ACUTE ACALCULOUS CHOLECYSTITIS

Ten cases of acute acalculous cholecystitis, presenting to one univers ity affiliated institution, are described. These patients were predomi nantly older males with either overt vascular disease or a predisposit ion to vascular disease and were without the usual precipitating facto rs described for acalculous cholecystitis. Ultrasonography was helpful in making the diagnosis and early laparotomy revealed gangrenous chol ecystitis in all patients, three of whom had perforated gall-bladders. Although there was no mortality, morbidity was high, and patients sta yed in hospital a mean of 10.5 days. A vascular aetiology seems likely and early surgery is recommended to avoid the high mortality reported in the literature. It seems that this form of acalculous cholecystiti s is different to that seen in other clinical settings.