Abstract
Gangrenous cholecystitis (GC) is a serious complication of acute cholecystitis that
has been associated with increased morbidity. Patient with GC can present with a wide
variety of non-specific clinical, laboratory, and imaging characteristics, making
the diagnosis challenging. This disease requires emergent treatment, which is why
a quick and reliable diagnosis is essential for the wellbeing of the patient. The
authors herein present a case of GC in a patient whose initial complaint was intractable
hiccups, and provide a thorough review of the literature of cases of GC with atypical
presentations.
Abbreviations:
mm Hg (millimeter of mercury), mg/dl (milligrams per deciliter), /cu∙mm (per one cubic millimeter), ×103 (thousand), Afib (atrial fibrillation), ALT (alanine transaminase), AS (aortic stenosis), AST (aspartate transaminase), C (cholecystitis), CA (cancer), CBD (common bile duct), CKD (chronic kidney disease), CRP (C-reactive protein), CT (computed topography), DMII (diabetes mellitus II), ED (emergency department), ERCP (endoscopic retrograde cholangiopancreatography), GC (gangrenous cholecystitis), GERD (gastroesophageal reflux disease), GGT (gamma-glutamyl transferase), HTN (hypertension), ILD (interstitial lung disease), IU/L (international units per liter), N/V (nausea and vomiting), O2 (oxygen), RUQ (right upper quadrant), SGOT (serum glutamic oxaloacetic transaminase), SGPT (serum glutamic pyruvic transaminase), SPS (statistical package for social sciences), T (temperature), WBC (white blood cell)Keywords
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References
- Acute cholecystitis.BMJ [Br Med J]. 2002; 325: 639-643
- Gangrenous cholecystitis: analysis of imaging findings in histopathologically confirmed cases.Indian Journal of Radiology and Imaging. 2018; 28: 49-54
- Factors affecting morbidity and mortality in gangrenous cholecystitis.vol. 106. 2006: 545-549
- Current diagnosis and treatment of cholecystitis.Curr Surg. 2002; 59: 51-54
- Gangrenous cholecystitis: analysis of risk factors and experience with laparoscopic cholecystectomy.Surgery. 1999; 126 ([discussion 685-6]): 680-685
- A comparative appraisal of emphysematous cholecystitis.Am J Surg. 1975; 129: 10-15
- Outcomes of contemporary management of gangrenous and non-gangrenous acute cholecystitis.HPB (Oxford). 2011; 13: 551-558
- Clinically diagnosed cholecystitis: a case series.Neurol J Surg Case Rep. 2018; 2018 ([pp. rjy031-rjy031])
- Old man gallbladder syndrome: gangrenous cholecystitis in the unsuspected patient population.Int J Surg Case Rep. 2015; 11: 46-49
- Emergency department evaluation of geriatric patients with acute cholecystitis.Acad Emerg Med. 1997; 4: 51-55
- Gangrenous cholecystitis: mortality and risk factors.Int Surg. 2015; 100: 254-260
- Prognostic factors for the development of gangrenous cholecystitis.Am J Surg. 2003; 186: 481-485
- Development of symptoms and complications in individuals with asymptomatic gallstones.Br J Surg. 2004; 91: 734-738
- The impact of patient delay and physician delay on the outcome of laparoscopic cholecystectomy for acute cholecystitis.Am J Surg. 1999; 178: 303-307
- Gangrenous cholecystitis in the laparoscopic era.Aust N Z J Surg. 2000; 70: 428-430
- Hiccup: mystery, nature and treatment.Journal of Neurogastroenterology and Motility. 2012; 18: 123-130
- Nausea, vomiting, and hiccups: a review of mechanisms and treatment.Anesth Prog. 2010; 57: 150-157
- Persistent hiccups.BMJ. 1992; 305: 1237-1238
- Gag reflex for arrest of hiccups.Med Hypotheses. 2005; 65: 1206
- Can gangrenous cholecystitis be prevented?: a plea against a “wait and see” attitude.J Clin Gastroenterol. 2004; 38: 710-716
- Predictive factors for the type of surgery in acute cholecystitis.Am J Surg. 2001; 182: 291-297
- CT findings in acute gangrenous cholecystitis.AJR Am J Roentgenol. 2002; 178: 275-281
- Gangrenous cholecystitis in the decade before and after the introduction of laparoscopic cholecystectomy.JSLS: Journal of the Society of Laparoendoscopic Surgeons. 2005; 9: 169-173
- Gallbladder perforation: risk factors and outcome.J Surg Res. 2006; 131: 204-208
- Gangrenous Cholecystitis with Atypical Presentation in an Elderly Diabetic Woman.Case Rep Clin Med. 2014; 3: 503-507
- Hiccups can be serious: Gangrenous cholecystitis. Case report.J Am Geriatr Soc. 2011; 59 (SUPPL. 1)
- No stones about it, atypical disease presentation delays diagnosis: A case of missed cholecystitis leading to perforation in an elderly patient.J Am Geriatr Soc. 2018; 2018 (Supplement 2): S25-S26
Article Info
Publication History
Published online: August 17, 2018
Accepted:
August 16,
2018
Received:
August 14,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
