Acute necroinflammatory disease of gallbladder with multifactorial pathogenesis
Gallbladder stasis and ischemia leads to distension and eventually necrosis/perforation
Accounts for 10% of acute cholecystitis; associated with high morbidity/mortality
Gallbladder stasis and ischemia leads to distension and eventually necrosis/perforation
Accounts for 10% of acute cholecystitis; associated with high morbidity/mortality
Gallstones are classified as cholesterol stones and pigmented stones (black and brown), and are present in approx 20% of females and 8% of males in the United States
These stones cause the majority of all biliary tract problems, and depending on where the stone become impacted, specific problems occur.
Bile flows out the gallbladder, down the cystic duct into the common bile duct, and ultimately into the 1st portion of the duodenum.
Symptomatic cholelithiasis (biliary colic)
Choledocholithiasis
Acute<unk> 
Ascending cholangitis<unk> 
Burns
CAD
DM
Immunosuppression
Infection
Mechanical ventilation
Medications (eg, opioids, sunitinib)
Multiple transfusions
Nonbiliary surgery
Sepsis/hypotension
Vasculitis
TPN, especially TPN > 3 mo
Acalculous cholecystitis
Gallbladder disease
Acute calculous cholecystitis
Symptomatic cholelithiasis 
Choledocholithiasis
Ascending cholangitis
Acute cholecystitis
Symptomatic cholelithiasis