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Case of the Month

May 2015

Patient Data: 78 year old male intensive care patient

Clinical Info: Patient has the clinical symptoms of a cholecystitis


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Gallbladder without stones but with a thick wall


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Another image of the gallbladder. There are no stones in the gallbladder, no stone in the gallbladder neck


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The next day the situation is unchanged


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Another image shows again no gallstones


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The contents of the gallbladder are still fairly clear. No other cause for the gallbladderwall thickening could be found. So a punction was performed and pus was aspirated


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A pigtail catheter was placed and the patient recovered in a few days time. The patient had an acalculous cholecystitis and also afterwards no other cause for the thickened gallbladderwall was found


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This a small gallbladder with a very thick wall without stones in a young female patient with severe liver function tests. Is this also an acute aculculous cholecystitis


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This patient does not have an acute acalculous cholecystis but a hepatitis. A hepatitis can sometimes cause some pain over the liver, but otherwise the clinical symptoms differ from a cholecystitis and does not need a percutaneous drainage

An acalculous cholecystitis is rare and is usually found in patents with a poor physical condition, like in this case of an ICU patient. A thickened gallbladderwall has a lot of different causes and these must be differentiated from a true acute acalculous cholecystitis

For other cases of cholecystitis and other causes of gallbladderwall thickening see

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