Causes of Acalculus Cholecystitis

Q) Which of the following is not a cause of acalculus cholecystitis? Questions on bile duct

a) Kinking of the neck of gall bladder

b) Acalculus cholecystitis Sphincter spasm

c) Thrombosis of cystic artery

d) Over eating

Ans d

Acalculus cholecystitis can be both acute and chronic in the absence of stones. Although it can present acutely, acalculous cholecystitis typically presents more insidiously.

Mostly the acute form is recognized and chronic form is called biliary dyskinesia.

The cause of acalculus cholecystitis are

  1. Kinking or fibrosis of neck of gall bladder.
  2. Thrombosis of cystic artery
  3. Sphincter of Oddi spasm
  4. Prolonged fasting
  5. Dehydration
  6. Sepsis
  7. Systemic diseases MODS

Ref: By Jarrell - NMS Surgery (National Medical Series for Independent) (Sixth Edition) (2015-07-30) [Paperback]

Jaundice in acalculus cholecystitis  is known to occur because of ischemia and inflammation cystic duct gets obstructed due to edema

Diagnosis

Chronic acalculus cholecystitis is a cholescintigraphy nuclear scan (HIDA) with the administration of cholecystokinin (CCK). After the . A calculated ejection fraction of 35% or less may be indicative of hypokinetic functioning of the gallbladder. An ultrasound of the gallbladder may also be useful. If this shows a thickened gallbladder wall of over 3.5 mm, this may be due to cholecystitis.

Acute acalculus cholecystitis - USG CT or HIDA

 

BEST BOOKSMCQ practise 

MRCS Part A: Essential Revision Notes: Book 1

MRCS Part A: Essential Revision Notes: Book 2

 


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