Gorgan Madalina-Maria, Grigorescu Ioana, Dumitrascu Dan L
2 Medical Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Eur J Case Rep Intern Med. 2016 Sep 12;3(6):000472. doi: 10.12890/2016_000472. eCollection 2016.
Acute cholecystitis after colonoscopy is a rare event, with less than 10 cases described in the literature. We report the case of a male patient with silent gallstones who underwent colonoscopy for follow-up of his Crohn's disease. The colonoscopy revealed erosions in the terminal ileum, from which biopsies were taken. A sessile polyp 4 mm in diameter at the recto-sigmoid junction was also removed. Less than 24 h after the colonoscopy, the patient complained of upper right quadrant pain, nausea and vomiting. Based on the clinical findings, laboratory data and ultrasonography, we diagnosed acute cholecystitis and excluded any complication after the colonoscopy. Laparoscopic cholecystectomy was performed and the patient was discharged.
Cholecystitis following colonoscopy can be a rare complication or a coincidence.Rarely, manoeuvres during colonoscopy may dislodge small gallstones which then obstruct the bile duct causing acute cholecystitis.Imaging and the clinical picture help to differentiate bowel perforation, a fairly common early event after colonoscopy, from other complications.
结肠镜检查后发生急性胆囊炎是一种罕见事件，文献中报道的病例不足10例。我们报告一例患有静止性胆结石的男性患者，其因克罗恩病随访接受了结肠镜检查。结肠镜检查发现回肠末端有糜烂，并取了活检。还切除了直肠乙状结肠交界处一个直径4毫米的无蒂息肉。结肠镜检查后不到24小时，患者出现右上腹疼痛、恶心和呕吐。根据临床表现、实验室数据和超声检查，我们诊断为急性胆囊炎，并排除了结肠镜检查后的任何并发症。实施了腹腔镜胆囊切除术，患者出院。
结肠镜检查后胆囊炎可能是一种罕见的并发症或巧合。很少情况下，结肠镜检查过程中的操作可能会使小胆结石移位，进而阻塞胆管导致急性胆囊炎。影像学检查和临床表现有助于将结肠镜检查后相当常见的早期事件——肠穿孔与其他并发症区分开来。
