A case of chronic acalculous cholecystitis diagnosed by delayed contrast emptying in gallbladder

Chronic acalculous cholecystitis is a diagnosis of exclusion in patients complaining acalculous biliary pain. The possible causes of acalculous biliary pain are chronic gallbladder (GB) inflammation, GB dysfunction, cholesterolosis, cystic duct stenosis or microlithiasis. Recently, laparoscopic cholecystectomy is the choice of treatment for acalculous biliary pain. We experienced a 32-year-old woman whose initial symptoms were right upper quadrant pain and nausea only. The abdominal computed tomography, DISIDA scan, and upper and lower endoscopic examinations were nonspecific. Up to 48 hours after endoscopic retrograde cholangio-pancreatography, contrast emptying of GB was delayed, implying dysfunctional GB. As the patient`s right upper quadrant pain and tenderness became aggravated, the laparoscopic cholecystectomy was done and the final diagnosis of chronic acalculous cholecystitis was confirmed.