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1. Based on research, It is to be believed Mr. Lars is diagnoised with Acute Acalculous Cholecystitis. With Lars having symptoms such as nausea, vomiting, fever and feeling of tenderness when the affected area is touched, one is to think Lars has Acalculous Cholecystitis. Usually a sonography is used as the initial technique for evaluating patients with suspected gallbladder disease due to its high detection of gallbladder stones and its speed and portability (Vriesman and Smithuis, 2000). With the ultrasonography and CT scan showing that Lars gallbladder wall thickness was of greater than 3mm, a subserosal halo of the intramural edema, and absence of gallstones, he is further diagnosed with AAC. Another factor that supports the diagnosis of AAC is the finding of inflammatory responses which include the left shift and leukemoid response. A left shift is an increase in of immature neutrophils (Harvey, 2012) The left shift describes leukocytosis which is an increase of neutrophils, and less mature cell forms (Abramson and Melton, …show more content…
Due to Lars prolonged absence of fat intake, (low-calorie rapid loss diet), and waiting till his symptoms worsened to go see a physician, he developed AAC. With the rapid loss of weight, he disrupted his bile chemistry which also led to the obstruction of the cystic duct. The lack of fat intake made the liver produce higher amounts of cholesterol making more bile salts which goes to the gallbladder, irritated the wall of the gallbladder and in most cases create gallstones. This would have diagnosed him with acalculous cholecytitis. With his case being that he did not have any gallstones, he was diagnosed with AAC. It is possible with the excess bile being stored in his gallbladder, it led to its expansion which would in return explain the pain Lars felt in his abdominal section when it was touched. The obstruction of the bile is what caused Lars levels of alanine aminotransferase and alkaline obstruction of cystic duct to

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