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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

Gallbladder without stones but with a thick wall

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

The next day the situation is unchanged

Another image shows again no gallstones

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

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

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

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

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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