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Ir Med J 2018 May 10;111(5):763. Epub 2018 May 10.

Department of General Paediatrics OLCHC, Crumlin Road, Crumlin, Dublin

World J Gastroenterol 2018 Nov;24(43):4870-4879

Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan.

Acute acalculous cholecystitis (AAC) is the inflammatory disease of the gallbladder in the absence of gallstones. AAC is estimated to represent at least 50% to 70% of all cases of acute cholecystitis during childhood. Although this pathology was originally described in critically ill or post-surgical patients, most pediatric cases have been observed during several infectious diseases. Read More

J Surg Res 2018 Dec 3;232:539-546. Epub 2018 Aug 3.

Department of Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts.

Background: Percutaneous cholecystostomy (PC) tube is a preferred option in acute cholecystitis for patients who are high risk for cholecystectomy (CCY). There are no evidence-based guidelines for patient care after PC. We identified the predictors of disease recurrence and successful interval CCY. Read More

J Laparoendosc Adv Surg Tech A 2018 Nov 16. Epub 2018 Nov 16.

5 Division of Acute Care Surgery, Department of Surgery, Duke University Medical Center , Durham, North Carolina.

Background: An increasing number of end-stage heart failure patients are supported with left ventricular assist device (LVAD) implantation and must be maintained on consistent anticoagulation. These patients are experiencing prolonged survival and, in some, there is development of new biliary disease. However, safety and outcomes of this procedure in this unique patient group is not well reported. Read More

Diagnosis (Berl) 2018 11;5(4):257-266

Department of Pathology, Yale School of Medicine, New Haven, CT, USA.

This is a case report involving diagnostic errors that resulted in the death of a 15-year-old girl, and commentaries on the case from her parents and involved providers. Julia Berg presented with fatigue, fevers, sore throat and right sided flank pain. Based on a computed tomography (CT) scan that identified an abnormal-appearing gall bladder, and markedly elevated bilirubin and "liver function tests", she was hospitalized and ultimately underwent surgery for suspected cholecystitis and/or cholangitis. Read More

Case Rep Oncol Med 2018 21;2018:5308585. Epub 2018 Oct 21.

Department of Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.

Colorectal cancer (CRC) is one of the most common cancers and the second highest cause of cancer-related deaths (Jemal et al., 2011). Common presentations of CRC include alterations in bowel habit, weight loss, and lower gastrointestinal bleeding. Read More

F1000Res 2018 18;7. Epub 2018 Oct 18.

Department of Gastroenterology, University of Washington Harborview Medical Center Campus, Seattle, USA.

Acalculous cholecystitis is a life-threatening gallbladder infection that typically affects the critically ill. A late diagnosis can have devastating outcomes because of the high risk of gallbladder perforation if untreated. The diagnosis is not straightforward as Murphy's sign is difficult to illicit in the critically ill and many imaging findings are either insensitive or non-specific. Read More

Ann Med Surg (Lond) 2018 Nov 10;35:189-191. Epub 2018 Oct 10.

Clinical Pathology Department, St. Joseph Hospital, 2900 N Lake Shore Dr, Chicago, IL, 60657, USA.

Introduction: Epstein Barr virus (EBV) is a human herpes virus 4, transmitted through intimate contact between susceptible persons and asymptomatic EBV shedders. It usually presents with fever, pharyngitis and lymphadenopathy. Majority of individuals with primary EBV infection recover uneventfully. Read More

Acta Gastroenterol Belg 2018 Jul-Sep;81(3):393-397

Baskent University, Faculty of Medicine, Radiology Department, Ankara, Turkey.

Background And Study Aims: Conventional use of percutaneous cholecystostomy [PC] is bridging therapy to delayed cholecystectomy for acute cholecystitis in high-surgical risk patients. Primary aim of this report is to evaluate the long-term outcome of PC as a definitive treatment for acute acalculous cholecystitis [AAC].

Patients And Methods: Seventy-one AAC patients who underwent PC procedure were identified. Read More

Am J Clin Pathol 2019 Jan;151(1):100-107

Department of Pathology, University of Rochester Medical Center, Rochester, NY.

Objectives: Indications for cholecystectomy have changed dramatically over the past three decades. Cystoisospora belli has been reported in cholecystectomy specimens of immunocompetent patients. The present study was designed to determine the prevalence and clinical association of C belli in the gallbladder. Read More

J Pediatr Gastroenterol Nutr 2018 Sep 25. Epub 2018 Sep 25.

Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Objectives: Chronic acalculous cholecystitis (CAC) increasingly is being diagnosed as a cause of recurring biliary symptoms in children, but its clinical diagnosis remains challenging. The primary objective was to evaluate the utility of hepato-cholescintigraphy in pediatric patients with suspected CAC. A secondary objective was to describe their clinical follow-up after diagnosis. Read More

Radiol Case Rep 2018 Dec 13;13(6):1116-1118. Epub 2018 Sep 13.

South West Healthcare, 25 Ryot St, Warrnambool, Victoria 3280, Australia.

Acute acalculous cholecystitis (AAC) is a rare condition occurring in only 5%-10 % of patients with acute cholecystitis. Systemic illness caused, for example, by , and Salmonella species can result acute inflammation of gallbladder wall. It is a surgical emergency and if left untreated can lead to high mortality due to gangrene or perforation of gallbladder. Read More

Scand J Surg 2018 Sep 18:1457496918798209. Epub 2018 Sep 18.

2 Department of Radiology, Derriford Hospital, Plymouth, UK.

Background: Acute cholecystitis has the potential to cause sepsis and death, particularly in patients with poor physiological reserve. The gold standard treatment of acute cholecystitis (cholecystectomy) is often not safe in high-risk patients and recourse is made to percutaneous cholecystostomy as either definite treatment or temporizing measure. The aim of this study is to evaluate early and late outcomes following percutaneous cholecystostomy in patients with acute cholecystitis treated at our institution. Read More

J Gastrointest Surg 2018 Sep 17. Epub 2018 Sep 17.

Department of Surgery, University of North Carolina at Chapel Hill, 4030 Burnett Womack Building, 101 Manning Drive, CB 7081, Chapel Hill, NC, 27599-7081, USA.

Background: Data comparing outcomes following cholecystectomy and cholecystostomy tube placement (CTP) in elderly patients are lacking. We aimed to compare the post-procedural outcomes between cholecystectomy and CTP in elderly patients with acute cholecystitis.

Methods: We performed a retrospective, population-based analysis using the National Inpatient Sample for the period 2000-2014. Read More

J Travel Med 2018 Aug;25(1)

Alfred Health, Melbourne, Victoria, Australia.

The first case of Shigella-associated acalculous cholecystitis is described. A 27-year-old woman presented to hospital with diarrhoea and acute acalculous cholecystitis one day after return to Australia from Vietnam. Her feces culture grew multi-drug resistant ESBL-producing Shigella sonnei and she improved with antimicrobial therapy and intravenous fluids. Read More

BMC Surg 2018 08 30;18(1):69. Epub 2018 Aug 30.

University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy.

Following publication of the original article [1], the authors reported that one of the authors' names is spelled incorrectly. Read More

Fukushima J Med Sci 2018 ;64(2):95-102

Department of Internal Medicine, Kanazawa Medical Station VieC.

A 29-year-old man with fever and right upper quadrant pain was referred to our hospital. Ultrasonography revealed intense gallbladder edema and pericardial effusion. Despite no symptoms and signs related to heart failure, the patient was clinically suspected of cardiac dysfunction related to acute peri-myocarditis based on his symptoms of preceding fever and headache, pericardial effusion, positive troponin T value, elevated B-type natriuretic peptide level, and sequential changes on electrocardiography. Read More

Cureus 2018 Jun 22;10(6):e2864. Epub 2018 Jun 22.

Hepatopancreatobiliary & Transplant Surgery, Singapore General Hospital, Singapore, SGP.

We describe a case of melioidosis presenting as acalculous cholecystitis in a middle-aged Chinese male. The patient presented with clinical features of cholecystitis and computed tomography (CT) imaging did not reveal other obvious sources of sepsis other than acalculous cholecystitis. The decision was made by the hepatobiliary team to proceed with an urgent cholecystectomy in view of patient's septic presentation. Read More

Adv Surg 2018 Sep 20;52(1):57-71. Epub 2018 Jun 20.

Department of Surgery, University of Arizona, 1501 North Campbell Avenue, Room 4237, PO Box 245131, Tucson, AZ 85724-5131, USA. Electronic address:

Med Sante Trop 2018 May;28(2):193-196

Service d'hépato-gastroentérologie du CHU Campus de Lomé, Togo.

