Clinical Presentation, Imaging, and Management of Acute Cholecystitis

Katabathina, Venkata S.; Zafar, Abdul Mueed; Suri, Rajeev

doi:10.1053/j.tvir.2015.07.009

Cited by 35 publications

(33 citation statements)

References 29 publications

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“…This characteristic physical examination finding was known as Murphy's sign. 6 Murphy's sign sensitivity was 62% and specificity was 96% for acute cholecysitis diagnosis. 7 The diagnosis is made based on this clinical features and supported by findings from relevant laboratory and imaging studies.…”

Section: Discussionmentioning

confidence: 90%

Acute Calculous Cholecystitis in a Young Female Patient: A Unique Case

Shalim¹,

Arianthi²,

Wirawan³

2019

IJMBS

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Acute cholecystitis needs to be rapidly diagnosed and treated correctly. The classic patient characteristics were obese, increasing age, and being female. In a few cases, cholecystitis can occured in an atypical patient, such as in young age. Here, we report a 25-year-old obese female patient that came with right upper abdominal pain which was associated with nausea and vomiting. From imaging studies, we found that she had distended gallbladder with multiple stones. Open cholecystectomy was done and patient did well postoperatively. Acute cholecystitis had to be suspected in all age, especially in patient with another risk factor like obesity in our case. Keywords: acute cholecystitis, gallstone, cholecystectomy

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Section: Discussionmentioning

confidence: 90%

Acute Calculous Cholecystitis in a Young Female Patient: A Unique Case

Shalim¹,

Arianthi²,

Wirawan³

2019

IJMBS

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“…In addition, Croteau et al reported seven cases of acute acalculous cholecystitis occurred in patients with relapsing -remitting multiple sclerosis during or shortly after alemtuzumab treatment, suggesting an acute cytokine release syndrome as a pathogenic mechanism 7 . Gangrenous cholecystitis is caused by ischemia arising from vascular insu ciency and it evolves into necrosis and perforation of the gallbladder wall with bile leakage 8 . Surgical societies released their recommendations to manage surgical disease during the COVID-19 pandemic 9 .…”

Section: Discussionmentioning

confidence: 99%

Acute acalculous cholecystitis on a COVID-19 patient: a case report

Mattone

Sofia

Schembari

et al. 2020

Preprint

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Background coronavirus disease-19 (COVID-19) has spread to several countries around the world and has become an unprecedented pandemic. We report an extremely rare case of acute acalculous cholecystitis on a COVID-19 patient. In our knowledge, this is the first report of laparoscopic cholecystectomy performed on a COVID-19 patient. Case presentation: a COVID-19 patient was diagnosed with acute acalculous cholecystitis and a multidisciplinary team decided to perform a percutaneous transhepatic biliary drainage (PTBD) as the first treatment. SARS-CoV-2 RNA was not found in the bile fluid. Because of deterioration of the patient’s clinical conditions, laparoscopic cholecystectomy had to be performed and since the gallbladder was gangrenous, the severe inflammation made surgery difficult to perform. Conclusions acalculous cholecystitis was related with mechanical ventilation and prolonged total parenteral nutrition, in this case the gangrenous histopathology pattern and the gallbladder wall ischemia was probably caused by vascular insufficiency secondary to severe acute respiratory distress syndrome of COVID-19 pneumonia. The percutaneous transhepatic gallbladder drainage (PTBD) was performed according to Tokyo Guidelines because of high surgical risk. Laparoscopic cholecystectomy was next performed due to no clinical improvement. The absence of viral RNA in the bile highlights that SARS-CoV-2 is not eliminated with the bile while it probably infects small intestinal enterocytes which is responsible of gastrointestinal symptoms such as anorexia, nausea, vomiting, and diarrhea. Although the lack of evidence and guidelines about the management of patient with acute cholecystitis during COVID-19 pandemic, laparoscopic cholecystectomy, at most preceded by PTGBD on high surgical risk patients, remains the gold standard for the treatment of acute cholecystitis on COVID-19 patients.

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“…CTguided intervention, however, is often used in patients where ultrasound is unable to visualize the gallbladder due to anatomy (under-distended gallbladder, overlying bowel loops, or body habitus) or pathology (wall edema or gallstones). 23 Sedation with intravenous midazolam and fentanyl is usually administered at the start. The gallbladder is punctured with an access needle (22-18 gauge) and appropriate needle position can be confirmed by bile aspiration or contrast injection under fluoroscopy.…”

Section: Preprocedural Considerationsmentioning

confidence: 99%

“…This approach is often performed along the long axis of the gallbladder to allow for further interventions such as gallstone removal or stenting. 23…”

Section: Preprocedural Considerationsmentioning

confidence: 99%

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Percutaneous Cholecystostomy: Evidence-Based Current Clinical Practice

Gulaya

Desai

Sato

2016

Semin intervent Radiol

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The role of percutaneous cholecystostomy (PC) in the management of acute cholecystitis and cholangitis is outlined in the revised 2013 Tokyo Guidelines. These two emergencies constitute the vast majority of PC performed today for therapeutic purposes, and research has repeatedly shown the utility of PC in these conditions. PC is typically employed in the management of critically ill patients who are not surgical candidates. Indications and contraindications to PC are reviewed. Additional innovative applications of PC have been developed since it was first described in 1980. These include biliary drainage, dilation of biliary strictures, and stenting of the biliary tree including the common bile duct. Special consideration must be given to the patient selection criteria when deciding who can benefit from PC. Patient comorbidities can also influence the PC technique employed. Both transhepatic and transperitoneal approaches have distinct advantages and disadvantages. The technical success rate for PC is 95 to 100% and the complication rate is extremely low. Most complications are minor.

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Clinical Presentation, Imaging, and Management of Acute Cholecystitis

Cited by 35 publications

References 29 publications

Acute Calculous Cholecystitis in a Young Female Patient: A Unique Case

Acute Calculous Cholecystitis in a Young Female Patient: A Unique Case

Acute acalculous cholecystitis on a COVID-19 patient: a case report

Percutaneous Cholecystostomy: Evidence-Based Current Clinical Practice

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