Complications
The complications of acute cholecystitis include:
- empyema
- gangrenous cholecystitis
- occurs in 2% to 30% of cases. Gangrene occurs most commonly at the fundus due to a compromised vascular supply (1).
- perforation of the gallbladder
- in 3% to 10% of patients (after the gallbladder has perforated, patients may experience transient relief of their symptoms because the gallbladder decompresses, but peritonitis then develops) (1)
- emphysematous cholecystitis
- caused by secondary infection of the gallbladder wall with gas-forming organism
- common in elderly, and men with diabetes
- requires immediate antibiotics (directed at anaerobes, coliforms, and Clostridia species) and urgent surgery due to high incidence of perforation (2)
- pancreatitis
- perihepatic abscess
- portal pyaemia and septicaemia
References:
- Indar AA, Beckingham IJ. Acute cholecystitis. BMJ. 2002 Sep 21;325(7365):639-43.
- Elwood DR. Cholecystitis. Surg Clin North Am. 2008;88(6):1241-52
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