Al-Nowfal Ahmed, Al-Abed Yahya A
Department of Surgery, Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex, UK.
Int Med Case Rep J. 2016 Jun 2;9:135-7. doi: 10.2147/IMCRJ.S100648. eCollection 2016.
Biliary colic is a common clinical presentation, with the majority of cases being related to gallstone disease. However, rarely, patients may present with biliary symptoms without evidence of gallbladder stones - referred to as acalculous gallstone disease. This case report details a rare case of chronic biliary colic associated with ketamine abuse.
A 24-year-old Caucasian female presented to the emergency department with a history of intermittent right upper quadrant pain associated with nausea and malaise. She had experienced bouts of similar symptoms three times a year for the past 4 years. Various investigations had been conducted during her multiple admissions, which showed possible dilatation of the common bile duct, with no evidence of gallstones.
Patients can present with a dilated common bile duct and an acalculous cholecystitis. This requires considerable investigation, with an emphasis on drug history, especially with the current rise of recreational hallucinogenic drug abuse.