GALLBLADDER ABNORMALITIES IN MEDICAL ICU PATIENTS - AN ULTRASONOGRAPHIC STUDY

Patients in the intensive care unit (ICU) have many risks factors for gallbladder stasis or acute acalculous cholecystitis (ACC), including fasting, total parenteral nutrition, sedation, mechanical ventilation, infection and shock. We have performed a prospective study to estimat e the prevalence of ultrasonographic gallbladder abnormalities in 30 c onsecutive medical ICU patients during the first 2 days of their stay in the ICU. Two patients had previously undergone cholecystectomy and were excluded from the study. Seventeen (61%) of the remaining 28 pati ents presented with gallbladder abnormalities. Considering three major criteria of ACC, 14 patients (50%) presented with either sludge (25%) , wall thickening (22%) or hydrops (11%). However, none of the patient s needed a surgical procedure during the study because of gallbladder disease. We conclude that an important proportion of ICU patients pres ented with gallbladder abnormalities shown by ultrasonography and that this may have implications for establishing a diagnosis of ACC using ultrasonographic criteria.