Risk factors

Acute acalculous cholecystitis occurs in patients with chronic debilitating disease, or with superimposed critical illness after major burn injury. It may be associated with a decrease in gastric motility and prolonged ileus. Risk factors for the development of acute acalculous cholecystitis include mechanical ventilation, hyperalimentation, dehydration, fasting, narcotic utilization, massive blood transfusions, open wounds and abscesses, and chronic renal failure. Up to 4 per cent of patients with an ileus and on hyperalimentation may develop acute acalculous cholecystitis. It has been suggested that the use of positive end-expiratory pressure (PEEP), which produces an increase in bile and biliary stasis with a decrease in portal flow, may also be associated with acute acalculous cholecystitis.

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