title: Acute acalculous cholecystitis and cardiovascular disease: a land of confusion.
abstract: Acute acalculous cholecystitis (AAC) can be defined as acute inflammatory disease of the gallbladder without evidence of gallstones. The first case was reported in 1844 by Duncan et al.; however, some cases may have been missed previously in view of the complexity of the diagnosis. Several risk factors have been identified, and cardiovascular disease (CVD), in view of its multiple mechanisms of action, seems to play a key role. Atypical clinical onset, paucity of symptoms, overlap with comorbidities, and lack of robust, controlled trials result often in under or misdiagnosed cases. Moreover, laboratory results may be negative or not specific in the late stage of the disease, when a surgical treatment cannot be longer helpful if complications arise. A rapid diagnosis is therefore essential to achieve a prompt treatment and to avoid further clinical deterioration. In this short review, we would present the current evidence regarding epidemiology, pathophysiology, and clinical presentation of the complex relation between AAC and CVD. Then, we fully emphasize the role of ultrasound to achieve an early diagnosis and an appropriate treatment in suspected cases, reducing mortality and complications rates.
authors.affiliation: Unit of Internistic Ultrasound, Department of Medicine and Science of Aging, "G. d'Annunzio" University, Chieti, Italy ; Internal Medicine Unit, Department of Medicine and Science of Aging, "G. d'Annunzio" University, Chieti, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Tana
authors.affiliation: Internal Medicine Unit, Guastalla Hospital, Ausl Reggio Emilia, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Tana
authors.affiliation: Unit of Internistic Ultrasound, Department of Medicine and Science of Aging, "G. d'Annunzio" University, Chieti, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Cocco
authors.affiliation: Unit of Internistic Ultrasound, Department of Medicine and Science of Aging, "G. d'Annunzio" University, Chieti, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Iannetti
authors.affiliation: Geriatric Unit, Garibaldi Hospital, Catania, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Romano
authors.affiliation: Unit of Internistic Ultrasound, Department of Medicine and Science of Aging, "G. d'Annunzio" University, Chieti, Italy.
authors.forename: Cosima
authors.initials: C
authors.lastname: Schiavone
keywords: Acute acalculous cholecystitis; Cardiovascular disease; Emergency Department; Gallbladder; Surgery; Ultrasonography