Introduction:

Different acute systemic diseases (heart failure, cirrhosis, hepatitis) can produce gallbladder edema and be confused with acute cholecystitis. This study’s objective is to analyze the patients presented to cholecystectomy due to gallbladder wall thickening confused as cholecystitis in the Emergency Department.

Material and methods:

An observational retrospective study in a Regional Reference Center was conducted from December 2016 to November 2019. Patients admitted to the emergency department for possible acute cholecystitis were reviewed.

Results:

Of 3,393 patients analyzed with suspected cholecystitis, 31 patients were confused with acute cholecystitis for gallbladder wall thickening secondary to diverse acute diseases, and presented for cholecystectomy. The majority were male (51%). In all patients, the gallbladder wall thickening due to edema more than 5 mm without signs of cholecystitis was corroborated, (mean: 8.96 mm, range: 5-16 mm). The admission diagnoses that were confused as cholecystitis were liver diseases, dengue, cardiovascular diseases, pneumonia, and pancreatitis. In seven patients (22.6%), cholecystectomy for suspected cholecystitis was performed. Two patients presented post-surgical complications (6.5%), and none died. In the histopathological study, no signs of calculous cholecystitis were found. In the analysis, the operated patients had a hospital stay larger than patients no operated, showing statistical significance (p = 0.004).

Conclusion:

In the emergency treatment of patients with suspect cholecystitis, it is mandatory ruled out gallbladder edema secondary to acute diseases. Surgical treatment in patients confused as acute cholecystitis can increase the length of hospital stay.