Acute Acalculous Cholecystitis: Diagnosis and Treatment

Last updated: 27 Haziran 2026Medical content review: Op.Dr.Gökhan ATEŞ

Acute acalculous cholecystitis is acute inflammation of the gallbladder without stones. It typically occurs in patients with severe comorbidities, prolonged ICU stay or major trauma, and requires prompt diagnosis.

Risk factors

  • ICU admission
  • Prolonged fasting and total parenteral nutrition
  • Major trauma or burns
  • Sepsis
  • Severe comorbidities such as diabetes or heart failure

Symptoms

Right-upper-quadrant tenderness, fever and leukocytosis; in sedated patients the picture may be subtle, so clinical suspicion is essential.

Diagnosis

Ultrasound is the first step — wall thickening, pericholecystic fluid and a sonographic Murphy sign are typical. CT and HIDA scintigraphy may support diagnosis.

Treatment

  • Antibiotics and supportive care
  • Early laparoscopic cholecystectomy when feasible
  • Percutaneous cholecystostomy in severely ill patients unfit for surgery

Frequently Asked Questions

It represents roughly 5–10% of all cholecystitis cases but tends to be more severe.

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The information on this page is provided for general patient education only and does not replace diagnosis, treatment or any surgical decision. An assessment appropriate for you can only be made after a clinical examination and the necessary investigations.