The prevalence of gallstones is high in the United States, and thus should be
considered as part of a differential for a patient presenting with abdominal pain. Be able
to recognize and know how to treat acute cholecystitis, but also know when to expect
and how to treat acalculous cholecystitis.
Remember:
Consider acalculous cholecystitis in patients with serious comorbidities,
including trauma, burns, or prolonged states of fasting
Management is similar to that of acute calculous cholecystitis, but
patients with severe illness may require percutaneous drainage if unable
to tolerate surgery
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K N O W M E D G E
If choledocholithiasis is suspected, broad-spectrum antibiotics covering enteric gram-
negative bacteria should be started. Fluoroquinolones are usually a good initial choice.