hepatic and biliary disorders
Acute Cholecystitis
Key Points
Most (≥95%) patients with acute cholecystitis have cholelithiasis. In older patients, symptoms of cholecystitis may be nonspecific (eg, anorexia, vomiting, malaise, weakness), and fever may be absent. Although acute cholecystitis resolves spontaneously in 85% of patients, localized perforation or another complication develops in 10%. Diagnose via ultrasonography and, if results are equivocal, cholescintigraphy. Treat patients with IV fluids, antibiotics, and analgesics; do cholecystectomy when patients are stable. 