A Rare Case of Acute Calculous Cholecystitis With Gallbladder Hydrops

Abstract

Gallbladder hydrops or mucocele is usually due to the obstruction of the gallbladder by a gallstone. It is usually characterized by an increase in gallbladder volume, which remains clinically silent and is often incidentally diagnosed during exploratory laparotomy or laparoscopy. We report a rare case of acute calculous cholecystitis with gallbladder hydrops (measuring 17 cm in maximum dimension) due to the obstruction of the cystic duct by a gallstone in a 67-year-old female. We highlight the importance of early magnetic resonance imaging (MRI) in patients with right upper quadrant (RUQ) pain to rule out gallbladder hydrops especially in those with a history of gallstones.

A Rare Case of Calculous Gallbladder Hydrops Presenting With Atypical Abdominal and Urinary Symptoms

“…A US or CT would demonstrate a distended and oedematous gallbladder with mobile or impacted non-mobile gallstones in the cystic duct or Hartman pouch [5]. Gallbladder hydrops is frequently undiagnosed before surgery and is, instead, incidentally discovered during laparoscopic cholecystectomy [3].…”

“…It is during decompression of the gallbladder intraoperatively, when clear mucous-like fluid instead of green or brown bile is suctioned, that a diagnosis of gallbladder hydrops is often made [3].…”

“…Kawasaki disease) and extrinsic compression of the biliary tree (e.g., adhesions and congenital strictures) [ 2 ]. Bile stasis from prolonged obstruction results in bacterial colonisation and an increase in intraluminal pressure, leading to gallbladder wall distention, ischaemia and inflammation [ 3 ].…”

“…It is caused by chronic obstruction of the cystic duct or distal biliary tree often secondary to obstructed gallstones and concurrent cholecystitis [ 2 ]. It is usually diagnosed incidentally radiologically or intraoperatively [ 3 ]. This case report presents and discusses the atypical clinical presentation, impressive radiological and intraoperative images and surgical management of a 56-year-old female with a rare calculous gallbladder hydrops extending 217mm in maximal length.…”

The value of preoperative neutrophil/lymphocyte ratio in predicting the severity of cholecystolithiasis with cholecystitis in elderly patients

“…Gallbladder stones with cholecystitis are a prevalent biliary system disease in hepatobiliary surgery [ 5 ]. The pathogenesis of this condition involves the blockage of the cystic duct due to gallbladder stones, leading to inflammation and bile stasis.…”