Purpose: To determine the epidemiological and diagnostic aspects of hepatobiliary diseases in people with HIV infection at the Lomé University Hospital.

Methods And Patients: This 5-year retrospective descriptive and analytic study included all people with HIV infection aged 15 years and older of either sex admitted with a hepatobiliary disease.

Results: Among all patients admitted for hepatobiliary diseases, people with HIV infection accounted for 2%. Read More

J Burn Care Res 2018 Aug;39(5):724-728

Consultant Burns and Plastic Surgeon, East Grinstead, UK.

Acute acalculous cholecystitis (AAC) is an acute inflammatory disorder of the gallbladder, which can complicate the recovery of burn patients. No formal literature review has been performed about this uncommon but potentially fatal complication in burn care. A Pubmed search from 1950 to 2015 was performed using MESH terms: "acalculous cholecystitis," "burns or thermal injuries or thermal damage," and "cholecystitis or gallbladder inflammation. Read More

Cureus 2018 Apr 19;10(4):e2505. Epub 2018 Apr 19.

Department of General and Visceral Surgery, Katholisches Klinikum Bochum - St. Josef Hospital, Ruhr University Bochum.

Infectious mononucleosis is a common disease of the adolescent caused by the Epstein-Barr virus (EBV). We present a rare case of a male adult with acalculous cholecystitis due to infectious mononucleosis. A correct diagnosis was challenging due to a false negative antibody test. Read More

BMJ Case Rep 2018 May 23;2018. Epub 2018 May 23.

Department of Medical Imaging, The Prince Charles Hospital, Chermside, Queensland, Australia.

Spontaneous acalculous gallbladder perforation is a rare radiological and clinical phenomenon with life-threatening consequences. In the setting of recent cardiac transplantation, the condition is increasingly uncommon and difficult to diagnose preoperatively. We describe a case of spontaneous acalculous gallbladder perforation in an intensive care unit (ICU) patient, most likely due to a combination of cardiac transplantation and immunosuppression. Read More

Medicine (Baltimore) 2018 May;97(19):e0674

Hepatobiliary and Pancreatic Surgery.

Rationale: Gallbladder perforation is a serious clinical condition and associated with high morbidity and mortality. A definitive diagnosis is contentious before surgery.

Patient Concerns: We herein report a case of perforation of the gallbladder neck secondary to chemotherapy and radiation for nasopharyngeal carcinoma patient. Read More

Cureus 2018 Feb 28;10(2):e2243. Epub 2018 Feb 28.

Department of Internal Medicine, University of Missouri Kansas City (UMKC).

Acute acalculous cholecystitis (AAC) is most commonly seen after surgery in critically ill patients. Early diagnosis and treatment is the key in the management of AAC. Ultrasound is the commonly used first modality for right upper quadrant (RUQ) pain with sensitivity equal to or greater than 80% for AAC. Read More

J Ultrasound Med 2018 Apr 30. Epub 2018 Apr 30.

Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas Health Science Center, Houston, Texas, USA.

Objectives: Patients with hematologic malignancies, especially those with acute disease or those receiving intense chemotherapy, are known to develop acute acalculous cholecystitis (AAC). The aim of this study was to evaluate the diagnostic and prognostic value of the established ultrasound (US) diagnostic criteria for AAC in patients with acute hematologic malignancies who were clinically suspected to have AAC.

Methods: We retrospectively studied the US findings of the gallbladder in patients with hematologic malignancies and correlated these findings with the duration of clinical symptoms, complications, and gallbladder-specific mortality. Read More

Aust Crit Care 2018 Apr 18. Epub 2018 Apr 18.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea. Electronic address:

Introduction: Critical care patients have many risk factors for acute cholecystitis (AC). However, less data are available regarding newly developed AC in critically ill patients.

Objectives: To investigate the clinical features of AC occurring in critically ill patients after admission to an intensive care unit (ICU). Read More

BMJ Case Rep 2018 Apr 13;2018. Epub 2018 Apr 13.

Department of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada.

We present the case of a young female with symptoms of biliary colic and a biochemical profile consistent with biliary obstruction. Imaging was suspicious for Mirizzi's syndrome. Intraoperatively, the patient was found to have a complete intrahepatic gallbladder causing common hepatic duct compression with final pathology confirming acute cholecystitis. Read More

Int J Surg Case Rep 2018 3;46:13-15. Epub 2018 Apr 3.

