Acute Acalculous Cholecystitis Due to COVID-19, an Unusual Presentation

Abaleka, Fuad I; Nigussie, Bisrat; Bedanie, Genanew; Amir, Mohammad; Galiboglu, Selin

doi:10.7759/cureus.15431

Cited by 16 publications

(14 citation statements)

References 11 publications

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“…The histology for both cases showed vascular thrombi, consistent with findings of systemic hypercoagulability described by numerous studies. Previously, a couple of papers have been reported showing acute cholecystitis as a complication of severe COVID-19 [ 15 - 19 ]. Three of these cases have histologic findings compatible with ours, further supporting that microthrombi are a common COVID-19-related pathologic change.…”

Section: Discussionmentioning

confidence: 99%

A Series of COVID-19 Cases With Findings in the Gastrointestinal and Hepatobiliary System

Dong-ling¹,

Hacking²,

Lee³

2022

Cureus

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Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread worldwide. Most of the infected patients present with respiratory symptoms and acute lung damage. Here, we present three cases of patients with COVID-19 disease whose main clinical manifestations are gastrointestinal symptoms. In our first case, we present a COVID-19 patient with histologic findings associated with ischemic necrosis of the small bowel. In the second and third cases, we demonstrate acute cholecystitis and histology showing microvascular thrombosis. These three cases highlight the ischemic and thrombotic changes seen in the setting of COVID-19 infection without classic respiratory symptoms, with resulting severe gastrointestinal and hepatobiliary disease requiring surgical management. Although the bile or stool viral load was not tested in these patients, the small intestine and gallbladder were infected with SARS-CoV-2, most likely via the epithelial angiotensin-converting enzyme 2 (ACE2) receptor.

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Section: Discussionmentioning

confidence: 99%

A Series of COVID-19 Cases With Findings in the Gastrointestinal and Hepatobiliary System

Dong-ling¹,

Hacking²,

Lee³

2022

Cureus

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“…When SARS-CoV-2 binds, it causes endothelitis which generates thromboembolism in various organs, including the gallbladder. (15,16) Some publications have tried to demonstrate the relationship between AC and COVID-19. Yin et al looked for RT-PCR in the biliary fluid, without detecting it, ruling out that SARS-CoV-2 is eliminated through bile and considering that AC is a complication of SARS-CoV-2 (17).…”

Section: Discussionmentioning

confidence: 99%

Colecistitis acalculosa y covid-19. Reporte de caso

Pérez-Murcia

Amado

Camacho

2022

Med.

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Introducción. La COVID-19 (del inglés Coronavirus disease 2019), se caracteriza principalmente por su sintomatología respiratoria, pero se han descrito numerosas formas de presentación con un aumento reciente de las manifestaciones gastrointestinales. Presentación del caso. Varón de 33 años con sobrepeso y sin otros antecedentes conocidos, que consulta por sintomatología sugestiva de patología biliar y hallazgo a la revisión por sistemas de tos y disnea. Es llevado a cirugía por hallazgo de CA (Colecistitis Acalculosa) y en el posoperatorio presenta dificultad respiratoria identificando SARS-CoV-2 (del inglés severe acute respiratory syndrome coronavirus 2) positivo, falla cardíaca idiopática previa y trombosis pulmonar aguda. Discusión. La presentación de CA con SARS-CoV-2 es infrecuente, no tiene un patrón clínico establecido y sí múltiples factores de confusión que lo tornan en un reto diagnóstico e incluso un factor de distracción para el diagnóstico de la COVID-19 y sus complicaciones.

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“…After identifying 671 articles, 153 articles involving 171 cases were eligible: 104 viral infection and 67 rheumatic disease AAC patients. [8,11–162] Viral infection types included: Epstein Barr virus, hepatitis virus, dengue virus, SARS-CoV-2 (COVID-19), human immunodeficiency virus, and cytomegalovirus. Rheumatic diseases included: systemic lupus erythematosus, adult-onset Still disease, Henoch-Schönlein purpura, polyarteritis nodosa, Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis), microscopic polyangiitis, temporal arteritis, Wegener granulomatosis (granulomatosis with polyangiitis), Kawasaki syndrome, systemic juvenile idiopathic arthritis, and juvenile dermatomyositis (Table 1).…”

Section: Methodsmentioning

confidence: 99%

Is conservative management a safe approach for patients with acute acalculous cholecystitis presenting with an acute abdomen?

Chang,

Wang,

Shi

et al. 2023

Medicine

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Patients with acute acalculous cholecystitis (AAC) often present with acute abdominal symptoms. However, recent clinical studies have suggested that some patients with AAC and an acute abdomen, especially when caused by viruses or rheumatic disease, may not require cholecystectomy and that conservative treatment is adequate. Whether cholecystectomy is superior to conservative treatment for patients with AAC presenting with a severe acute abdomen is still uncertain. This was a case series study of AAC-related literature published between 1960 and 2022. In total, 171 cases (104 viral infection-associated AAC and 67 rheumatic disease-associated AAC) were included. The prognoses of patients receiving cholecystectomy or conservative treatment were compared. To account for confounding factors, etiological stratification and logistic regression were performed. The prognosis was similar for patients undergoing cholecystectomy and conservative treatment (P value .364), and virus infection-associated AAC had a better prognosis than rheumatic disease-associated AAC (P value .032). In patients with AAC caused by viruses or rheumatic disease, the acute abdomen can be adequately managed by conservative treatment of the underlying etiology and does not mandate surgical intervention.

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Acute Acalculous Cholecystitis Due to COVID-19, an Unusual Presentation

Cited by 16 publications

References 11 publications

A Series of COVID-19 Cases With Findings in the Gastrointestinal and Hepatobiliary System

A Series of COVID-19 Cases With Findings in the Gastrointestinal and Hepatobiliary System

Colecistitis acalculosa y covid-19. Reporte de caso

Is conservative management a safe approach for patients with acute acalculous cholecystitis presenting with an acute abdomen?

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