Surgery>>>>>The Gallbladder and Extrahepatic Biliary System
Question 9#

Risk factors for acalculous cholecystitis include:

A. Sepsis
B. Severe burns
C. Prolonged parenteral nutrition
D. Multiple trauma
E. All of the above

Correct Answer is E

Comment:

Acute inflammation of the gallbladder can occur without gallstones. Acalculous cholecystitis typically develops in critically ill patients in the intensive care unit. Patients on parenteral nutrition with extensive burns, sepsis, major operations, multiple trauma, or prolonged illness with multiple organ system failure are at risk for developing acalculous cholecystitis. The cause is unknown, but gallbladder distention with bile stasis and ischemia has been implicated as causative factors. Pathologic examination of the gallbladder wall reveals edema of the serosa and muscular layers, with patchy thrombosis of arterioles and venules. US is the diagnostic test of choice. Percutaneous US or CT-guided cholecystostomy is typically the intervention of choice, as they are often unfit for surgery. After recovery from the systemic disease, cholecystectomy may be indicated.