Acute Cholecystitis as a Potentially Fatal Complication of Cerebrovascular Disease.

BACKGROUND/

OBJECTIVE

Acute cholecystitis (AC) can occur as a potentially fatal complication in critically ill patients, with multiple risk factors such as old age, male sex, diabetes mellitus, and history of cardiovascular disease reported. Recently, a history of cerebrovascular disease (CVD) has been suggested as a risk factor for the development of a complication in which vascular disease pathogenic factors, including atherosclerosis and ischemia, may play a role. However, little has been reported about the occurrence of AC in patients who have experienced CVD. This study aimed to investigate the incidence and clinical details of AC after CVD.

METHODS

This was a retrospective review performed at a single institution. The records of all patients hospitalized with CVD were examined. In addition to the incidence of AC, atherosclerotic factors as well as previously reported risk factors were reviewed and then compared with those in patients with traumatic brain injury (TBI).

RESULTS

AC was identified in 4/156 (2.6%) patients with CVD and 1/135 (0.7%) patients with TBI, which was not a statistically significant difference ( P = 0.233). In addition, factors were comparable, except for hypertension, fever, and nonambulant status, which were found significantly more often in CVD patients. Notably, three of the four patients developed AC after recurrent CVD.

CONCLUSIONS

AC can occur as a potentially fatal complication in CVD patients. In addition to nonspecific clinical findings, consciousness disturbance with neurological deficits may lead to delayed diagnosis. A prospective study with a larger cohort is warranted to clarify the relationship between AC development and CVD.