IBCC Episode 63 - Acalculus Cholecystitis

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss acalculus cholecystitis, focusing on its diagnosis and treatment in critically ill patients. They explain that it's a rare condition where the gallbladder becomes inflamed without gallstones, typically in patients with pre-existing critical illnesses. The discussion covers risk factors like trauma, burns, sepsis, and the importance of perfusion, clinical presentation, and the challenges of diagnosis due to non-specific symptoms and the limitations of lab results. Ultrasonography is highlighted as the best diagnostic tool, while the HIDA scan is deemed less useful. Treatment primarily involves percutaneous cholecystostomy to drain the gallbladder, along with antibiotics, though surgery may be necessary in some cases. The hosts emphasize the importance of considering acalculus cholecystitis in septic ICU patients, while also cautioning against over-interpreting ultrasound findings and promoting better critical care practices to potentially reduce its incidence.