scholarly journals Acute acalculus cholecystitis and hepatitis caused by Brucella melitensis

2010 ◽  
Vol 4 (07) ◽  
pp. 464-467 ◽  
Author(s):  
Fawzia Eida AL-Otaibi
Keyword(s):  
Acute Cholecystitis ◽  
Brucella Melitensis ◽  
Acalculous Cholecystitis ◽  
Rare Presentation

Acute cholecystitis is a very rare presentation of brucellosis. A case of acalculous cholecystitis caused by Brucella melitensis is reported with a review of previously reported cases.

scholarly journals Acute Acalculous Cholecystitis: A Rare Presentation of Primary Epstein-Barr Virus Infection in Adults—Case Report and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Zuhal Yesilbag ◽  
Asli Karadeniz ◽  
Fatih Oner Kaya
Keyword(s):  
Epstein Barr Virus ◽  
Conservative Therapy ◽  
Gastrointestinal Symptoms ◽  
Acalculous Cholecystitis ◽  
Acute Acalculous Cholecystitis ◽  
Epstein Barr Virus Infection ◽  
Rare Presentation ◽  
Barr Virus ◽  
Ebv Infection ◽  
Epstein Barr

Primary Epstein-Barr virus (EBV) infection is almost always a self-limited disease characterized by sore throat, fever, and lymphadenopathy. Hepatic involvement is usually characterized by mild elevations of aminotransferases and resolves spontaneously. Although isolated gallbladder wall thickness has been reported in these patients, acute acalculous cholecystitis is an atypical presentation of primary EBV infection. We presented a young women admitted with a 10-day history of fever, nausea, malaise who had jaundice and right upper quadrant tenderness on the physical examination. Based on diagnostic laboratory tests and abdominal ultrasonographic findings, cholestasis and acute acalculous cholecystitis were diagnosed. Serology performed for EBV revealed the acute EBV infection. Symptoms and clinical course gradually improved with the conservative therapy, and at the 1-month follow-up laboratory findings were normal. We reviewed 16 adult cases with EBV-associated AAC in the literature. Classic symptoms of EBV infection were not predominant and all cases experienced gastrointestinal symptoms. Only one patient underwent surgery and all other patients recovered with conservative therapy. The development of AAC should be kept in mind in patients with cholestatic hepatitis due to EBV infection to avoid unnecessary surgical therapy and overuse of antibiotics.

Percutaneous Cholecystectomy in the Intensive Care Patient

1998 ◽  
Vol 13 (2) ◽  
pp. 78-84
Author(s):  
John P. Mcgahan
Keyword(s):  
Intensive Care ◽  
Acute Cholecystitis ◽  
Intensive Care Patient ◽  
Acalculous Cholecystitis ◽  
Care Patient ◽  
Definitive Treatment ◽  
Acute Acalculous Cholecystitis ◽  
Percutaneous Cholecystostomy ◽  
Diagnostic Dilemma ◽  
Definitive Therapy

The diagnosis of acute cholecystitis in the intensive care patient is often problematic. While most patients with acute cholecystitis present with fever, increased white count, or symptomatology pertaining to the gallbladder, occasionally these patients may be comatose and often present a diagnostic dilemma. Surgical cholecystectomy is the treatment of choice for acute cholecystitis, but this therapy carries with it a high mortality rate in the desperately ill patient. Thus surgical cholecystostomy has been advocated as a temporizing procedure to be performed until these patients stabilize. More recently percutaneous cholecystostomy, performed at the patient's bedside under ultrasound guidance, has been successfully performed using small-size catheters. This is a low-risk temporizing procedure when performed by well-trained personnel. In fact, percutaneous cholecystostomy has been shown to be a definitive treatment in patients with acute acalculous cholecystitis. Patients with calculous cholecystitis may require more definitive therapy, such as cholecystectomy. Presented is a review of the development and the current applications of percutaneous cholecystostomy in intensive care patients with suspected acute cholecystitis.

scholarly journals Acalculous Acute Cholecystitis in Previously Healthy Children: General Overview and Analysis of Pediatric Infectious Cases

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Dimitri Poddighe ◽  
Matteo Tresoldi ◽  
Amelia Licari ◽  
Gian Luigi Marseglia
Keyword(s):  
Infectious Diseases ◽  
Acute Cholecystitis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pediatric Population ◽  
Acalculous Cholecystitis ◽  
Clinical Aspects ◽  
Acute Acalculous Cholecystitis ◽  
Healthy Children ◽  
General Overview

Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder, which does not appear to be associated with the presence of gallstones. AAC is estimated to represent more than 50% of cases of acute cholecystitis in the pediatric population. Although this pathology was initially described in critically ill patients, actually most pediatric cases have been observed during several infectious diseases. Particularly, here we reviewed pediatric infectious acute acalculous cholecystitis and analyzed the pathophysiological and clinical aspects of bacterial and viral forms.