General Surgical Department, Caboolture Hospital, QLD, 4510, Australia.

Introduction: Gallbladder torsion is a rare condition of increasing prevalence in recent years. It is often difficult to diagnose pre-operatively and delayed intervention can lead to significant complications.

Presentation Of Case: We present a case of an 81 year old lady who presented with symptoms of cholecystitis for 24 h with no evidence of cholelithiasis on imaging. Read More

Neurology 2018 May 30;90(18):e1548-e1552. Epub 2018 Mar 30.

From the Division of Pharmacovigilance I, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food & Drug Administration, Silver Spring, MD.

Objective: To evaluate acute acalculous cholecystitis (AAC) as a potential safety risk for patients treated with alemtuzumab.

Methods: The Food and Drug Administration Adverse Event Reporting System and the medical literature were searched for cases of AAC in conjunction with alemtuzumab for all clinical indications.

Results: Eight spontaneously reported cases meeting the case definition of AAC in close temporal association with alemtuzumab use were identified. Read More

Cureus 2018 Jan 20;10(1):e2092. Epub 2018 Jan 20.

Surgery, Gold Coast University Hospital.

Acute acalculous cholecystitis is an uncommon disease in children and is usually associated with trauma, burns, and infections. Whereas acute acalculous cholecystitis is only seen in 10% of cholecystitis in adults, it is uncommon in the paediatric population. A seven-year-old male presented to the emergency department of a regional hospital with a 36-hour history of right-upper-quadrant abdominal pain. Read More

PLoS Negl Trop Dis 2018 03 8;12(3):e0006177. Epub 2018 Mar 8.

Department of Internal Medicine, Spaarne Gasthuis Medical Centre, Hoofddorp, the Netherlands.

J Surg Case Rep 2018 Feb 28;2018(2):rjy031. Epub 2018 Feb 28.

NYIT-COM, New York Institute of Technology, Westbury, NY, USA.

In patients presenting with classic signs and symptoms of cholecystitis, the diagnosis is made based on confirmatory imaging studies. However, the most commonly utilized imaging studies lack accuracy, especially in the case of acalculous disease. Here we discuss four cases of patients presenting with symptoms of cholecystitis. Read More

CJEM 2018 Mar 1:1-3. Epub 2018 Mar 1.

‡Department of Emergency Medicine,University Health Network,Toronto,ON.

Infectious mononucleosis is typically a self-limited viral infection of adolescence and early adulthood that resolves in a period of weeks, causing no major sequelae. We describe a case of a healthy 18-year-old female diagnosed with infectious mononucleosis who also presented with right upper quadrant abdominal pain, moderate transaminitis, and cholestatic biochemistry. An ultrasound revealed acute acalculous cholecystitis, generally a condition seen in the context of critical illness. Read More

BMC Gastroenterol 2018 Feb 27;18(1):32. Epub 2018 Feb 27.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China.

Background: In patients with common bile duct stones (CBDS) and intact gallbladder, further management for the gallbladder after the CBDS clearance is still controversial. The relationship between gallbladder motility and the biliary complications were seldom discussed. Our study is to predict the subsequent biliary complications by gallbladder function test using fatty meal sonography (FMS) in patients with CBDS who had been treated by endoscopic retrograde cholangiopancreatography (ERCP). Read More

J Med Case Rep 2018 Jan 13;12(1). Epub 2018 Jan 13.

Faculty of Nursing, University College AAB Prishtina, Prishtina, Kosovo.

Background: Ascaris lumbricoides is one of the most common intestinal infections in developing countries, including Kosovo. In contrast to migration to the bile duct, migration of the worm to the gallbladder, due to the narrow and tortuous nature of the cystic duct, is rare. When it does occur, it incites acalculous cholecystitis. Read More

Hepatology 2018 05 27;67(5):2051-2054. Epub 2018 Feb 27.

Department of Gastroenterology, Division of Clinical Gastroenterology and Hepatology, Hospital das Clinicas-University of São Paulo School of Medicine, São Paulo, Brazil.

Clin Case Rep 2017 11 15;5(11):1775-1779. Epub 2017 Sep 15.

Medical Department Whangarei Base Hospital Whangarei New Zealand.

