Idiopathic eosinophilic cholecystitis with cholelithiasis: A Case Report And Review Of Literature

Abstract

Eosinophilic cholecystits is a rare form of cholecystitis in which eosinophils form the dominant component of inflammatory cells in the gallbladder wall. It is an acalculous cholecystitis but in rare cases it presents with cholelithiasis. It is frequently associated with severe diseases like eosinophilia-myalgia syndrome, hypereosinophilic syndrome, parasitic infestations or with drug intake. A 41-year-old man presented to us with complaints of abdominal pain and tenderness and guarding in the right upper quadrant. Ultrasonography of the abdomen showed a distended gallbladder with multiple calculi. During open cholecystectomy, a partially intrahepatic gallbladder with serosal congestion was found. Microscopic examination of the gallbladder showed eosinophils forming more than 90% of the inflammatory infiltrate. Eosinophils were present in all layers of the gallbladder. A histopathologic diagnosis of idiopathic eosinophilic cholecystitis with cholelithiasis was made. We present this case because of the rare occurrence of eosinophilic cholecystitis, the rarity of association of idiopathic eosinophilic cholecystitis with cholelithiasis and the need to investigate the patient meticulously for other associated disease conditions, which might have a worse prognosis than cholecystits itself.