Acute Acalculous Cholecystitis Following Cardiovascular Surgery—Case Histories

Abstract

Acute acalculous cholecystitis has been recognized with increasing frequency in recent years. The condition has been associated with trauma, burns, total parenteral nutrition, and unrelated surgical procedures. This report describes 3 patients who developed a particularly fulminant form of the disease following cardiovascular surgical procedures. Rapid deterioration and signs of impending cardiovascular collapse were characteristic of these patients; emergency sur gery was needed in each case. Tube cholecystostomy was performed in each case with no mortality. No patient required subsequent cholecystectomy during a mean follow-up of 4.3 years. It is concluded that the patient with cardiovascular disease may develop a more fulminant form of acute acalculous cholecystitis owing to the underlying vascular disease. Awareness of this condition and early surgical intervention with performance of tube cholecystostomy will decrease the mortality of this lethal process.