Acute Tuberculous Cholecystitis

Vallejo, Eduardo Arias

doi:10.1016/s0016-5085(19)36578-3

Cited by 16 publications

(3 citation statements)

References 2 publications

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“…Acalculous cholecystitis has occurred in disseminated fungal infections caused by several Candida species [25,26], in systemic leptospirosis [27], in chronic biliary tract carriers of typhoidal [28] and nontyphoidal Salmonella [29], during active cholera infection [30], and in tuberculosis [31]. Acalculous cholecystitis has occurred in disseminated fungal infections caused by several Candida species [25,26], in systemic leptospirosis [27], in chronic biliary tract carriers of typhoidal [28] and nontyphoidal Salmonella [29], during active cholera infection [30], and in tuberculosis [31].…”

Section: Patterns Of Clinical Illnessmentioning

confidence: 99%

Acute acalculous cholecystitis

Barie

Eachempati

2003

Curr Gastroenterol Rep

136

104

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Acute cholecystitis can develop without gallstones in critically ill or injured patients. However, the development of acute acalculous cholecystitis is not limited to surgical or injured patients, or even to the intensive care unit. Diabetes, malignant disease, abdominal vasculitis, congestive heart failure, cholesterol embolization, and shock or cardiac arrest have been associated with acute acalculous cholecystitis. Children may also be affected, especially after a viral illness. The pathogenesis of acute acalculous cholecystitis is a paradigm of complexity. Ischemia and reperfusion injury, or the effects of eicosanoid proinflammatory mediators, appear to be the central mechanisms, but bile stasis, opioid therapy, positive-pressure ventilation, and total parenteral nutrition have all been implicated. Ultrasound of the gallbladder is the most accurate diagnostic modality in the critically ill patient, with gallbladder wall thickness of 3.5 mm or greater and pericholecystic fluid being the two most reliable criteria. The historical treatment of choice for acute acalculous cholecystitis has been cholecystectomy, but percutaneous cholecystostomy is now the mainstay of therapy, controlling the disease in about 85% of patients. Rapid improvement can be expected when the procedure is performed properly. The mortality rates (historically about 30%) for percutaneous and open cholecystostomy appear to be similar, reflecting the severity of illness, but improved resuscitation and critical care may portend a decreased risk of death. Interval cholecystectomy is usually not indicated after acute acalculous cholecystitis in survivors; if the absence of gallstones is confirmed and the precipitating disorder has been controlled, the cholecystostomy tube can be pulled out after the patient has recovered.

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Section: Patterns Of Clinical Illnessmentioning

confidence: 99%

Acute acalculous cholecystitis

Barie

Eachempati

2003

Curr Gastroenterol Rep

136

104

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“…In one study, microangiography of the gallbladder arterial vasculature showed poor and irregular capillary filling in patients with AAC, whereas patients with acute calculous cholecystitis had strongly dilated arterioles with regular filling of the capillary network suggesting an ischemic mechanism of injury in AAC [24••]. Finally, several bacterial, fungal, parasitic, and viral infections of the gallbladder wall have been implicated (Table 1) [25][26][27][28][29][30][31][32][33][34][35]. Although bacterial infections may occur secondarily to an initial chemical or ischemic event, opportunistic infections may directly cause cholecystitis instead of the more common cholangiopathy in immunocompromised patients [36].…”

Section: Introductionmentioning

confidence: 99%

Acute acalculous cholecystitis

Owen¹,

Jain

2005

Curr Treat Options Gastro

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Acute acalculous cholecystitis is defined as acute inflammation of the gallbladder in the absence of gallstones. Patients are usually critically ill with atherosclerotic heart disease, recent trauma, burn injury, surgery, or hemodynamic instability. The presentation of acute acalculous cholecystitis may be insidious, characterized by unexplained fever, leukocytosis, hyperamylasemia, or abnormal aminotransferases, and patients often lack right upper quadrant tenderness. Diagnostic evaluation includes ultrasonography, computerized tomography, and cholescintigraphy. Given the high mortality of untreated disease, definitive treatment consists of cholecystectomy or, in poor surgical candidates, cholecystostomy. Endoscopic therapy with nasobiliary drainage and lavage is an effective treatment option in patients unable to tolerate surgery or cholecystostomy.

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“…Of the nontrauma postoperative patients, more than 80% of reported cases of AAC have been of the male gender . However, AAC has also been identified in a demographic variety of patients as a result of secondary infection or disease states such as disseminated candidiasis , hemolytic streptococcal septicemia , malaria , tuberculosis , Salmonella of nontyphoidal and typhoidal species , as well as Epstein–Barr virus and other viral pathogens.…”

mentioning

confidence: 99%

Spontaneous Rupture of the Gall Bladder: An Unusual Forensic Diagnosis

Dean

Jamison

Lane

2014

Journal of Forensic Sciences

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Peritonitis secondary to spontaneous rupture/perforation of the gall bladder is a rare condition overall and is even less common in the forensic population. We report the case of a middle-aged man who died from generalized peritonitis from gall bladder perforation due to acute acalculous cholecystitis. This condition usually occurs in critical patients with systemic illness, and although the exact pathogenesis remains unclear, the development of acalculous cholecystitis appears to be multifactorial. Antemortem diagnosis is reliant upon clinical presentation, laboratory data, and radiologic studies. Surgery and appropriate antibiotics are mainstays of treatment; however, there is an emerging role for minimally invasive procedures. Histopathologic features show significant overlap with the calculous type. Although increasing numbers of acalculous cholecystitis have been diagnosed in the critically ill, the fatal presentation of a perforated gall bladder following an undiagnosed case of acute acalculous cholecystitis is unusual in a nonhospitalized and ambulatory man.

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Acute Tuberculous Cholecystitis

Cited by 16 publications

References 2 publications

Acute acalculous cholecystitis

Acute acalculous cholecystitis

Acute acalculous cholecystitis

Spontaneous Rupture of the Gall Bladder: An Unusual Forensic Diagnosis

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