Gangrenous cholecystitis

Gangrenous cholecystitis is the most common complication of acute cholecystitis, affecting ~15% (range 2-30%) of patients. 

Gangrenous cholecystitis occurs as a result of ischaemia with necrosis of the gallbladder wall 4

Risk factors
  • male
  • increasing age
  • delayed surgery
  • cardiovascular disease
  • diabetes mellitus
Ultrasound

In addition to features of acute cholecystitis, the following may help diagnosis gangrenous cholecystitis 3:

  • intraluminal membranes
  • asymmetrical wall thickness
  • focal perfusion defects on Doppler (representing areas of necrosis)
CT

In addition to features of acute cholecystitis, the following may help diagnosis gangrenous cholecystitis 1:

  • gallbladder wall or lumen gas
  • focal irregularity or defect in the gallbladder wall
  • intraluminal membranes
  • the absence of mural enhancement
  • pericholecystic abscess

Mortality is increased compared to uncomplicated acute cholecystitis, estimated at between 15-50% 4

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Article Information

rID: 25209
Section: Pathology
Synonyms or Alternate Spellings:
  • Membranous cholecystitis

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