Acalculous hemorrhagic cholecystitis is a rare complication of acute cholecystitis and is associated with a high mortality rate. We present a case of acalculous hemorrhagic cholecystitis with hematoma in the gallbladder lumen, which was diagnosed using magnetic resonance imaging (MRI). The T1- & T2-weighted MRI revealed gallbladder distension with a hypointense intraluminal hematoma. The excellent tissue contrast provided by MRI is useful for detecting hematomas in the cases of hemorrhagic cholecystitis.
Acalculous Cholecystitis ; Cholecystitis ; Cholecystitis, Acute ; Gallbladder ; Hematoma ; Magnetic Resonance Imaging

Mesenteric venous thrombosis is rare but can cause ischemia or infarction of small bowel. Mesenteric venous thrombosis is classified as either primary or secondary. Despite considerable advances in medical diagnosis and treatment, the diagnosis is often delayed and prognosis is still poor. We report three cases of mesenteric venous thrombosis treated by different modalities each other. The first case was superior mesenteric venous thrombosis secondary to acute acalculous cholecystitis and treated with anticoagulation. The second case was primary mesenteric venous thrombosis and treated by anticoagulation combined with percutaneous transhepatic thrombolysis. The third case was also primary mesenteric venous thrombosis, but, needed surgery with anticoagulation.
Acalculous Cholecystitis ; Diagnosis ; Infarction ; Ischemia ; Prognosis ; Venous Thrombosis*

No abstract available.
Acalculous Cholecystitis* ; Churg-Strauss Syndrome* ; Colitis, Ischemic* ; Ulcer*

SLE is an autoimmune disease with multiorgan involvement and a wide range of clinical manifestations, and inflammation of gallbladder also can be represented. There were a few cases of acute acalculous cholecystitis (AAC) in previous reports. Most of them tended to already know about underlying SLE when detected AAC at that time. It may be difficult to detect AAC caused by SLE not due to biliary stone if physician is not conscious of undiagnosed lupus. We introduce a 70-year old female patient, who is diagnosed with AAC. Her symptoms were satisfied the ACR classification criteria for SLE, and was diagnosed with SLE, simultaneously. After a high dose steroid pulse therapy, followed by cyclophosphamide, her symptoms have improved rapidly. In order to better diagnose and treat the disease, we need to be aware of AAC as a potential manifestation of SLE.
Acalculous Cholecystitis* ; Autoimmune Diseases ; Cholecystitis ; Classification ; Cyclophosphamide ; Female ; Gallbladder ; Humans ; Inflammation ; Lupus Erythematosus, Systemic*

PURPOSE: We evaluated the therapeutic efficacy and complications of percutaneous cholecystostomy in acalculou s acute cholecystitis. MATERIALS AND METHODS: We performed percutaneous cholecystostomy under ultrasound guidance for the treatment of 18 patients with acalculous acute cholecystitis. We retrospectively analyzed the therapeutic efficacy and complications. RESULTS: A dramatic improvement in clinical condition was observed in 16(88%) patients within 24 --48 hours. One patient was successfully treated with second trial because of technical failure at initial trial. No major complications occured except a gallbladder laceration. Most of patients complained minor symptoms such as fever, pain, mild dyspnea and refered pain to right shoulder, and these symptoms were resolved within one week. There was no complications related to vasovagal reflex. CONCLUSION: In the treatment of acalculous acute cholecystitis, percutaneous cholecystostomy is a safe and effective method.
Acalculous Cholecystitis* ; Cholecystitis, Acute ; Cholecystostomy* ; Dyspnea ; Fever ; Gallbladder ; Humans ; Lacerations ; Reflex ; Retrospective Studies ; Shoulder ; Ultrasonography

