Acute acalculous cholecystitis as a rare gastroenterological association of COVID-19: a case series and systematic review

doi:10.18053/jctres.09.202302.010

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“…Деякі клінічні центри звітували про початок захворювання саме з шлунково-кишковими проявами [1]. При дослідженні вірусу SARS-CoV-2 виявили, що ангіотензин-перетворюючий ензим 2 (ACE2), що є найчутливішим рецептором для SARS-CoV-2, у великій кількості експресований саме в шлунково-кишковому тракті, клітинах печінки та підшлункової залози, високий рівень ACE2 рецепторів в холангіоцитах [2]. До того ж, ACE2 високо експресований в судинному ендотелії, що зі свого боку викликає ендотеліїти в мікро-і макроциркуляторному руслі та призводить до тромбоемболій в різних органах, однак найбільше з високою експресією ACE2 рецепторів, а саме в пневмоцитах та холангіоцитах жовчовивідних шляхів [3].…”

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Analysis of management tactics of patients with acute noncalculous cholecystitis in combination with coronavirus disease

Pokidko,

Hutsol,

Katsal

2024

Rep. of Vinnytsia Nation. Med. Univ.

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Annotation. The purpose of the study is to analyze the results of treatment, the frequency of complications and the general course of the disease of patients with acute noncalculous cholecystitis with concomitant acute respiratory infection SARS-CoV-2, to investigate the etiopathogenetic relationship of these pathologies. The results of treatment of 27 patients with acute noncalculous cholecystitis and concomitant coronavirus disease in the period from 2021 to 2023 were analyzed. Among them, 18 (66.6%) were women and 9 were men (33.4%). The diagnosis of acute cholecystitis was established according to the Tokyo Guidelines (Tokyo Guidelines 2018), coronavirus disease using polymerase chain reaction (PCR). The patients underwent physical examinations, a full range of laboratory tests, instrumental ultrasound diagnostics of abdominal organs, and histological examination of postoperative material. It was found that 27 patients (100%) had non-calculous forms of acute cholecystitis. 20 patients (74.1%) received surgical intervention as a method of treatment for acute noncalulosis cholecystitis, 7 patients (25.9%) received conservative treatment. From 20 operated patients, the results of histological examination in the form of phlegmonous changes of the bladder were obtained in 15 (75%) cases, gangrenous changes in 5 (25%) cases. Minimally invasive technique in the form of laparoscopic cholecystectomy was used in 19 (95%) cases, open laparotomy access was in 1 (5%) case. The degree of severity according to the 2018 Tokyo Protocol was Grade I in 15 (75%) cases, Grade II in 5 (25%) cases. Postoperative complications were in 1 (5%) case in the form of eventeration. The total mortality was 0 (0%) cases. Active tactics of management of patients with acute noncalculous cholecystitis with concomitant coronavirus disease, in the form of surgical intervention, showed positive results and can be used as an appropriate method of treatment.

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