伴有罕见影像学表现的出血性胆囊炎：一则病例报告及对 NSAIDs 被忽视用药史的教训。
Hemorrhagic cholecystitis with rare imaging presentation: a case report and a lesson learned from neglected medication history of NSAIDs.
机构信息
Department of Radiology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Department of Surgery, Shengzhou People's Hospital, Shengzhou, 312400, China.
出版信息
BMC Gastroenterol. 2020 Jun 5;20(1):172. doi: 10.1186/s12876-020-01312-0.
BACKGROUND
Gallbladder carcinogenesis, frequently occurredin chronic cholecystitis patients, requires radical resection. We herein describe a hemorrhagic cholecystitis case that failed to be differentiated from gallbladder cancer preoperatively owing to the neglected medication history of long term oral nonsteroidal anti-inflammatory drugs (NSIADs) intake.
CASE PRESENTATION
A 57-year-old Chinese female was admitted for right upper quadrant pain with the initial diagnosis of cholecystitis. Radiological studies were unable to exclude the differential diagnosis of suspected gallbladder cancer. During the scheduled radical resection of the suspected lesions, the gross dissection showed an interesting presentation of hemorrhagic cholecystitis, without any pathological evidence of malignancies. Additional postoperative investigation revealed a neglected medication history of long-term NSAIDs use.
CONCLUSIONS
This case suggests the importance of preoperative review of medication history and patient education on prescription drug abuse.
背景
胆囊癌常发生于慢性胆囊炎患者，需要进行根治性切除。我们在此描述了一例因长期口服非甾体抗炎药（NSAIDs）而被忽视的用药史，术前未能将其与胆囊癌区分开来的出血性胆囊炎病例。
病例介绍
一名 57 岁中国女性因右上腹疼痛就诊，最初诊断为胆囊炎。影像学研究无法排除疑似胆囊癌的鉴别诊断。在预定的疑似病变根治性切除术中，大体解剖显示出有趣的出血性胆囊炎表现，没有任何恶性肿瘤的病理证据。术后进一步调查发现，患者长期存在被忽视的 NSAIDs 用药史。
结论
该病例提示术前审查用药史和对处方药物滥用的患者教育的重要性。
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