Acute acalculous cholecystitis: A rare presentation of typhoid fever in adults

2006 ◽  
Vol 38 (3) ◽  
pp. 196-200 ◽  
Author(s):  
Chung-Hsu Lai ◽  
Chun-Kai Huang ◽  
Chuen Chin ◽  
Hsi-Hsun Lin ◽  
Chih-Yu Chi ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Acalculous Cholecystitis ◽  
Acute Acalculous Cholecystitis ◽  
Rare Presentation

scholarly journals Acute acalculous cholecystitis on a COVID-19 patient: a case report

2020 ◽  
Author(s):  
Edoardo Mattone ◽  
Maria Sofia ◽  
Elena Schembari ◽  
Valentina Palumbo ◽  
Rosario Bonaccorso ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gastrointestinal Symptoms ◽  
Acalculous Cholecystitis ◽  
Gallbladder Wall ◽  
Acute Acalculous Cholecystitis ◽  
Surgical Risk ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Vascular Insufficiency ◽  
High Surgical Risk

Abstract Background coronavirus disease-19 (COVID-19) has spread to several countries around the world and has become an unprecedented pandemic. We report an extremely rare case of acute acalculous cholecystitis on a COVID-19 patient. In our knowledge, this is the first report of laparoscopic cholecystectomy performed on a COVID-19 patient. Case presentation: a COVID-19 patient was diagnosed with acute acalculous cholecystitis and a multidisciplinary team decided to perform a percutaneous transhepatic biliary drainage (PTBD) as the first treatment. SARS-CoV-2 RNA was not found in the bile fluid. Because of deterioration of the patient’s clinical conditions, laparoscopic cholecystectomy had to be performed and since the gallbladder was gangrenous, the severe inflammation made surgery difficult to perform. Conclusions acalculous cholecystitis was related with mechanical ventilation and prolonged total parenteral nutrition, in this case the gangrenous histopathology pattern and the gallbladder wall ischemia was probably caused by vascular insufficiency secondary to severe acute respiratory distress syndrome of COVID-19 pneumonia. The percutaneous transhepatic gallbladder drainage (PTBD) was performed according to Tokyo Guidelines because of high surgical risk. Laparoscopic cholecystectomy was next performed due to no clinical improvement. The absence of viral RNA in the bile highlights that SARS-CoV-2 is not eliminated with the bile while it probably infects small intestinal enterocytes which is responsible of gastrointestinal symptoms such as anorexia, nausea, vomiting, and diarrhea. Although the lack of evidence and guidelines about the management of patient with acute cholecystitis during COVID-19 pandemic, laparoscopic cholecystectomy, at most preceded by PTGBD on high surgical risk patients, remains the gold standard for the treatment of acute cholecystitis on COVID-19 patients.

Significance of Preoperative Ultrasound Measurement of Gallbladder Wall Thickness

2007 ◽  
Vol 73 (9) ◽  
pp. 926-929 ◽  
Author(s):  
James Majeski
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Wall Thickness ◽  
Open Cholecystectomy ◽  
Acalculous Cholecystitis ◽  
Gallbladder Wall ◽  
Chronic Cholecystitis ◽  
Entire Series ◽  
Calculous Cholecystitis ◽  
Gallbladder Ultrasound

