Acute cholecystitis is one of the main causes of medical care in emergencies around the world. It is defined as inflammation of the gallbladder caused mainly by obstruction of the cystic duct by stones. In a small number of patients, the inflammatory process can develop in the absence of stones, receiving the name of alitiásic cholecystitis, having a faster evolution and often evolving with perforation. Acute alitiásic cholecystitis (AAC) corresponds to 15% of cases of acute cholecystitis and mainly affects patients in severe condition and with comorbidities. Its pathophysiology is still little known, but ischemia and stasis are identified as the main causes. Its high mortality is related to biliary peritonitis due to coleperitoneum. A patient admitted to the emergency department of Hospital Regional do Cariri with acute inflammatory abdomen was diagnosed with coleperitoneum, due to AAC complication, and underwent urgent laparoscopic cholecystectomy, with good clinical evolution in the postoperative period and early return to his activities. Keywords: acute cholecystitis, coleperitoneum, cholecystectomy