Acute Cholecystitis as a Complication After Colonoscopy: A Case Report and Literature Review

Abstract

Acute cholecystitis after colonoscopy is a rare event, with less than 10 cases described in the literature. We report the case of a male patient with silent gallstones who underwent colonoscopy for follow-up of his Crohn's disease. The colonoscopy revealed erosions in the terminal ileum, from which biopsies were taken. A sessile polyp 4 mm in diameter at the recto-sigmoid junction was also removed. Less than 24 h after the colonoscopy, the patient complained of upper right quadrant pain, nausea and vomiting. Based on the clinical findings, laboratory data and ultrasonography, we diagnosed acute cholecystitis and excluded any complication after the colonoscopy. Laparoscopic cholecystectomy was performed and the patient was discharged. LEARNING POINTS• Cholecystitis following colonoscopy can be a rare complication or a coincidence.• Rarely, manoeuvres during colonoscopy may dislodge small gallstones which then obstruct the bile duct causing acute cholecystitis.• Imaging and the clinical picture help to differentiate bowel perforation, a fairly common early event after colonoscopy, from other complications.

Probiotics to manage inflammation in HIV infection

“…This episode was registered as a grade 3 adverse event unlikely related to the probiotic intervention, but possibly related to the colonoscopy procedure. Cholecystitis has previously been reported after colonoscopy, but in a shorter time interval after the procedure, and no causality has been established (353,354).…”

Probiotics to HIV-Infected Immunological Nonresponders: Altered Mucosal Immunity and Microbial Diversity Restricted to Ileum

“…In this study, one participant had an SAE unlikely related to the probiotic intervention, but possibly related to the colonoscopy procedure. 41,42 Our study adds data to evidence that probiotics should be considered safe in INRs.…”

Acute Cholecystitis, A Rare Complication Following Routine Colonoscopy: Case Series and Literature Review

“…Post colonoscopy cholecystitis was first reported in 2001 by Milman and Goldenberg in a series of two patients [ 5 ]. After this initial report, an additional seven authors reported cholecystitis after colonoscopy [ 6 - 12 ] in a total of twelve patients (Table 3 ). The precise mechanism leading to cholecystitis after colonoscopy remains unknown.…”

“…and Enterococcus facecalis in the pericholecystic fluid of their patient with gangrenous cholecystitis. In all remaining cases [ 5 , 6 , 8 - 10 ], the most likely underlying pathophysiology is due to increased lithogenicity of bile, as a direct result of the fasting state and commonly used large volume laxatives consumed for bowel cleansing.…”