Acute Cholecystitis -Current Views

Acute cholecystitis is predominantly a disease of females who account for 62 percent of cases and mainly affects those between 40 and 50 years1 and is closely associated with cholelithiasis. It occurs all over the world but Africa is a low risk area as compared to Europe and North America. The disease has been observed in children with ascariasis or those with acquired immune deficiency syndrome (AIDS). The commonest bacteria isolated in acute cholecystitis are E Coli. Clinical presentation includes a raised temperature. Leukocytosis may be absent even in those patients with gangrenous acute cholecystitis. However, Murphy's sign remains very specific. The mainstay of treatment remains surgical either open or laparoscopic cholecystectomy and in high-risk patients percutaneous or open cholecystostomy. Laparoscopic cholecystectomy has greatly increased operating time but reduced hospital stay. The over all mortality has remained 5-12% in the last 2 decades.