Evaluation of patients with signs and symptoms of biliary tract disease usually includes ultrasound assessment of the gallbladder. Does measurement of the thickness of the gallbladder wall yield any significant information to the clinical surgeon? The records of all my patients undergoing cholecystectomy since 1990 were reviewed. The entire series consists of 401 consecutive patients, in whom 388 procedures were completed laparoscopically, with 14 patients requiring conversion to an open cholecystectomy. Each patient's preoperative evaluation included a gallbladder ultrasound, which included measurement of the diameter of the gallbladder wall. The entire series of cholecystectomies was evaluated according to the ultrasound measured diameter of the gallbladder wall. A thin gallbladder wall was less than 3 mm in diameter. A thick gallbladder wall was 3 mm or greater in diameter. Of the 401 consecutive patients who underwent cholecystectomy for symptomatic gallbladder disease, 86 (21.5%) were removed laparoscopically for acalculous disease. Eleven per cent of patients with acalculous cholecystitis had acute cholecystitis and 89 per cent had chronic cholecystitis. Every patient with either a thin or thick gallbladder wall with acalculous cholecystitis had a successful laparoscopic cholecystectomy. Three-hundred fifteen patients had a laparoscopic cholecystectomy for calculous cholecystitis. In patients with calculous cholecystitis, 28.3 per cent had acute cholecystitis and 71.7 per cent had chronic cholecystitis. The gallbladder wall was found to be greater than 3 mm in 38 per cent of patients with acute calculous cholecystitis and greater than 3 mm in 41 per cent of patients with chronic calculous cholecystitis. One-hundred, forty-two patients, out of a series total of 401, had a gallbladder wall thickness greater than 3 mm by preoperative sonography and 14 of these patients (10%) required conversion to an open cholecystectomy. A preoperative gallbladder ultrasound evaluation for symptomatic cholecystitis, which documents a thick gallbladder wall (≥3 mm) with calculi, is a clinical warning for the laparoscopic surgeon of the potential for a difficult laparoscopic cholecystectomy procedure which may require conversion to an open cholecystectomy procedure.

scholarly journals Percutaneous Cholecystostomy for Severe Acute Cholecystitis: A Useful Procedure in High-Risk Patients for Surgery

2018 ◽  
Vol 108 (2) ◽  
pp. 124-129 ◽  
Author(s):  
S. Aroori ◽  
C. Mangan ◽  
L. Reza ◽  
N. Gafoor
Keyword(s):  
High Risk ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Length Of Hospital Stay ◽  
Acalculous Cholecystitis ◽  
Percutaneous Cholecystostomy ◽  
High Risk Patients ◽  
Risk Patients ◽  
Physiological Reserve ◽  
American Society

Background: Acute cholecystitis has the potential to cause sepsis and death, particularly in patients with poor physiological reserve. The gold standard treatment of acute cholecystitis (cholecystectomy) is often not safe in high-risk patients and recourse is made to percutaneous cholecystostomy as either definite treatment or temporizing measure. The aim of this study is to evaluate early and late outcomes following percutaneous cholecystostomy in patients with acute cholecystitis treated at our institution. Methods: All patients who underwent percutaneous cholecystostomy for acute cholecystitis (excluding patients with malignancy) between January 2005 and September 2014 were included in the study. Results: A total of 53 patients (22 female, median age, 74 years; range, 27–95 years) underwent percutaneous cholecystostomy during the study period. In total, 12 patients (22.6%) had acalculous cholecystitis. The main indications for percutaneous cholecystostomy were significant co-morbidities (n = 28, 52.8%) and patients too unstable for surgery (n = 21, 39.6%). The median time to percutaneous cholecystostomy from diagnosis of acute cholecystitis was 3.6 days (range, 0–45 days). The median length of hospital stay was 27 (range, 4–87) days. The overall 90-day mortality was 9.3% with two further deaths at 12-month follow up. The mortality was significantly higher in patients with American Society of Anesthesiology grade 4–5 (18% vs 0% in American Society of Anesthesiology grade 2–3, p = 0.026) and in patients with acalculous cholecystitis (25% vs 4.5%, p = 0.035). The overall readmission rate was 18%. A total of 24 (45.2%) patients had surgery: laparoscopic cholecystectomy, n = 11; laparoscopic converted to open, n = 5; open total cholecystectomy, n = 5; open cholecystectomy, n = 1; laparotomy and washout, n = 1; laparotomy partial cholecystectomy and closure of perforated small intestine and gastrostomy, n = 1. Conclusion: Percutaneous cholecystostomy is a useful temporary or permanent procedure in patients with acute cholecystitis of both calculous and acalculous origin, who are unfit for surgery.

scholarly journals Acute Cholecystitis and Granulamatous Hepatitis Caused by Brucella Melitensis

2018 ◽  
Vol 38 (1) ◽  
pp. 79-83
Author(s):  
Çiğdem YILDIRIM ◽  
Eda OTMAN AKAT ◽  
Meltem IŞIKGÖZ TAŞBAKAN ◽  
Oğuz Reşat SİPAHİ ◽  
Hüsnü PULLUKÇU ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Brucella Melitensis
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