Recurrent Cholecystitis Due to Gallstone Obstruction of a Lumen-Apposing Metal Stent

Abstract

An 86-year-old man with limited performance and substantial comorbidity presented to the emergency department with fever, upper abdominal discomfort, and confusion. His medical history noted an endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis with a lumen-apposing metal stent 22 days prior. On admission, his hematology tests were unremarkable except for elevated C-reactive protein (125 mg/L [reference range, <10 mg/L]). Computed tomography revealed a recurrent cholecystitis with a gallstone obstructing the lumen-apposing metal stent (orange arrow, Figure A), with 2 larger stones in the gallbladder (red arrow, Figure A).