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Acute acalculous cholecystitis in hospitalized patients in intensive care unit: study of 5 cases

BACKGROUND: Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder with no evidence of gallstones. It occurs mostly in patients in intensive care units and is associated with several risk factors (fasting, parenteral nutrition, mechanical ventilation) leading to ischemia of the g...

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Autores principales: Mossaab, Ghannouchi, Ben Khlifa, Mohamed, Karim, Nacef, Moez, Boudokhan, Oussama, Jaoued, Hajer, Nouira, Ali Habiba, Ben Sik, Zoukar, Olfa, Jemaa, Yosra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9674906/
https://www.ncbi.nlm.nih.gov/pubmed/36411913
http://dx.doi.org/10.1016/j.heliyon.2022.e11524
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author Mossaab, Ghannouchi
Ben Khlifa, Mohamed
Karim, Nacef
Moez, Boudokhan
Oussama, Jaoued
Hajer, Nouira
Ali Habiba, Ben Sik
Zoukar, Olfa
Jemaa, Yosra
author_facet Mossaab, Ghannouchi
Ben Khlifa, Mohamed
Karim, Nacef
Moez, Boudokhan
Oussama, Jaoued
Hajer, Nouira
Ali Habiba, Ben Sik
Zoukar, Olfa
Jemaa, Yosra
author_sort Mossaab, Ghannouchi
collection PubMed
description BACKGROUND: Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder with no evidence of gallstones. It occurs mostly in patients in intensive care units and is associated with several risk factors (fasting, parenteral nutrition, mechanical ventilation) leading to ischemia of the gallbladder wall. METHODS: This is a retrospective multiple cases study of five cases of AAC in patients hospitalized in the Medical Intensive Care Unit at Tahar Sfar Hospital in Mahdia over a 4-year period between January 2016 and December 2020. RESULTS: The mean age of our patients was 62.5 years (±8) with a male predominance (sex ratio 4/1). The mean Charlson comorbidity index was 4. Four patients were under invasive mechanical ventilation and total parenteral nutrition. Three patients were under vasoactive drugs. All patients had fever, the patient who was conscious presented with abdominal pain and vomiting with right hypochondrium tenderness, while two patients presented with abdominal bloating and bowel obstruction. All patients had a biological inflammatory syndrome, two patients had cytolysis, and only one patient had cholestasis. All patients had a thickening of the gallbladder wall greater than 3mm on ultrasound. Treatment was based on broad-spectrum antibiotic therapy followed by early (<72 h) cholecystectomy. Only one patient had postoperative peritonitis. All patients had gangrenous cholecystitis. Three patients died of multi-visceral failure. CONCLUSION: This study, in spite of its small sample size, gave us an idea of patients at risk of developing this disease, on the difficulty of diagnosis and on the importance of surgical treatment.
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spelling pubmed-96749062022-11-20 Acute acalculous cholecystitis in hospitalized patients in intensive care unit: study of 5 cases Mossaab, Ghannouchi Ben Khlifa, Mohamed Karim, Nacef Moez, Boudokhan Oussama, Jaoued Hajer, Nouira Ali Habiba, Ben Sik Zoukar, Olfa Jemaa, Yosra Heliyon Case Report BACKGROUND: Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder with no evidence of gallstones. It occurs mostly in patients in intensive care units and is associated with several risk factors (fasting, parenteral nutrition, mechanical ventilation) leading to ischemia of the gallbladder wall. METHODS: This is a retrospective multiple cases study of five cases of AAC in patients hospitalized in the Medical Intensive Care Unit at Tahar Sfar Hospital in Mahdia over a 4-year period between January 2016 and December 2020. RESULTS: The mean age of our patients was 62.5 years (±8) with a male predominance (sex ratio 4/1). The mean Charlson comorbidity index was 4. Four patients were under invasive mechanical ventilation and total parenteral nutrition. Three patients were under vasoactive drugs. All patients had fever, the patient who was conscious presented with abdominal pain and vomiting with right hypochondrium tenderness, while two patients presented with abdominal bloating and bowel obstruction. All patients had a biological inflammatory syndrome, two patients had cytolysis, and only one patient had cholestasis. All patients had a thickening of the gallbladder wall greater than 3mm on ultrasound. Treatment was based on broad-spectrum antibiotic therapy followed by early (<72 h) cholecystectomy. Only one patient had postoperative peritonitis. All patients had gangrenous cholecystitis. Three patients died of multi-visceral failure. CONCLUSION: This study, in spite of its small sample size, gave us an idea of patients at risk of developing this disease, on the difficulty of diagnosis and on the importance of surgical treatment. Elsevier 2022-11-11 /pmc/articles/PMC9674906/ /pubmed/36411913 http://dx.doi.org/10.1016/j.heliyon.2022.e11524 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Mossaab, Ghannouchi
Ben Khlifa, Mohamed
Karim, Nacef
Moez, Boudokhan
Oussama, Jaoued
Hajer, Nouira
Ali Habiba, Ben Sik
Zoukar, Olfa
Jemaa, Yosra
Acute acalculous cholecystitis in hospitalized patients in intensive care unit: study of 5 cases
title Acute acalculous cholecystitis in hospitalized patients in intensive care unit: study of 5 cases
title_full Acute acalculous cholecystitis in hospitalized patients in intensive care unit: study of 5 cases
title_fullStr Acute acalculous cholecystitis in hospitalized patients in intensive care unit: study of 5 cases
title_full_unstemmed Acute acalculous cholecystitis in hospitalized patients in intensive care unit: study of 5 cases
title_short Acute acalculous cholecystitis in hospitalized patients in intensive care unit: study of 5 cases
title_sort acute acalculous cholecystitis in hospitalized patients in intensive care unit: study of 5 cases
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9674906/
https://www.ncbi.nlm.nih.gov/pubmed/36411913
http://dx.doi.org/10.1016/j.heliyon.2022.e11524
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