Acute non-lithotripsy cholecystitis accounts for 5% to 10% of acute cholecystitis without the presence of stones in the gallbladder. The pathogenesis of AAC is not fully understood, but usually occurs in critically ill patients with severe trauma, burns, abdominal non-biliary surgery, and sepsis. Several factors are involved in the pathogenesis. Most believe that it is related to biliary stasis in the gallbladder, ischemia-reperfusion injury, and bacterial infection. The clinical data of acute non-calculous cholecystitis in the elderly admitted to our hospital in the past 20 years are analyzed as follows.1 Clinical data Our department admitted 30 elderly patients with ACC from January 1988 to August 2008, 18 males and 12 females; age 60-89 years old, average 70.5 years old. None of the patients had a history of cholecystitis before the onset of the disease. There were 11 cases after trauma and surgery, including 3 cases of burns, 2 cases after subtotal gastrectomy, 2 cases of pelvic fracture, 1 case after traumatic liver and spleen rupture, 1 case after small intestine rupture, 1 case after nephrectomy, 1 case after epidural hematoma; 8 cases of hypertension, 5 cases of chronic bronchitis, 2 cases of diabetes mellitus, and 1 case of severe acute pancreatitis; the rest of the cases had no combined diseases. There were three cases of misdiagnosis of gastrointestinal perforation, two cases of ectopic appendicitis, one case of acute pancreatitis and one case of acute intestinal obstruction, respectively. The clinical manifestations were similar to those of acute calculous cholecystitis, mainly manifested as: epigastric pain, abdominal distension, nausea, vomiting, fever, jaundice; epigastric pressure pain, rebound ……