一名患有类固醇诱导型糖尿病患者的急性胆囊炎的困难鉴别诊断

Masui Yoshinori, Sako Akahito, Tsuda Naonori, Nishimura So, Seyama Yasuji, Nishida Masato, Shindo Junichi, Sakamoto Takaaki, Kaneko Hiroshi, Yanai Hidekatsu

Department of Internal Medicine, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba 272-8516, Japan.

J Clin Med Res. 2011 Dec;3(6):331-3. doi: 10.4021/jocmr752w. Epub 2011 Nov 10.

UNLABELLED

An impairment of gallbladder motility due to autonomic neuropathy may cause cholestasis and result in gallbladder stone formation. Diabetes is one of risk factors for acute cholecystitis. Diabetes and steroid use are associated with the susceptibility to bacterial infections, we are apt to diagnose steroid-induced diabetic patients manifesting symptoms of cholecystitis as having acute bacterial infective cholecystitis. Here, we report a very rare steroid-induced diabetic patient complicated with gallbladder torsion-induced necrotizing cholecystitis due to a floating gallbladder.

KEYWORDS

Cholecystitis; Diabetes; Floating gallbladder; Torsion.

摘要

自主神经病变导致的胆囊动力障碍可能会引起胆汁淤积并导致胆囊结石形成。糖尿病是急性胆囊炎的危险因素之一。糖尿病和使用类固醇与细菌感染易感性相关，我们容易将表现出胆囊炎症状的类固醇诱导糖尿病患者诊断为急性细菌性感染性胆囊炎。在此，我们报告一例非常罕见的类固醇诱导糖尿病患者，该患者因胆囊漂浮并发胆囊扭转导致坏死性胆囊炎。