Abstract

IntroductionGangrenous cholecystitis is a severe complication of acute cholecystitis. We present an unusual case of gangrenous cholecystitis which was totally asymptomatic, with normal pre-operative parameters, and was discovered incidentally during a laparoscopic cholecystectomy. We have not found any similar cases in the published literature.Case presentationA 79-year-old British Caucasian man presented initially with acute cholecystitis which responded to conservative management. After six weeks he was asymptomatic and had normal blood parameters. An elective laparoscopic cholecystectomy was performed and our patient was found to have a totally gangrenous gall bladder.ConclusionIt is important to keep a high index of suspicion for the diagnosis of gangrenous cholecystitis in order to avoid potentially serious complications.

Highlights

  • Gangrenous cholecystitis is a severe complication of acute cholecystitis

  • It is important to keep a high index of suspicion for the diagnosis of gangrenous cholecystitis in order to avoid potentially serious complications

  • Fagan et al [5] demonstrated that nine variables were associated with Gangrenous cholecystitis (GC), but Contini et al [4], showed that there is no single clinical or laboratory finding, apart from a high white cell count (WCC), predictive of severe inflammation of the gallbladder

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Summary

Introduction

Gangrenous cholecystitis (GC) is a serious complication of acute cholecystitis [1,2]. Laboratory investigations on admission showed a WCC 23.7 × 109/L, CRP 148 mg/L, alkaline phosphatase 54 IU/ L, alanine aminotransferase 31 IU/L, bilirubin 12 mmol/ L, amylase

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