Low serum iron concentration in acute cholecystitis. A discriminator of severity of infection.

This study demonstrates that serum iron levels are significantly depressed during acute cholecystitis. Mean admission serum iron concentration for 18 patients who had required emergency cholecystectomy within 48 hours of hospitalization was 40.9 micrograms/100 ml +/- 27.08 (7.32 mumol/l) while for 108 patients who had undergone elective cholecystectomy in the same 18-month period the mean concentration was 90.5 micrograms/100 ml +/- 34.27 (16.2 mumol/l); a mean difference of 49.6 micrograms/100 ml (3.92 mumol/l) (t = 5.8395, P less than 0.00001). Mean serum iron level in seven patients with culture positive acute cholecystitis was 26.4 micrograms/100 ml +/- 10.45 (4.73 mumol/l), significantly different (P less than 0.05) than in 11 patients with culture negative cholecystitis, 50.3 micrograms/100 ml +/- 30.41 (9.00 mumol/l). Admission serum iron level averaged 25.6 micrograms/100 ml (4.58 mumol/l) in three patients with gangrenous gallbladders and was 18 micrograms/100 ml (3.22 mumol/l) in one patient with empyema of the gallbladder. Determination of serum iron level may help distinguish patients with significant infections requiring urgent surgery from patients with biliary colic.