Leukocytosis of Unknown Origin: Gangrenous Cholecystitis

Nidimusili, Amara; Alraies, M. Chadi; Eisa, Naseem; Alraiyes, Abdul Hamid; Shaheen, Khaldoon

doi:10.1155/2013/418014

Cited by 7 publications

(7 citation statements)

References 8 publications

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“…It was first discovered and reported in the medical literature in 1976 by J.J. McCoy, Jr., and colleagues. [7] Our study showed gangrenous cholecystitis in 3(2.12%) cases which was similar to the findings of the study conducted by Nidimusili et al and Kayyali et al [8,9] Gangrenous cholecystitis is the end result of gall bladder inflammation that starts from vascular compromise and progresses to ischemia, necrosis and ultimately perforation of the gall bladder wall. Diabetes mellitus, associated cardiovascular diseases, and advanced age are some of the key factors that causes increase in the probability of gangrenous cholecystitis.…”

Section: Discussionsupporting

confidence: 90%

Histopathological Spectrum of Gall Bladder Lesions in A Tertiary Care Hospital in The MalwaBeltA Hospital Based Study

Thukral

Roychoudhury

Bansal

et al. 2018

APALM

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Introduction: Gallbladder stones are commonest disorder among gall bladder lesions and are usually asymptomatic. Its frequency in cholecystectomy specimens is not clear. The aim of this study was to report the morphological variants and frequency of different lesions in cholecystectomy specimens. Objective: To study the various histopathological spectrum of gall bladder lesions. Materials and Methods: In present study we have studied total 141 cases of gall bladder lesion during the period of 6 months from April 2017 to October 2017 in the Dept. of Pathology at Adesh Institute of Medical Sciences and Research, Bathinda. Results: Benign lesions of gall bladder outnumbered the malignant ones with non-neoplastic lesions accounting for 93.6% (132 cases) with chronic calculous cholecystitis contributing the majority of the non-neoplastic lesions (49.64%) followed by cholesterolosis (22.69%), acalculous cholecystitis (4.96%), followed by gangrenous and xanthogranulomatous cholecystitis. Females were predominantly affected in the present study with total 107 cases out of 141 cases-75.8% cases. Most of the non-neoplastic lesions of the gall bladder lesions are common in 3rd, 4th and 5th decades of life. Neoplastic lesions of the gall bladder were common in 5th, 6th and 7th decades of life. Out of 141 cases 5 cases are of adenocarcinoma of gall bladder-3.5% of all cases. The mean age of patient with adenocarcinoma of gall bladder is 60.8 years. Conclusion: Gall bladder lesions were common indication for surgical intervention and pathological evaluation. Most of them were inflammatory lesions with cholelithiasis, however thorough examination is important as these lesions may progress to fatal malignancies.

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Section: Discussionsupporting

confidence: 90%

Histopathological Spectrum of Gall Bladder Lesions in A Tertiary Care Hospital in The MalwaBeltA Hospital Based Study

Thukral

Roychoudhury

Bansal

et al. 2018

APALM

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“…Although one study suggests elevated WBCs are the only predictive factor of GC [14], other studies have aimed to correlate additional factors such as elevated liver enzymes, hyperbilirubinemia, and preoperative SIRS as symptoms of underlying GC in presenting patients [15][16]. Our patient had an upward trend of AST, ALT, bilirubin, and WBCs from the time of admission to the preoperative stage.…”

Section: Discussionmentioning

confidence: 87%

The Use of Systemic Inflammatory Response Syndrome (SIRS) and Elevated Liver Enzymes as Predictive Factors of Gangrenous Cholecystitis: A Case Report

Pyfrom¹,

Ali²,

Ghouse³

et al. 2023

Cureus

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Gangrenous cholecystitis is a severe complication of acute cholecystitis. It is often found incidentally during laparoscopic cholecystectomy or during conversion to open surgery and diagnosed with subsequent pathological analysis. While intraoperative diagnosis is typically through direct visualization of the gallbladder, specific diagnostic modalities may guide physicians toward an earlier diagnosis. Surgical intervention and a more aggressive approach are often needed to prevent the advancement of the disease and its catastrophic complications. This case report illustrates the distinct risk factors predisposing a patient to develop gangrenous cholecystitis. Comorbidities such as hypertension, coronary artery disease, age, the relevance of the SIRS criteria, and elevated liver enzymes are explored as predictive factors in a patient with gangrenous cholecystitis.

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“…23 The WBC may be found higher, up to 17.4 × 10 9 /L in a case of more severe cholecystitis or gangrenous form. 24 The maximal leukocytosis of 20.3 × 10 9 /L was recorded in a case with acute on top of chronic cholecystitis. 25 On the contrary, in patients with non-gangrenous acute cholecystitis, up to 32% had no leukocytosis, and 28% had neither fever nor leukocytosis whereas in patients with gangrenous acute cholecystitis, 27% lacked leukocytosis, and 16% lacked fever and leukocytosis.…”

Section: Discussionmentioning

confidence: 91%

Leukemoid Reaction in a Case of Chronic Cholecystitis With Focal Mild Acute Inflammation

2021

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Leukemoid reaction is a rare condition of marked increase of the white blood cells (WBC) in the peripheral blood, mostly more than 50 × 109/L. Although its most common cause is infection, acute or chronic cholecystitis has been hardly mentioned. This report aimed to present the leukemoid reaction found in a Thai who had chronic cholecystitis with focal acute inflammation. A 74-year-old woman had low-graded fever and generalized vague abdominal discomfort for 2 days. The physical examination showed the body temperature 37.7 °C and unremarkable abdominal signs. Her blood tests showed: hemoglobin 9.0 g/L, WBC 52.48 × 109/L, neutrophil 91%, band form 1%, platelet 434 × 109/L, and alkaline phosphatase (ALP) 290 U/L. The blood cultures yielded no growth. The computed tomography of the abdomen revealed 2 stones in the common bile duct (CBD) causing obstruction; the gall bladder (GB) showed mild dilatation with thin wall containing multiple small gall stones; no pericholecystic fluid and normal size of spleen. She promptly underwent operative cholecystectomy, CBD choledochoscopy, stones removal and T-tube choledochostomy. Along with the surgery, intravenous ertapenem was also administered. The pathology of the gall bladder was chronic cholecystitis with focal mild acute inflammation. With these therapies, fever daily decreased and finally disappeared within 5 days meanwhile the WBC count also gradually diminished every day till 8.04 × 109/L within 7 days. The WBC count was still normal one month later. The diagnosis of leukemoid reaction was concluded and it was presumably be associated with chronic calculous cholecystitis with focal acute inflammation although the BCR-ABL translocation had never been explored.

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Leukocytosis of Unknown Origin: Gangrenous Cholecystitis

Cited by 7 publications

References 8 publications

Histopathological Spectrum of Gall Bladder Lesions in A Tertiary Care Hospital in The MalwaBeltA Hospital Based Study

Histopathological Spectrum of Gall Bladder Lesions in A Tertiary Care Hospital in The MalwaBeltA Hospital Based Study

The Use of Systemic Inflammatory Response Syndrome (SIRS) and Elevated Liver Enzymes as Predictive Factors of Gangrenous Cholecystitis: A Case Report

Leukemoid Reaction in a Case of Chronic Cholecystitis With Focal Mild Acute Inflammation

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