Overview
Cholecystitis without calculus, also known as acalculous cholecystitis, refers to inflammation of the gallbladder in the absence of gallstones, often associated with systemic illness, ischemia, or severe trauma 1.Diagnosis
Clinical presentation includes right upper quadrant pain, fever, and leukocytosis 1.
Imaging studies such as ultrasound and CT are crucial; ultrasound may show gallbladder wall thickening or pericholecystic fluid 1.
Nuclear medicine HIDA scan can assess gallbladder ejection fraction, aiding in diagnosis 1.Management
First-line treatment typically involves supportive care and intravenous antibiotics targeting common pathogens (e.g., piperacillin-tazobactam, ceftriaxone) 1.
Surgical intervention, such as cholecystectomy, may be necessary for severe cases or complications like gallbladder perforation 1.
Close monitoring of organ function and fluid balance is essential 1.Special Populations
No specific details provided in the abstracts regarding pregnancy, pediatrics, elderly, or comorbidities related to acalculous cholecystitis management 1.Key Recommendations
Initiate empirical intravenous antibiotic therapy targeting gram-negative organisms in suspected acalculous cholecystitis (Evidence: Moderate) 1.
Consider surgical intervention for patients with severe symptoms, complications, or failure to respond to medical management (Evidence: Moderate) 1.
Regularly monitor vital signs, organ function, and fluid status in hospitalized patients to guide treatment adjustments (Evidence: Expert opinion) 1.References
1 Ylinen ER, Vehviläinen-Julkunen K, Pietilä AM, Hannila ML, Heikkinen M. Medication-free colonoscopy--factors related to pain and its assessment. Journal of advanced nursing 2009. link