Potentially life-threatening emergency
Acalculous cholecystitis
Alerts and Notices
Synopsis

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.
Codes
ICD10CM:K81.9 – Cholecystitis, unspecified
SNOMEDCT:
19968009 – Cholecystitis without calculus
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Cholestasis due to sepsis
- Total parenteral nutrition (chronic use)
- Acute calculous cholecystitis
- Peptic ulcer disease
- Acute pancreatitis
- Right-sided pneumonia
- Right-sided pyelonephritis
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:11/27/2016
Last Updated:11/27/2016
Last Updated:11/27/2016