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Progression of Acute Acalculous Cholecystitis to Gallbladder Perforation in a Hospitalized Old Patient and Managed by Percutaneous Drainage
摘要
A-79-year old male patient suffered from fever, diarrhea, and right upper quadrant pain. Leukocytosis and urinary tract infection were noted. Computed tomography (CT) was performed, and the diagnosis of acute cholecystitis and right pleural effusion was made. Conservative treatment with antibiotics was given. However, right upper quadrant pain persisted for 6 days. Repeated CT revealed worsening of acute cholecystitis and right pleural effusion, and development of localized pericholecystic fluid accumulation which was probably a pericholecystic abscess. Percutaneous cholecystostomy and drainage of the abscess were carried out. Antibiotics were changed based on the cultures of the abscess and the urine. Percutaneous drainage of the right pleural effusion was performed due to the patient's dyspnea. The patient had an uneventful course during the 27 days of hospitalization.