What is a distended gallbladder and sepsis (Systemic Inflammatory Response Syndrome) concerning for?

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Last updated: March 26, 2025View editorial policy

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Differential Diagnosis for Distended Gallbladder and Sepsis

  • Single most likely diagnosis
    • Emphysematous cholecystitis: This condition is characterized by a distended gallbladder and is often associated with sepsis. It typically occurs in diabetic patients and is caused by a gas-producing bacterial infection.
  • Other Likely diagnoses
    • Acute cholecystitis: Inflammation of the gallbladder can cause distension and may lead to sepsis if left untreated or if there is a perforation.
    • Ascending cholangitis: An infection of the bile duct can cause sepsis and may be associated with a distended gallbladder, especially if there is an obstruction.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Gallbladder perforation: A perforated gallbladder can lead to peritonitis and sepsis, making prompt diagnosis and treatment crucial.
    • Sepsis due to other causes (e.g., pneumonia, urinary tract infection): While a distended gallbladder may be present, sepsis can have many causes, and it's essential to consider other potential sources of infection.
  • Rare diagnoses
    • Mirizzi syndrome: A rare condition where a gallstone becomes impacted in the cystic duct, causing obstruction and potentially leading to a distended gallbladder and sepsis.
    • Gallbladder cancer: Although rare, gallbladder cancer can cause a distended gallbladder and may be associated with sepsis, especially if there is tumor necrosis or perforation.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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