[Primary acute acalculous cholecystitis].

Acute acalculous cholecystitis (AAC) is a life-threatening condition whose incidence is steadily increasing although still lower than the corresponding lithiasic forms: AAC represents around 5-10% of all cases of acute cholecystitis. The severity of the disease is due to the rapid evolution towards gallbladder necrosis and biliary peritonitis. AAC is more frequently a disease of the critically ill patient arising in postoperative courses or in stressing conditions. Not rarely, however, it may occur with no evident predisposing factors and it seems related, in such cases, to elderly ages and to atheromatous vascular conditions. The authors report two cases of idiopathic AAC in elderly patients: pathogenic and clinical features as well as therapeutic options are analyzed and discussed.