The submerged part of acute acalculous cholecystitis in adults: Case report.

Acute acalculous cholecystitis is one of the clinical entities widely known to be potentially detrimental and whose difficulty in identification may be only the "tip of the iceberg" of its true state of management embarrassment. Indeed, this condition is at the same time more frequent in the group of elderly and comorbid patients, famous for being a perplexing diagnosis and especially of fulminant evolution. For these reasons, it is essential that clinicians are aware of this occurrence, emphasizing that diagnostic and therapeutic delay can lead to adverse outcomes. In this sense, we present a case of acute acalculous cholecystitis where the initial diagnosis was missed despite appropriate investigation methods and ultimately led to biliary peritonitis. We hope that this report will serve as a reminder of how positive patient outcomes warrant a high index of suspicion for the condition and the importance of designing a rapid management pathway.