Acute noncalculous cholecystitis associated with severe injury

Abstract

1. 1. Postoperative acute cholecystitis is not necessarily a disease of advancing age; it may be seen more frequently in the older age groups only because of the greater incidence of major surgery in older persons. 2. 2. Acute noncalculous cholecystitis occurring postoperatively or as a complication of severe injury may arise from causes different from acute cholecystitis in the uninjured patient [4–6]. 3. 3. Dehydration, narcotic therapy, and fever, with resultant increased viscosity of the bile, may predispose to acute cholecystitis. 4. 4. Multiple blood transfusions with increased biliary secretion of blood breakdown products may be an important factor in the etiology of post-traumatic acute cholecystitis. 5. 5. Sepsis may predispose to acute cholecystitis. 6. 6. The finding of right upper quadrant pain in postoperative or injured patients must suggest the diagnosis of acute cholecystitis. We have noted the development of right upper quadrant pain with jaundice in patients other than those described in this report. These cases have been treated by medical means and may represent acute cholecystitis not progressing to gangrenous gallbladder demanding surgery. 7. 7. The period between the eighth and sixteenth day after injury appears to be the period of greatest risk for the development of post-traumatic acute noncalculous cholecystitis.