When it comes to stones, people naturally think of valuable diamonds, transparent and rounded jade, jagged and strange stones… …Unfortunately, human gallbladder stones are so low-key that they are simple, but bovine gallbladder stones are very expensive – cow’s yellow. That’s right, we eat this ingredient in Niuhuang Shangqing Pills. The cow’s gallstones can cure and eliminate diseases for humans, while human gallstones are never the same room of the nest. With the rapid development of medical imaging represented by ultrasound, doctors can now diagnose gallbladder stones with a high accuracy rate. Hearing is false, seeing is “stone”, modern technology provides a “lens”, although not to find the Malaysia Airlines plane, but staged a stone out of the search. The stone is not necessarily round, but the world is flat, see the front, you can not ignore the back: acute non-stone cholecystitis, commonly known as “non-stone cholecystitis”. Cholecystitis is a very common disease, and many doctors are patients with this disease. Stones are the main cause of cholecystitis, which can account for 80-95% of the obstruction of bile flow. While we often see limescale clogging the drainage ducts, stones can also clog the “downstream ducts” of the gallbladder, thus triggering acute cholecystitis and acute cholangitis, which are common surgical emergencies. Everything has a cause, and acute non-stone cholecystitis is not a “wukong” that just popped out of a stone. It has a deep “background” and is usually due to obstruction of the mucous membrane of the gallbladder neck due to congestion and edema, yes, obstruction, but the cause of the obstruction is different from a tangible stone. This is often due to bacterial infection, or irritation from concentrated bile, and rarely in patients with organ failure after severe trauma or major surgery. The bile duct system then becomes a rolling pin of incompetence. The pressure in the gallbladder increases and then begins to increase, the wall of the gallbladder becomes thinner and thinner, and the gallbladder is in danger! If you do not get effective treatment at this stage, it will lead to impaired blood circulation in the gallbladder and induce gangrene of the gallbladder wall and gallbladder perforation. The bubble is always going to burst, except that the gallbladder is coming to a real – hard landing. The destructive force of the body formed by perforation of the gallbladder into the free peritoneal cavity is medically known as biliary peritonitis and has a high mortality rate. Even if the perforation is encapsulated by the surrounding tissue, a peri-gallbladder abscess can form. The surrounding gallbladder harbors dirt and grime and cannot be eliminated without a thorough sweep to cut down the root of the problem and eliminate the aftermath. Therefore, surgery is the best treatment option to avoid the formation of chronic sinus tracts and the continuation of the diseased gallbladder. For patients who cannot tolerate surgery, percutaneous drainage of the gallbladder can be performed first. Non-surgical treatment is limited to those with mild disease and requires close observation, and requires surgical treatment as a strong back-up. This kind of heartbeat is not easy to play. How do you identify acute non-stoic cholecystitis? Although there is a “cloak of invisibility” and also love to play “lost”, after all, it is still a little easier to diagnose the disease than to find the Malaysia Airlines plane. Symptoms may be similar to acute calculous cholecystitis, typically abdominal pain, chills, fever, or atypically, anorexia; signs may be typical of gallbladder tenderness, i.e., positive Murphy’s sign; ultrasound and other imaging may show a thickened gallbladder, an enlarged gallbladder, and fluid around the gallbladder. Acute non-lithotripsy cholecystitis should be classified as a criminal when combined with known risk factors such as old age, serious illness, burns, trauma, prolonged parenteral nutrition, diabetes mellitus, and immunosuppression. For criminals, 24/7 monitoring is essential; acute nonstone cholecystitis also requires dynamic medical observation, which requires more cooperation from the affected patient. Patients are still generally wary of stones and are often under-aware of this “invisible danger”. This requires not only patient and careful explanation by the attending physician, but also a broad and simple introduction to the subject so that more people can recognize and understand such a disease. In this way, each patient can receive the right treatment at the right time, and the doctor’s eyes can be discerning, and the patient can cooperate with him/her, so that he/she can go back to heaven and experience the new chapter of “The Stone Story”.