PURPOSE: Acalculous cholecystitis (ACC) is a rare, but potentially lethal disease, which occurs in critically ill patients and those recovering from non-biliary tract operations. Recently, an increase in the presentation of mild form ACC was noted to occur in outpatients. This study was performed to assess the clinical features and prognosis of ACC. METHODS: One thousand consecutive laparoscopic cholecystectomies, performed by a single surgeon at the Eulji Medical Center, between September, 2001 and May, 2005, were retrospectively analyzed. According to the clinical data, the preoperative findings, operative results and pathology reports, 35 patients were diagnosed with acalculous cholecystitis. RESULTS: No significant differences were found in the age and sex distributions, laboratory findings between ACC and calculous cholecystitis (CC) or incidence of associated diseases. The number of cases undergoing PTGBD, or with an inflammatory grade score during the operation, were higher for those with an ACC, but the operative times and conversion rates to open cholecystectomy were no different. Of the 35 ACC patients, only 20 had the true criteria of acute acalculous cholecystitis. However, the other 15 patients showed no strong evidence typical of acalculous cholecystitis. CONCLUSION: We experienced acalculous cholecystitis different from rare and lethal form of acalculous cholecystitis. But diagnosis of this mild form of ACC is also delayed due to lack of objective findings. High suspicious index of these diagnostic entities should be kept in mind and we should rule out other disease entities as soon as possible if ACC is questionable, so we can perform laparoscopic cholecystectomy safely on these mild forms of ACC.
Acalculous Cholecystitis* ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Critical Illness ; Diagnosis ; Humans ; Incidence ; Operative Time ; Outpatients ; Pathology ; Prognosis ; Retrospective Studies ; Sex Distribution

Acalculous Cholecystitis ; microbiology ; Adult ; Cholecystitis, Acute ; diagnosis ; microbiology ; Enzyme-Linked Immunosorbent Assay ; Humans ; Leptospirosis ; complications ; diagnosis ; Male ; Pancreatitis ; etiology ; microbiology

Acute acalculous cholecystitis (AAC) is defined as acute inflammation of the gallbladder in the absence of gallstones. AAC occurs in patients after major surgery and in the presence of serious co-morbidities such as severe trauma, burns, sepsis, prolonged intravenous hyperalimentation and hemodynamic instability. AAC is rare in patients with none of the established risk factors. We present a case of a 38-year-old woman who developed AAC after laparoscopic appendectomy.
Acalculous Cholecystitis ; Appendectomy ; Burns ; Female ; Gallbladder ; Gallstones ; Hemodynamics ; Humans ; Inflammation ; Parenteral Nutrition, Total ; Risk Factors ; Sepsis

Endoscopic snare papillectomy (ESP) for ampulla of Vater tumor (AVT) has been performed successfully instead of surgical ampullectomy (SA) because ESP is a less invasive procedure than SA. Hemorrhage, perforation and pancreatitis are relatively common complications of ESP and other rare complications such as cholangitis, liver abscess has been reported. Recently we encountered a case of acute acalculous cholecystitis after ESP for AVT, which was treated successfully with percutaneous cholecystostomy with intravenous antibiotics. We therefore report this case with a brief review of the literature.
Acalculous Cholecystitis* ; Adenoma* ; Ampulla of Vater ; Anti-Bacterial Agents ; Cholangitis* ; Cholecystostomy ; Hemorrhage ; Liver Abscess ; Pancreatitis ; SNARE Proteins*

The nephrotic syndrome is characterized by generalized edema, hypoproteinemia(<2 g/dL), proteinuria(>40 mg/m2/hr), and hypercholesterolemia(>200 mg/dL). It is reported that hypoalbuminemia, which is one of the four diagnostic criteria of the nephrotic syndrome, is associated with gallbladder wall thickening. An explanation for the thickened wall in hypoalbuminemic states is the accumulation of fluid in the subserosal layer of the gallbladder wall which contains the most areolar tissue. This report describes a patient who was initially diagnosed with the nephrotic syndrome at the age of 4 and subsequently developed acute acalculous cholecystitis at the age of 5.8 with an albumin level of 1.3 g/dL. The patient responded to fluid therapy, nasogastric suction, and broad spectrum antibiotics.
Acalculous Cholecystitis* ; Anti-Bacterial Agents ; Edema ; Fluid Therapy ; Gallbladder ; Humans ; Hypoalbuminemia ; Nephrotic Syndrome* ; Suction