Acute acalculous cholecystitis in critically ill patients. Case reports.

Five cases of acute acalculous cholecystitis complicating trauma or an existing major illness are reviewed. This condition differs from classical cholecystitis in many aspects. It is serious and often fatal (3 of our patients died) with multifactorial pathogenesis. Clinical signs and laboratory investigations may be difficult to interpret because of associated conditions. Serial ultrasound examinations in high-risk patients in whom the disease is suspected should lead to earlier diagnosis. Early cholecystectomy is mandatory.