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新型冠状病毒感染引起的急性非结石性胆囊炎:一例报告及文献综述

Acute acalculous cholecystitis caused by SARS-CoV-2 infection: A case report and literature review.

作者信息

Futagami Hana, Sato Hiroki, Yoshida Ryuichi, Yasui Kazuya, Yagi Takahito, Fujiwara Toshiyoshi

机构信息

Center for Graduate Medical Education, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.

Department of Gastroenterological Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.

出版信息

Int J Surg Case Rep. 2022 Jan;90:106731. doi: 10.1016/j.ijscr.2021.106731. Epub 2021 Dec 29.

Abstract

BACKGROUND

Emerging data indicate that gastrointestinal disorders, in addition to pulmonary dysfunction, are also hallmarks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

CASE PRESENTATION

A 42-year-old man with maintenance hemodialysis developed high fever and dyspnea. He was positive for SARS-CoV-2 and was diagnosed with pneumonia. After treatment for SARS-CoV-2, his respiratory condition improved. However, he developed right upper quadrant pain with elevated inflammatory markers (white blood cells, 21,160/μL; c-reactive protein, 163.9 mg/L) on the 13th day. Abdominal computed tomography revealed acute acalculous cholecystitis. Percutaneous transhepatic gallbladder drainage (PTGBD) was performed together with antibiotic therapy, which resulted in improvement of symptoms. Laparoscopic cholecystectomy was performed 36 days after PTGBD.

CONCLUSION

We report a rare case of acute acalculous cholecystitis (AAC) following pneumonia caused by SARS-CoV-2 infection. We also conducted a literature search to characterize SARS-CoV-2-related cholecystitis. Infection with SARS-CoV-2 is an important trigger for AAC, and appropriate therapeutic alternatives should be cautiously selected according to individual cases.

摘要

背景

新出现的数据表明,除了肺功能障碍外,胃肠道疾病也是严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的特征。

病例介绍

一名维持性血液透析的42岁男性出现高热和呼吸困难。他的SARS-CoV-2检测呈阳性,被诊断为肺炎。经过SARS-CoV-2治疗后,他的呼吸状况有所改善。然而,在第13天,他出现了右上腹疼痛,炎症指标升高(白细胞,21,160/μL;C反应蛋白,163.9mg/L)。腹部计算机断层扫描显示急性非结石性胆囊炎。在进行抗生素治疗的同时进行了经皮经肝胆管胆囊引流术(PTGBD),症状得到改善。在PTGBD后36天进行了腹腔镜胆囊切除术。

结论

我们报告了一例由SARS-CoV-2感染引起的肺炎后罕见的急性非结石性胆囊炎(AAC)病例。我们还进行了文献检索,以描述与SARS-CoV-2相关的胆囊炎。SARS-CoV-2感染是AAC的重要触发因素,应根据个体情况谨慎选择合适的治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4534/8749190/8db2b269e483/gr1.jpg

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