238. Acalculous Cholecystitis: A Novel and Lethal Unrecognized Complication in Severe CoVID 19

Abstract Background SARS-COV-2 infection is known to cause tissue damage in several organs outside of the respiratory tract. The pathogenesis hypothesized be caused by direct viral damage, endothelial injury, and ischemic or thrombotic events. Gastrointestinal symptoms were first characterized mainly as diarrhea diffuse abdominal pain discomfort, which can hard interpret setting a generalized inflammatory response; gallbladder injury inflammation causing acute acalculous cholecystitis has been scarcely reported Methods Here we discuss five cases patients presenting with cholecystitis. All underwent multiple imaging studies, all them compatible cholecystitis; some had an report lithiasic cholecystitis, while rest microlithiasis biliary sludge. Four out laparoscopic cholecystectomy; biopsies taken, consistently those remaining patient died CoVID 19 complications prior surgery, but after percutaneous cholecystostomy tube was placed. Results these have common prolonged fasting, because they required invasive mechanical ventilation, consequently, developed focal pneumonia distress syndrome. This fast related development gangrenous ischemia gallbladder, manifests late complication due SARS-CoV-2 infection, addition being angiotensin-2 converting receptors virus replication proteins, well pro-inflammatory hypoxia state that itself causes (9). showed cholestatic pattern, highlighting this average time 3 weeks onset SARS-CoV2 symptoms, fact most negative test already shown at complication. Conclusion Acalculous one extrapulmonary seen not common, generated higher mortality rate its diagnosis non-specific clinical picture certain occasions Disclosures Authors: No disclosures.