title: Male gender and sonographic gall bladder wall thickness: important predictable factors for empyema and gangrene in acute cholecystitis.
abstract: OBJECTIVE
  To underline the status of male gender and gall bladder wall thickness as significant risk factors for acute cholecystitis complications.
  
  
  METHODS
  The retrospective study, with purposive sampling of the patients of acute cholecystits in age above 18 years, who were operated within 10 days of onset of symptoms, was conducted at the Department of Surgery, Dow University Hospital, Karachi, by reviewing the patients' medical record from March 2010 to August 2012. Correlation of incidence of acute cholecystitis complications (empyema and gangrene) to male gender and to the sonographic gall bladder wall thickness more than 4.5 mm was analysed using SPSS 16.
  
  
  RESULTS
  Out of 62 patients, 8 (13%) patients had gangrene while 10 (16.12%) had empyema. Overall, there were 21 (33.87%) males in the study. Ten (47.6%) of the male patients developed empyema or gangrene of the gall bladder as a complication of acute cholecystitis. Of the 41 (66.12%) female patients, only 8 (19.5%) developed these complications. There were 22 (35.48%) cases of gall bladders with sonographic wall thickness more than 4.5 mm who were operated for acute cholecystitis. Of them, 16 (72.7%) had empyema or gangrene.
  
  
  CONCLUSIONS
  Male gender and sonographic gall bladder wall thickness more than 4.5 mm were statistically significant risk factors for suspicion of complicated acute cholecystitis (empyema/gangrene) and by using these risk factors, we can prioritise patients for surgery in the emergency room.
authors.forename: Muhammad Laiq-uz-Zaman
authors.initials: ML
authors.lastname: Khan
authors.forename: Mujeeb Rehman
authors.initials: MR
authors.lastname: Abbassi
authors.forename: Muhammad
authors.initials: M
authors.lastname: Jawed
authors.forename: Ubedullah
authors.initials: U
authors.lastname: Shaikh
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D004653:Empyema / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000000981:diagnostic imaging* / Q000601:surgery; D005734:Gangrene / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014463:Ultrasonography; D055815:Young Adult