Title: Acalculous Cholecystitis<br/>Author: Michael Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
        <strong><u>Acalculous Cholecystitis in the Critically Ill</u></strong></p>
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                Acute acalculous cholecystitis (AAC) accounts for almost 50% of cases of acute cholecystitis in the critically ill ICU patient.</li>
        <li>
                Importantly, the mortality rate for AAC can be as high as 50%.</li>
        <li>
                Risk factors for AAC include:
                <ul>
                        <li>
                                CHF</li>
                        <li>
                                Cardiac arrest</li>
                        <li>
                                DM</li>
                        <li>
                                ESRD on hemodialysis</li>
                        <li>
                                Postoperative</li>
                        <li>
                                Burns</li>
                </ul>
        </li>
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                Unfortunately, the physical exam is unreliable, especially in intubated and sedated patients.</li>
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                Furthermore, less than half of patients with AAC are febrile or have a leukocytosis.  LFTs can also be normal in up to 20% of patients.</li>
        <li>
                Ultrasound remains the most common imaging modality for diagnosis.</li>
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                <strong>Take Home Point: Consider AAC in the septic critically ill patient without a source.</strong></li>
</ul>
<fieldset><legend>References</legend>

                <p>
        Rezende-Neto JB, et al. Abdominal catastrophes in the intensive care unit. <em>Crit Care Clin</em> 2013; 29:1017-44.</p>
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