In critically ill patients, presenting symptoms may include unexplained fever, new leukocytosis, or vague abdominal discomfort. Ambulatory patients may complain of smoldering, typically colicky right upper quadrant (RUQ) pain and positive Murphy sign, but many present with sepsis and peritonitis from gallbladder rupture or necrosis from longstanding acalculous cholecystitis.
Physical examination may reveal a palpable RUQ mass and jaundice, both of which are uncommon in patients with acute calculous cholecystitis. A high index of suspicion for acalculous cholecystitis should be had for patients who have been recently or critically ill with sepsis of an unclear etiology, particularly if vague gastrointestinal complaints are present.
K81.9 – Cholecystitis, unspecified
19968009 – Cholecystitis without calculus
Differential Diagnosis & Pitfalls
Drug Reaction Data