Key messages

• Acute acalculous cholecystitis is gallbladder inflammation without calculi.

• It may be due to ischemia, and risk factors include ventilation, dehydration, fasting, narcotics, transfusion, hyperalimentation, wounds, and renal failure.

• In addition to a right upper quadrant mass, tenderness, and fever, an ultrasonogram showing a thickened gallbladder wall, pericholecystic fluid, subserosal edema, intramural gas, or mucosal membrane sloughing is consistent with the diagnosis.

• Cholecystectomy rather than cholecystostomy is the preferred treatment.

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