Department of General and Digestive Surgery, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
Rev Esp Enferm Dig. 2011 Aug;103(8):431-3. doi: 10.4321/s1130-01082011000800009.
the patients affected by systemic lupus erythematosus (SLE) often suffer gastrointestinal symptoms. The differential diagnosis should contemplate pathology of the gall bladder. We present the case of a patient with hemorrhagic lithiasic cholecystitis and hemobilia.
24 year old female diagnosed with SLE under treatment with Sintrom®, Dacortin® and Dolquine® that presented acute lithiasic cholecystitis and hemobilia with a distal calculus. Cholecystectomy and aperture of the ductus choledochus were performed allowing to confirm the hemobilia and to extract the calculus.
The treatment of cholecystitis in the patients with SLE is controversial due to the fact that most reviewed cases have been solved with cholecystectomy, or in other cases with conservative treatment with corticosteroids. We believe that the presence of cholelithiasis in a patient with SLE with pain on the right hypochondrium and ultrasound confirming the suspicion of cholecystitis demands a surgical treatment since the cause may be vascular, lithiasic or combined. Besides, the possible complications will not respond to pharmaceutical treatment.
患有系统性红斑狼疮 (SLE) 的患者常伴有胃肠道症状。鉴别诊断应考虑胆囊病变。我们报告了一例患有出血性胆石性胆囊炎和胆血症的患者。
24 岁女性，诊断为 SLE，正在接受 Sintrom®、Dacortin®和 Dolquine®治疗，表现为急性胆石性胆囊炎和胆血症，伴有远端结石。行胆囊切除术和胆总管切开术，以确认胆血症并取出结石。
SLE 患者的胆囊炎治疗存在争议，因为大多数回顾性病例均通过胆囊切除术解决，或者在其他情况下通过皮质类固醇保守治疗。我们认为，对于右季肋部疼痛且超声检查怀疑胆囊炎的 SLE 患者，如果存在胆石症，则需要手术治疗，因为病因可能是血管性、胆石性或混合性的。此外，药物治疗可能无法应对潜在的并发症。
