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Acalculous cholecystitis: Clinical manifestations, diagnosis, and management - UpToDate

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INTRODUCTION Acalculous cholecystitis is an acute necroinflammatory disease of the gallbladder with a multifactorial pathogenesis. It accounts for approximately 10 percent of all cases of acute cholecystitis and is associated with high morbidity and mortality rates. This topic will review the pathophysiology, diagnosis, and management of acalculous cholecystitis. Clinical issues related to acute calculous cholecystitis and chronic cholecystitis are discussed separately. (See "Acute calculous cholecystitis: Clinical features and diagnosis" and "Treatment of acute calculous cholecystitis".) PATHOGENESIS Acalculous cholecystitis results from gallbladder stasis and ischemia, which then cause a local inflammatory response in the gallbladder wall. The majority of patients with acalculous cholecystitis have multiple risk factors (table 1) [1-7]. In some cases, specific primary infections predispose to acalculous cholecystitis (table 2). As an example, acalculous cholecystitis occurring in pat

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