The presence of several factors may contribute to the risk for gangrenous cholecystitis.
General risk factors:
(1) male gender
(2) older age (> 50 years)
(3) diabetes
(4) coronary artery disease or history of cardiovascular disease
(5) delay in surgery, including delay in presentation
Several of these are associated with risk for arteriosclerosis.
In addition, some patients may have:
(1) an ischemic event related to:
(1a) polyarteritis nodosa (PAN) or other vasculitis
(1b) emboli (hepatic artery embolization, cholesterol emboli)
(2) a preceding surgery or therapeutic intervention (ERCP, gastric resection)
Patients with gangrenous cholecystitis were more likely to have (manifestations rather than causal):
(1) systemic inflammatory response (SIRS)
(2) leukocytosis
(3) elevated serum bilirubin
