severity of acute cholecystitis
Last edited 02/2022
A method for classification of severity acute cholecystitis has been suggested:
- grade III (severe) acute cholecystitis
- associated with dysfunction of any one of the following organs/systems:
- cardiovascular dysfunction - hypotension requiring treatment with dopamine ≥5 µg/kg per min, or any dose of norepinephrine
- neurological dysfunction - decreased level of consciousness
- respiratory dysfunction - PaO2/FiO2 ratio <300
- renal dysfunction - oliguria, creatinine >2.0 mg/dl
- hepatic dysfunction - PT-INR>1.5
- hematological dysfunction - platelet count <100,000/mm3
- grade II (moderate) acute cholecystitis
- associated with any one of the following conditions:
- elevated white blood cell count (>18,000/mm3)
- palpable tender mass in the right upper abdominal quadrant
- duration of complaints >72 h
- marked local inflammation (gangrenous cholecystitis, pericholecystic abscess, hepatic abscess, biliary peritonitis, emphysematous cholecystitis)
- grade I (mild) acute cholecystitis
- does not meet the criteria of 'Grade III' or 'Grade II' acute cholecystitis
- grade I can also be defined as acute cholecystitis in a healthy patient with no organ dysfunction and mild inflammatory changes in the gallbladder, making cholecystectomy a safe and low-risk operative procedure (1)
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