Acute Reactive Acalculous Cholecystitis Secondary to Duodenal Ulcer Perforation

Rahim, Shab E Gul; Alomari, Mohammad; Khazaaleh, Shrouq; Al‐Omari, Ahmed; Momani, Laith Al

doi:10.7759/cureus.4331

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…Longer ICU stay, specifically, more than 24 hours, was associated with lower mortality but LOS less than 24 hours might not be associated with higher mortality. 2020 to conduct the following study: "Mortality of severe COVID-19 patients in intensive care unit; an observational study from a major COVID-19 receiving hospital" The institutional review board needs to be informed and approached for revision of approval shall any significant change(s) are made in the study design/protocol. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue.…”

Section: Discussionmentioning

confidence: 99%

Mortality of Patients With Severe COVID-19 in the Intensive Care Unit: An Observational Study From a Major COVID-19 Receiving Hospital

Rahim¹,

Amin²,

Noor³

et al. 2020

Cureus

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To determine the mortality of patients with severe COVID-19 in the intensive care unit (ICU) in relation to age, gender, co-morbidities, ventilatory status, and length of stay (LOS). Methods This was a cross-sectional study based on data retrieved for 204 patients admitted to the ICU of Hayatabad Medical Complex, Peshawar, Pakistan, from April to August 2020. Study variables were age, gender, comorbid conditions, ventilatory status, and length of stay (LOS). The data were analyzed using SPSS version 21 (IBM Corp., Armonk, NY). The independent t-test and the chi-square test were used to compare the means and frequencies of variables. Multivariate regression analysis was used to predict the likelihood of mortality. Results The overall mortality was 77%. Non-invasive ventilation (NIV) was administered to 61.8% of patients. Mortality was higher for invasive mechanical ventilation (IMV) (93.6% vs 66.7%, p<0.001) and for over 60 years (87.3% vs 72.3%, p=0.019). Mortality without co-morbidities was 75.2%. Comparative mortality rates for at least one co-morbidity (79.7%), diabetes mellitus (80.0%), hypertension (100%), diabetes mellitus and hypertension both (87.1%), and chronic obstructive pulmonary disease (75%) were insignificant. The LOS for survivors was longer (8.9±8.9 versus 5.4±5.2 days, p=0.017). The LOS < 24h was associated with higher mortality (85.9% vs 72.9%, p=0.040). On multivariable regression, the likelihood of mortality was high for IMV (7.330, 95% CI 2.667-20.143, p<0.001) and elderly (>60 years) patients (2.607, 95%CI 1.063-6.394, p=0.036). Mortality decreased with LOS longer than 24h (0.412, 95%CI 0.173-0.982, p=0.045). Comorbidities did not have any effect on mortality. Conclusions Age more than 60 years and IMV were independent risk factors for higher mortality. Longer ICU stay, specifically more than 24 hours, was associated with lower mortality but LOS less than 24 hours might not have a causal relationship with mortality. The odds of survival were not affected by co-morbidities.

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Section: Discussionmentioning

confidence: 99%

Mortality of Patients With Severe COVID-19 in the Intensive Care Unit: An Observational Study From a Major COVID-19 Receiving Hospital

Rahim¹,

Amin²,

Noor³

et al. 2020

Cureus

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“…The clinical presentation of both gallbladder disease and PUD are very similar, however perforated ulcers typically present with more severe symptoms. Though there are reported cases of simultaneous cholelithiasis/cholangitis with perforated duodenal ulcers, the diagnosis is often missed initially due to conflation of symptoms [ 4 ]. Bilio-enteric fistulas are often the result of chronic cholelithiasis pathology, and can result in the development of many types of communications to the gallbladder.…”

Section: Discussionmentioning

confidence: 99%

A unique presentation of perforated duodenal ulcer in a postpartum woman: a case report

Jain

Azzolini

Kipnis

2020

Journal of Surgical Case Reports

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Gallbladder disease and peptic ulcer disease (PUD) can present very similarly, and misdiagnosis can often result because of conflicting symptoms. PUD in pregnancy is relatively rare, in part due to the changes in estrogen and progesterone levels. We present a case of a postpartum female, post operation Day 5, with signs/symptoms, physical exam and laboratory work consistent with acute cholecystitis that was found to have a perforated duodenal ulcer intraoperatively. The authors suggest that a fistula would have resulted with ongoing disease. Bilio-enteric fistulas can often form due to ongoing cholelithiasis disease. Cholecystoduodenal fistulas (CDFs) are the most common fistulas to present. It is possible that the incidence of CDF formation secondary to perforated duodenal ulcers is underestimated due to signs and symptoms not presenting until gallstone ileus is diagnosed.

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“…The ultrasound examination showed a 5 mm gallbladder wall thickening with presence of multiple stones. Because of the profound pain, the obesity of the patient, and the luminal intestinal gas which limited the sonographic assessment of the other upper abdominal organs, we performed a computed tomography (CT) scan to exclude a secondary wall thickening of the gallbladder to sealed duodenal ulcer perforation or right sided diverticulitis [3,4]. The findings confirmed the diagnosis of acute cholecystitis.…”

Section: Case Reportmentioning

confidence: 99%

A Rare Case of a Left-sided Gallbladder Accompanied with an Aplastic Cystic Duct in a Patient with Acute Cholecystitis

et al. 2020

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Congenital defects/diseases Background: A left-sided gallbladder without situs inversus is a rare congenital anomaly of the gallbladder with a prevalence ranging from 0.04-0.3%. Case Repost: We present a case of a female patient, referred to our clinic with clinical features of an acute cholecystitis. After performing the standard preoperative investigations, which confirmed the diagnosis, the patient underwent a laparoscopic cholecystectomy. We found a left-sided gallbladder, attached to the lower surface of the left lobe of the liver. During the dissection in the Callot triangle an aplastic cystic duct was also identified. The extirpation of the gallbladder was performed anterograde, allowing a better exposition of the critical structures. Conclusions: A left sided gallbladder is almost an incidental finding, which can be accompanied with further anomalies of the biliary tree. A combination of these 2 variations is very rare without any other reported cases in the literature.

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Acute Reactive Acalculous Cholecystitis Secondary to Duodenal Ulcer Perforation

Cited by 5 publications

References 17 publications

Mortality of Patients With Severe COVID-19 in the Intensive Care Unit: An Observational Study From a Major COVID-19 Receiving Hospital

Mortality of Patients With Severe COVID-19 in the Intensive Care Unit: An Observational Study From a Major COVID-19 Receiving Hospital

A unique presentation of perforated duodenal ulcer in a postpartum woman: a case report

A Rare Case of a Left-sided Gallbladder Accompanied with an Aplastic Cystic Duct in a Patient with Acute Cholecystitis

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