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Complications

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The complications of acute cholecystitis include:

  • empyema
  • gangrenous cholecystitis
    • occurs in 2% to 30% of cases. Gangrene occurs most commonly at the fundus due to a compromised vascular supply (1).
  • perforation of the gallbladder
    • in 3% to 10% of patients (after the gallbladder has perforated, patients may experience transient relief of their symptoms because the gallbladder decompresses, but peritonitis then develops) (1)
  • emphysematous cholecystitis
    • caused by secondary infection of the gallbladder wall with gas-forming organism
    • common in elderly, and men with diabetes
    • requires immediate antibiotics (directed at anaerobes, coliforms, and Clostridia species) and urgent surgery due to high incidence of perforation (2)
  • pancreatitis
  • perihepatic abscess
  • portal pyaemia and septicaemia

References:

  1. Indar AA, Beckingham IJ. Acute cholecystitis. BMJ. 2002 Sep 21;325(7365):639-43.
  2. Elwood DR. Cholecystitis. Surg Clin North Am. 2008;88(6):1241-52

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