Acalculous cholecystitis in association with major burns.

Three cases of acute acalculous cholecystitis are presented, from a retrospective study of approximately 380 consecutive patients admitted to a regional adult burn centre. Two patients were male, one female. The mean body surface area (BSA) burn was 41 per cent, with a mean full thickness injury of 36.7 per cent. All patients survived but had markedly prolonged hospital stays. All patients demonstrated predisposing factors associated with acalculous cholecystitis; extensive burn area, multiple transfusions, bacteraemia, total parenteral nutrition (TPN), narcotic analgesics, and positive pressure ventilation. One patient required only conservative treatment. The other patients required surgical cholecystectomy. Cholecystostomy may have a role in critically ill patients.