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Q: Acalculous Cholecystitis
asked by: hurtin on June 2nd, 2006
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I was just recently diagnosed with acalculous cholecystitis after hida scan results showed a very slow ejection rate, they didn't give me percent numbers to go by so i'm not really sure how bad it really is. This is after 4 years of seaching for answers to urq and mid chest pain. I have had 3 endoscopy exams with the first showing a large ulcer, the second I was told I had erosions and stomach inflammation and the third supposedly clear. They’ve done over 20 biopsies, none of which have come back normal though all they’ve told me is they are abnormal with no cancer which is consistent with inflammation to the degree i’ve had.

I am scheduled to have my gallbladder removed on july 11th, the earliest date available. (i’m in canada and that’s our great health system) i’m now wondering what questions I should be asking that I haven’t as yet. Would acalculous cholecystitis cause all the problems i’ve had with my stomach? Would the extra acid cause the biopsy results? What else should I know and what else should I ask?
I’ve searched the net to find others with this diagnosis but haven’t been able to find much on it other than it’s usually trama patients or drug users with a very poor prognosis and as much as a 40% mortality rate which scares me to death. I’ve had no trama and i’ve never used drugs so how did I get this? My gastroenterologist claims this condition is quite rare, hence the length of time it took to diagnose.
I want to be as informed as possible and would welcome any comments from others that have experienced the same condition. Will my stomach problems be over once my gallbladder is gone?
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Doxielover
replied on June 8th, 2006
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Only time will tell if this was the cause for all of your stomach problems. But our body's have a way of trying to tell us something is up. My stomach was all twisted out of sorts..And as soon as I got my appendix out it was back to normal. If my memory serves me right the cholesystitis is inflammation of the gallbladder. Which is what they *think* I have but aren't sure. I thought that most people with this had normal hida scans, because the hida scan shows the level at which its functioning, and an inflammed gall bladder can function just fine.

I'm sorry that I can't be more helpful, maybe just try looking up play cholesystitis.

Good luck,
krystle
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hurtin
replied on June 9th, 2006
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Acalculous Cholecystitis
Thanks krystle, exactly my reasons for all the questions I now have after doing a search and finding cholecystitis is an inflammation of the gallbladder wall and nearby abdominal lining. Cholecystitis is usually caused by a gallstone in the cystic duct, the duct that connects the gallbladder to the hepatic duct.

I've had 2 ultrasounds both of which were clear, no gallstones but after the hida scan the doctor has said I have a non-functioning gallbladder and when I asked for the name of what I had to be written down this is what they have given me, acalculous cholecystitis. What I have found since on the net during searches really doesn't sound at all like what I have so now i'm really confused.
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Doxielover
replied on June 9th, 2006
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I'm honestly a litltle confused by what your doctor has told you, as well as you are, so you're not alone. Everything that I read about this specific type of cholesystitis is that it should be treated right away, and you're waiting a whole month. That sounds odd to me! You don't have to have gallstones for this inflammation.
"pathophysiology: the main cause of this illness is thought to be due to bile stasis and increased lithogenicity of bile."

i'm not sure that they could see this bile stasis on an ultrasound. I just can't put two and two together with you. A non-functioning gallbladder is totally opposite from inflammation of the gallbladder. I guess you could have both at the same time, which would expalin why your hida scan was low, if your bile duct is not working exactly right.

I'm sorry I can't give you a clear cut answer. You may want to call the doctor and tell them you're kind of confused as to whats going on. And is your gall bladder just not functioing or do you have the cholesystitis as well.

Plain cholesystis is an inflammation just as you said and you can have perfect hida and ultrasounds and still have the infalmmation. It generally flares and most people opt to have it removed because it causes a great deal of pain, that is my situation. Anywhere from 15 percent of people and under can have this without having stones. I don't have any stones. You can also have tiny chrystals though, that cannot be seen until they open your gall bladder up after removing it. The ultrasound can't pick up everything.
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hurtin
replied on June 10th, 2006
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Acalculous Cholecystitis
I'm not confused as to the diagnosis as I had asked for the exact term to be written down and the doctor wrote "acalculous cholecystitis" and added that the acalculous ment no stones. That was about the most that was explained to me other than it was rare hence the length of time for them to diagnosis the condition with the other factors of finding an ulcer and erosions, they had thought it was a stomach problem and hadn't even thought of gallbladder.

A months wait for an operating room in canada is short, the only thing that will bump my scheduled time is a cesarean section that day could push me back a hour or so or a mastectomy might change it a bit, words again from the surgeon. I am on the cancellation list so I might end up in there sooner. My gastroentrenolgist told me if I have severe pain to go the er and they would take it out that day, the surgeon never mentioned this.

From what I have now read on different sites I feel this is rather urgent as well but no one seems to excited about it but me. I can only hope I will get or time before it decides to rupture.
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sirrus
replied on June 10th, 2006
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Youve had this for four years, so I wouldn't worry too much...
If something would have happened by now!

:)
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hurtin
replied on June 13th, 2006
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Acalculous Cholecystitis
Exactly what an optimist would say but should one be a pessimist it could be your living on borrowed time and it’s about to rupture. Either way the sooner it comes out the better off i’ll be.
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