Leptospirosis is the commonest zoonotic infection worldwide but is vastly underreported and extremely heterogeneous in its presentation. Acalculous cholecystitis is an under recognized presentation of acute leptospirosis. In the appropriate clinical context, with a clear exposure history, recognition of this association presents a unifying diagnosis and limits unnecessary surgical interventions. Read More

Eur Radiol 2018 Apr 7;28(4):1449-1455. Epub 2017 Nov 7.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic Ro, 43-Gil, Songpa-gu, Seoul, 05505, Korea.

Objectives: To examine the outcomes of percutaneous cholecystostomy (PC) in patients with acute acalculous cholecystitis (AAC).

Methods: The study population comprised 271 patients (mean age, 72 years; range, 22-97 years, male, n=169) with AAC treated with PC with or without subsequent cholecystectomy. Clinical data from total 271 patients were analysed, and outcomes were assessed according to whether the catheter was removed or remained indwelling. Read More

Cureus 2017 Aug 16;9(8):e1569. Epub 2017 Aug 16.

Chair, Department of Medicine, Maimonides Medical Center.

Acalculous cholecystitis (AC) is an inflammation of the gallbladder in the absence of gallstones. There are many risk factors associated with AC. However, this report implicates allopurinol as an inciting agent for a severe systemic drug reaction, i. Read More

BMJ Case Rep 2017 Oct 10;2017. Epub 2017 Oct 10.

Department of Gastroenterology, Centro Hospitalar e Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

A 51-year-old man with no relevant medical history presents to the emergency department complaining of a recent worsening of few months upper abdominal pain with back radiation and postprandial fullness, without B symptoms. Laboratory analysis showed hyperamylasaemia, elevated lactate dehydrogenase and inflammatory parameters. Abdominal ultrasonography revealed a heterogeneous solid mass in the spleen/splenic hilum with pancreatic parenchyma continuity and no biliary tract dilation or gallstones. Read More

Pol Merkur Lekarski 2017 Sep;43(255):125-128

Józef Struś Hospital, Poznań, Poland: Pathomorphology Unit.

Acute acalculous cholecystitis (AAC) is a necroinflammatory disease of the gallbladder with no gallstones present. ACC is known to be a serious, even potentially lethal complication observed mainly in patients with various severe underlying conditions including trauma, burn and sepsis. Infection of cardiac implantable electronic devices may lead to cardiac device-related infective endocarditis (CDRIE). Read More

J Visc Surg 2017 Oct 24;154(5):345-353. Epub 2017 Aug 24.

Service de chirurgie digestive et de transplantation hépatique, université Claude-Bernard-Lyon-1, hôpital de la Croix-Rousse, Lyon, France.

Gallbladder (GB) adenomyomatosis (ADM) is a benign, acquired anomaly, characterized by hypertrophy of the mucosal epithelium that invaginates into the interstices of a thickened muscularis forming so-called Rokitansky-Aschoff sinuses. There are three forms of ADM: segmental, fundal and more rarely, diffuse. Etiology and pathogenesis are not well understood but chronic inflammation of the GB is a necessary precursor. Read More

Pediatr Infect Dis J 2018 02;37(2):e43-e45

From the Department of Infectious Diseases and Tropical Pediatrics, Hospital La Paz, Madrid, Spain.

Malaria has been associated with acute acalculous cholecystitis, a very uncommon complication in children. We present a 5-year-old girl, originally from Equatorial-Guinea, diagnosed with severe malaria with acute kidney injury, thrombocytopenia and acute acalculous cholecystitis. She was treated with intravenous quinine and clindamycin, plus cefotaxime and metronidazole with a full resolution without surgery. Read More

Rev Esp Enferm Dig 2017 Oct;109(10):708-718

Cirugía General y del Aparato Digestivo, Hospital General Universitario J M Morales Meseguer.

Background And Objectives: There is currently no consensus with regard to the use of cholecystectomy or percutaneous cholecystostomy as the therapy of choice for acute acalculous cholecystitis. The goal of this study was to review the scientific evidence on the management of these patients according to clinical and radiographic findings.

Methods: A systematic review of the literature from 2000 to 2016 was performed. Read More

BMJ 2017 08 3;358:j3386. Epub 2017 Aug 3.

Tunbridge Wells Hospital, Tunbridge Wells, UK.