MICROANGIOPATHY IN ACUTE ACALCULOUS CHOLECYSTITIS

Background Acute acalculous cholecystitis is a well recognized complic ation of many acute illnesses. Ischaemia of the gallbladder seems to h ave an important role in its pathogenesis. Methods Microangiography wa s performed in 15 gallbladders immediately after cholecystectomy by in fusing 10 per cent barium sulphate into the specimen. Five patients ha d symptomatic gallstone disease, five had acute gallstone-associated c holecystitis and five had acalculous cholecystitis. Sections for histo logical examination were taken from adjacent sides of the microangiogr aphy section. Filling of the vessels by contrast medium was compared w ith histological findings. Results Microangiography of the gallbladder in acute gallstone-associated cholecystitis showed strongly dilated a rterioles and regular filling of the capillary network, whereas in aca lculous cholecystitis the capillary filling was poor and irregular. Co nclusion Disturbed microcirculation may play an important role in the pathogenesis of acute acalculous cholecystitis.