Gallbladder perforation in cholecystitis with liver abscess formation and septic thrombophlebitis of portal vein mimicking presentation of liver malignancy

ADVANCES IN DIGESTIVE MEDICINE - Tập 1 - Trang 95-99 - 2014
Hsin-Chi Lin1,2, Tseng-Shing Chen2,3
1Division of Gastroenterology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan
2Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
3Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

Tóm tắt

SummaryGallbladder perforation is a rare complication of cholecystitis. Similarly, septic thrombophlebitis of the portal vein, also called pylephlebitis, is another rare complication of intra‐abdominal infections including cholecystitis. Both gallbladder perforation and pylephlebitis are associated with significantly higher morbidity and mortality. Herein, we report a patient with an atypical presentation of gallbladder perforation and liver abscess formation. A 68‐year‐old man suffered from malaise, poor appetite, and body weight loss for 1 month. Liver mass lesion and portal vein thrombosis were detected by ultrasound at a local clinic. He was referred to our institution under the tentative diagnosis of hepatocellular carcinoma. He underwent abdominal ultrasound and computed tomography examinations at our hospital. Cholecystitis with gallbladder perforation was highly suspected. Broad‐spectrum antibiotics were administered immediately. Percutaneous transhepatic gallbladder drainage was performed in this case, and pigtail drainage for liver abscess was done later. The patient's condition—cholecystitis, liver abscess, and pylephlebitis (followed by ultrasound)—improved after treatment. Furthermore, the patient recovered his appetite and his body weight increased.

Tài liệu tham khảo

10.1097/00000658-193499060-00005 Date R.S., 2012, Gallbladder perforation: case series and systematic review, Int J Surg, 10, 63, 10.1016/j.ijsu.2011.12.004 10.1097/00000658-196611000-00010 Williams N.F., 1976, Perforation of the gallbladder: analysis of 19 cases, Can Med Assoc J, 115, 1223 Aljiffry M., 2008, Type II gall bladder perforation with abdominal wall abscess in a cirrhotic patient: case report and review of the literature, J Surg Educ, 65, 367, 10.1016/j.jsurg.2008.07.004 Derici H., 2006, Diagnosis and treatment of gallbladder perforation, World J Gastroenterol, 12, 7832, 10.3748/wjg.v12.i48.7832 Sood B.P., 2002, Role of sonography in the diagnosis of gallbladder perforation, J Clin Ultrasound, 30, 270, 10.1002/jcu.10071 Tsai M.J., 2009, Can acute cholecystitis with gallbladder perforation be detected preoperatively by computed tomography in ED? Correlation with clinical data and computed tomography features, Am J Emerg Med, 27, 574, 10.1016/j.ajem.2008.04.024 Singal R., 2011, Management of gall bladder perforation evaluation on ultrasonography: report of six rare cases with review of literature, J Med Life, 4, 364 Morris B.S., 2007, The CT appearances of gallbladder perforation, Br J Radiol, 80, 898, 10.1259/bjr/28510614 10.1016/j.jss.2005.11.580 Derici H., 2011, Gallbladder perforation: clinical presentation, predisposing factors, and surgical outcomes of 46 patients, Turk J Gastroenterol, 22, 505, 10.4318/tjg.2011.0246 Ames J.T., 2011, Septic thrombophlebitis of the portal venous system: clinical and imaging findings in thirty‐three patients, Digest Dis Sci, 56, 2179, 10.1007/s10620-010-1533-6 Chirinos J.A., 2006, Septic thrombophlebitis: diagnosis and management, Am J Cardiovasc Drugs, 6, 9, 10.2165/00129784-200606010-00002 Choi S.H., 2004, Relationship between various patterns of transient increased hepatic attenuation on CT and portal vein thrombosis related to acute cholecystitis, AJR Am J Roentgenol, 183, 437, 10.2214/ajr.183.2.1830437 Kochar K., 2008, Intrahepatic perforation of the gall bladder presenting as liver abscess: case report, review of literature and Niemeier's classification, Eur J Gastroenterol Hepatol, 20, 240, 10.1097/MEG.0b013e3282eeb520 Hsu S.C., 2012, Successful staged treatment for acute cholecystitis complicated by portal vein thrombosis, Am Surg, 78, E19, 10.1177/000313481207800112
Thông tin
Thông tin xuất bản

ADVANCES IN DIGESTIVE MEDICINE

Tập 1

95-99

Thông tin tác giả