VALUE OF LAPAROSCOPY IN TRAUMA ICU PATIENTS WITH SUSPECTED ACUTE ACALCULOUS CHOLECYSTITIS

Patients who require prolonged intensive care following traumatic inju ries are at risk for developing acute acalculous cholecystitis (AAC). The diagnosis of AAC is often difficult to establish, resulting in inc reased morbidity and mortality in this critically ill population. We r easoned that diagnostic laparoscopy might provide a more accurate and timely method of diagnosis. Laparoscopy was performed in nine trauma I CU patients with suspected AAC. Four procedures were considered positi ve and five were negative. There were no false-positive or false-negat ive laparoscopic exams, and no procedure-related morbidity occurred. C omparison of multiple clinical, laboratory, and radiologic findings sh owed that only laparoscopy accurately distinguished between those pati ents with AAC and those without AAC. We conclude that diagnostic lapar oscopy is safe and definitive in trauma ICU patients with suspected AA C and should be performed prior to proceeding with laparotomy.