Acute acalculous cholecystitis – a rare postoperative complication following kidney transplantation

Abstract

BACKGROUND: While acute cholecystitis in patients with gallstone disease is a known event after transplantation, acalculous cholecystitis complicating kidney transplantation is extremely rare. METHODS (CASE REPORT): We report two patients with acalculous cholecystitis in the early postoperative course of kidney transplantation. RESULTS: Both patients presented with prolonged postoperative paralysis in the early post transplant course. Due to increasing clinical symptoms of an acute abdomen they underwent emergency laparotomy at postoperative days 8 and 9 respectively. The intraoperative situs revealed necrotizing cholecystitis in both, with perforation and biliary peritonitis in one patient. They underwent cholecystectomy, lavage and drainage and were finally discharged with acceptable graft function. CONCLUSIONS: Acute acalculous cholecystitis is a rare, but major complication following kidney transplantation. Awareness is mandatory, because clinical symptoms are not specific. Surgical source control consists of cholecystectomy and enables good transplant function to be restored.