An unexpected case of perforated acalculous acute cholecystitis caused by a fish bone

  Gastroenterology & Hepatology General Surgery

  Nicolae-Iustin Berevoescu

Now published in Journal of Gastrointestinal and Liver Diseases doi: 10.15403/jgld-165

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Abstract

The gallbladder inflammation is most often determined by the presence of gallstones. In the absence of this etiological factor, acute acalculous cholecystitis usually occurs in patients with multiple comorbidities or with an immunosuppressed status, and therefore its evolution is faster and more severe compared to acute calculous cholecystitis. Although it is known that the presence of a fish bone in the peritoneal cavity, through a gastrointestinal fistula is not quite rare, however, acute cholecystitis caused by a fish bone is very unexpected. Here, we present a case of a 75-year-old woman who ate fish two months before and presented at the Emergency Room with perforated acalculous acute cholecystitis and right subphrenic abscess The laparoscopy was performed, followed by the evacuation of the subphrenic abscess through aspiration, the bipolar cholecystectomy and the removal of a fish bone from nearby the cystic duct. Postoperative evolution was good, with hospital discharge of patient after five days. Two months later, good health, without any clinical complaints.

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