4 cases of little-known syndromes in acute cholecystitis are described. Cholecystic-pericardial and syncopal-cardiac syndrome are seen in 1.33 and 1.78% cases of acute cholecystitis, respectively, and are the variants of Botkin's biliary-cardiac syndrome. These syndromes disappear after surgery on biliary tract, therefore they must be indications for surgical treatment of cholecystitis.

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