This study is a clinical observation and recent literature review of 164 cases of acalculous cholecystitis, seen in Department of Surgery, Keimyung University, School of Medicine, Taegu, Korea. from August 1971 to December 1982.
The results were as follows;
1) The incidence of acalculous cholecystitis was 164 cases(21.6%) of 760 cases who underwent cholecystectomy.
2) The Sex ratio of male to female was 1 : 1.02 and the ratio of city to country was 1 : 1.21. The age range was 14 to 72 years, the average age was 46.3 years.
3) The incidence of acalculous cholecystitis with past history for one month to several years was 136 cases(82.9%) of 164 cases.
4) In addition to abdominal pain which was present in all cases, nausea, vomiting, fever, chills and jaundice were noted. Physical findings were abdominal tenderness, rigidity and palpable mass in the right upper quadrant. R.U.Q. abdominal tenderness were most prominent one which was noted in 127 cases (77.4%)
5) Leukocytosis was noted in 78 cases(47.6%) of 164 cases, serum bilirubin elevation above 2.0 mg% in 61 cases(37.2%) of 164 cases, and alkaline phosphatase elevation was noted in 77 cases (47.0%) of 164 cases.
6) Oral or I.V. chlecystocholangiography was performed in 100 cases of 164 ca.ess. The gall bladder was not visualized in 78 cases (83.0%) of 94 cases with oral cholecystography.
7) Of 65 cases in which the bile was cultured, 51 cases(78, 5%) yield a positive result. E. coli was the most common organism found in 29 cases(44.5%) and enterobacter in 12 cases (18.5%) the next most common.
8) Only a cholecystectomy was performed on 27 cases(22.6%), and cholecystectomy with choledochostomy on 118 cases(72.0%).
9) A postoperative complication occured in 25 cases(15. 1%) of which wound infection(12 cases) was the most common. The operative mortality was 2.4%(4 cases).
10) Ova or adult form of liver fluke were found in the bile of the gall bladder or common duct in 32 cases(19.5%), and ascaris lumbricoides was found in the common duct exploration in 10 cases(6.0%).
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