Natacha Helena Uryu, Giovana de Figueiredo Godoy, Wellington Forte Alves Junior, Isabel Butter Amim, Emilia Virginia Lima Curvelo Fontes, Adriano Corona Branco and José Francisco de Mattos Farah*
Department of Surgery, Hospital do Servidor Público Estadual, BrazilFulltext PDF
The development of a liver abscess linked to gall bladder perforation represents a rare complication of acute cholecystitis. Mortality rates of patients with gall bladder perforation vary from 12% to 16%, of which 86.6% gall bladder perforations are associates to cholelithiasis. Treatment for the rare association between complications of cholecystitis are divergent in the literature, however recent publications reveal a tendency towards using minimally invasive techniques during surgical treatment. A 72-year-old male with history of hypertension and diabetes, presenting abdominal pain, anorexia, and jaundice. Image exams indicated cholecystitis with surrounding abscess formation and a distant abscess, also identifying choledocholithiasis. Topography of the etiology had a significant role when choosing the order of the treatments of the different complications. Several non invasive procedures were applied prior to performing laparoscopic surgery. The patient recovered well and was discharged after 22 days. We believe an individualized approach is at the core of quality patient care. There is a consensus among several authors that the initial control of the septic state in which most patients are found is essential, however, it is important to emphasize that the identification of the correct primary infectious site can help determine the succession of treatments which can also positively influence the outcome of the case.
Acute abdomen; Cholecystectomy; Cholecystostomy; Choledocholithiasis; Laparoscopic; Gall bladder; Liver abscess; Sepsis; Surgery
Uryu NH, de Figueiredo Godoy G, Alves Junior WF, Amim IB, Lima Curvelo Fontes EV, Branco AC, et al. Rare Association between Gallbladder Perforation, Distant Hepatic Abscess Formation and Choledocolithiasis: Case Report and Literature Review. Ann Clin Case Rep. 2022; 7: 2192..