Prognosis

The overall mortality of a single episode of acute

cholecystitis is approximately 3 %.

Mortality is :

○ less than 1 % in young, otherwise

healthy patients
○ approaches 10 % in high-risk patients,
or in those with complications.
Complications
Gangrene
● 2-30% of cases
● Occurs at the gallbladder
fundus due to vascular
compromise
● People at risk:
○ Older patients
○ Men above 50 with cardiovascular
disease and leukocytosis
○ Patients with diabetes
○ Patients who delay seeking therapy
Perforation
● 10% of cases
● More common: Localised perforation at the
fundus, with the formation of pericholecystic
abscesses
○ A mass may be palpable
○ After perforation patients may have transient symptom
relief due to gallbladder decompression.
● Less common: Free perforation leading to
generalized biliary peritonitis (30% mortality
rate)
● People at risk:
○ patients unresponsive to conservative treatment or if
there has been a delay in seeking medical help.
Cholecystoenteric fistula

● Results from adhering to and causing

perforation of the gallbladder
directly into the duodenum, jejunum
and hepatic flexure of colon.
Gallstone ileus
● Caused by passage of a gallstone from
the biliary tract into the intestinal
tract, leading to small intestine
obstruction, usually in the terminal
ileum.