Acute acalculous cholecystitis
Elderly diabetic female presented with right hypochondrial pain and fever
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Ultrasound demonstrates marked thickening of the gallbladder wall (1.1 cm), no gallstones were demonstrated. The CBD measures 7mm however no calculus in it. Pancreas and liver were unremarkable (not shown). Positive Murphy sign during the examination.
The patient was referred to the radiology department for pigtail tube insertion, after tube insertion pus came out. Her septicemia was dramatically reduced with total leukocytes counts reaches from initial 22,000 /mm3 to 9,000 /mm3. After 4 days of pigtail insertion, cholecystectomy was done. Histopathology and surgical team confirms acalculous cholecystitis. No postoperative complications was noted. After 1 month follow up patient remained in good condition.