A Case Report of Sepsis Secondary to Perforated Cholecystitis in the Presence of Severe Aortic Stenosis: Diagnosis and Management

Gallbladder perforation is a rare complication of acute cholecystitis that is associated with significant morbidity and mortality. Many cases of gallbladder perforation are not diagnosed until surgery, as the physical symptoms closely mimic acute cholecystitis. Gallbladder perforation is most common...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-05, Vol.16 (5), p.e60382-e60382
Main Authors: Rahman, Austin, Collignon, Taylor E, Smith, Jason
Format: Article
Language:English
Subjects:
Abdomen
Aortic stenosis
Blood pressure
Cardiac/Thoracic/Vascular Surgery
Cardiovascular disease
Case reports
Creatinine
Emergency Medicine
Gallbladder
Gallbladder diseases
General Surgery
Hemoglobin
Hospitals
Hypertension
Leukocytes
Medical diagnosis
Nausea
Pain
Patients
Peritonitis
Phosphatase
Sepsis
Surgery
Tomography
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Summary:Gallbladder perforation is a rare complication of acute cholecystitis that is associated with significant morbidity and mortality. Many cases of gallbladder perforation are not diagnosed until surgery, as the physical symptoms closely mimic acute cholecystitis. Gallbladder perforation is most common among older males with associated comorbidities, and preoperative assessment of comorbidities, particularly cardiac, is critical to determine the appropriate clinical course. We report a case of a 77-year-old male who presented initially with low blood pressure and right upper quadrant pain (RUQ) after not feeling well for five days. CT of the abdomen/pelvis with IV contrast demonstrated acute perforated cholecystitis, and general surgery was consulted for a cholecystectomy. Due to the patient's past medical history of severe aortic stenosis (AS), cholecystectomy was deferred and a cholecystostomy tube was placed by interventional radiology. This report aims to provide an example of a case of perforated cholecystitis with sepsis and how it can be diagnosed and managed non-surgically in the presence of pre-existing severe AS.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.60382