Skip to main content
Log in

Acute acalculous cholecystitis in severely traumatized patients: a prospective sonographic study

  • Original Articles
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Summary

Acute acalculous cholecystitis is a well known complication in severely traumatized patients. Existing data originate from retrospective analyses and episodic case reports. In a prospective ultrasonographic study 25 polytraumatized patients admitted to our intensive care unit between January 1, 1989, and December 31, 1989, were examined in daily intervals for this condition. Trauma scoring was performed according to the injury severity score (ISS) and polytrauma score (PTS). “Stress cholecystitis” was defined as a combination of hydrops of the gallbladder, an increased mural thickness (>3.5 mm), and the demonstration of “sludge.” We were able to demonstrate this diagnostic triad in four out of 25 patients (=16%). As a consequence early elective cholecystectomy was done in one patient. The remaining patients were treated conservatively. The incidence of stress cholecystitis in severely traumatized patients is probably higher than figures so far published suggest. Ultrasonography is a reliable method of early detection and follow-up for this complication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Baker SP, O'Neill BO, Haddon W, Long WB (1974) The injury severity score. A method for describing patients with multiple injuries and evaluating emergency care. J. Trauma 14: 187–196

    Google Scholar 

  2. Bauer H (1985) Die Gallenblase als Stressorgan. Chirurg 55: 828–829

    Google Scholar 

  3. Becker CD, Burckhardt B, Terrier F (1986) Ultrasound in postoperative acalculous cholecystitis. Gastrointest Radiol 11: 47–50

    Google Scholar 

  4. Du Priest RW, Khaneja SC, Cowley RA (1979) Acute cholecystitis complicating trauma. Ann Surg 189: 84–89

    Google Scholar 

  5. Fiske CE, Laing FC, Brown TW (1980) Ultrasonographic evidence of gallbladder wall thickening in association with hypoalbuminaemia. Radiology 135: 713–716

    Google Scholar 

  6. Flament JB, Palot JP, Delattre JF, Rives J (1986) Les cholecystites aigues postoperatoires. Chirurgie 112: 115–122

    Google Scholar 

  7. Freising S (1983) Nekrotisierende Cholecystitis beim Polytrauma. Unfallheilkunde 86: 83–86

    Google Scholar 

  8. Glenn F (1979) Acute acalculous cholecystitis. Ann Surg 189: 458–465

    Google Scholar 

  9. Herlin P, Ericsson M, Holmin T, Jönsson PE (1982) Acute acalculous cholecystitis following trauma. Br J Surg 69: 475–476

    Google Scholar 

  10. Howard JM, Milford MT, de Bakey ME (1952) The significance of the sympathetic nervous system in acute cholecystitis. Surgery 32: 251–258

    Google Scholar 

  11. Johnson LB (1987) The importance of early diagnosis of acute acalculous cholecystitis. Surg Gynecol Obstet 164: 197–203

    Google Scholar 

  12. Kelbel C, Börner N, Weilemann LS (1988) Die sonographische Gallenblasenwandverdickung und ihre diagnostische Bedeutung bei intensivpflichtigen Patienten. Ultraschall Med 9: 106–109

    Google Scholar 

  13. Lindberg EF, Grinnan GLB, Smith L (1970) Acalculous cholecystitis in Viet Nam casualties. Ann Surg 171: 152–157

    Google Scholar 

  14. Lorgeron P, Parmentier G, Katz A (1983) L'abdomen du polytraumatise. (Paris) J Chir 120: 85–93

    Google Scholar 

  15. Orlando R, Gleason E, Drezner AD (1983) Acute acalculous cholecystitis in the critically ill patients. Am J Surg 145: 472–476

    Google Scholar 

  16. Rice J, Williams HC, Flint LM, Richardson JD (1980) Posttraumatic acalculous cholecystitis. South Med J 73: 14–17

    Google Scholar 

  17. Rüedi T, Frutiger A, Leutenegger A (1985) “Steinlose” nekrotisierende Cholezystitis beim Polytrauma. Helv Chir Acta 52: 131–134

    Google Scholar 

  18. Schweiberer L, Nast-Kolb D, Duswald KH (1987) Das Polytrauma—Behandlung nach dem diagnostischen und therapeutischen Stufenplan. Unfallchirurg 90: 529–538

    Google Scholar 

  19. Waydhas C, Sepp-Lukas L, Nast-Kolb D, Pfeifer KJ, Schweiberer L (1988) Cholezystitis nach Polytrauma. Unfallchirurg 91: 10–15

    Google Scholar 

  20. Wegener M, Börsch G, Schneider J (1987) Gallbladder wall thickening: A frequent finding in various nonbiliary disorders—A prospective ultrasonographic study. J Clin Ultrasound 15: 307–312

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Imhof, M., Raunest, J., Rauen, U. et al. Acute acalculous cholecystitis in severely traumatized patients: a prospective sonographic study. Surg Endosc 6, 68–71 (1992). https://doi.org/10.1007/BF02281083

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02281083

Key words

Navigation