition associated with a high incidence of perforation, gallbladder necrosis and mortality. The mortality rates reach as high as 50 percent if the diagnosis is delayed. It occurs usually in elderly patients in severe or multiple concomitant illnesses. These patients are critically ill in the intensive care unit.
Management of these patients is difficult. HIDA scans are not always reliable. An ultrasound, which reveals thickened gallbladder walls and gallbladder sludge, is very useful. Intravenous antibiotics are commonly administered to help control infection. Usually a cholecystectomy or a novel mechanism to decompress the gallbladder is employed.
