ACALCULOUS GANGRENOUS CHOLECYSTITIS- A CASE REPORT AND LITERATURE REVIEW

Introduction: Acalculous gangrenous cholecystitis (AGC) is a rare but potentially fatal condition characterized by gallbladder necrosis without calculi. It is predominantly seen in critically ill or immunocompromised patients, with a high mortality rate due to its rapid progression and diagnostic challenges. AGC often presents with nonspecific symptoms, making early recognition difficult. The condition is associated with increased morbidity due to delayed diagnosis, sepsis, and gallbladder perforation. Timely surgical intervention is essential for improving patient outcomes. We report the case of a 65-year- Case Presentation: old male with poorly controlled diabetes and a history of above-knee amputation due to gangrene, presenting with right upper quadrant pain, non-bilious vomiting, and fever. Laboratory investigations revealed leukocytosis, hyperbilirubinemia, and elevated creatinine, indicating biliary sepsis. Imaging studies, including USG and MRCP, confirmed acute cholecystitis with gallbladder perforation and adjacent bilioma. The patient underwent emergency open cholecystectomy with peritoneal lavage. Intraoperative findings revealed a necrotic gallbladder with dense adhesions and areas of erosion. Histopathology confirmed gangrenous cholecystitis. The patient showed significant improvement postoperatively and was discharged on the 14th day with no complications. This case underscores the diagnostic and treatmen Conclusion: t challenges associated with AGC. Early identification, precise imaging, and timely surgical action are essential for lowering morbidity and mortality rates. The report underscores the importance of considering AGC in critically ill patients with atypical abdominal symptoms, particularly in diabetic and immunocompromised individuals. Improved awareness and early intervention strategies can significantly enhance patient outcomes.