Saudi Journal of Gastroenterology
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Year : 2007  |  Volume : 13  |  Issue : 3  |  Page : 153-154
A 70 year old male with abdominal pain


Department of Surgical Specialties, King Fahad Specialist Hospital, Dammam, Eastern Province, Saudi Arabia

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How to cite this article:
Meshikhes AWN, Al-Najjar H. A 70 year old male with abdominal pain. Saudi J Gastroenterol 2007;13:153-4

How to cite this URL:
Meshikhes AWN, Al-Najjar H. A 70 year old male with abdominal pain. Saudi J Gastroenterol [serial online] 2007 [cited 2019 Jul 22];13:153-4. Available from: http://www.saudijgastro.com/text.asp?2007/13/3/153/33472


A 70-year-old male was admitted because of fatigability, right hypochondriac and right iliac fossa pain and vomiting of one day's duration. He was a known hypertensive and diabetic on oral hypoglycemics. On examination, his vital signs were normal, but there was tenderness on deep palpation of his right hypochondrial area. His white cell count was normal, but his liver enzyme levels were elevated and the urine was turbid with many pus cells and abundant bacteria. Citrobacter braakii was isolated on urine culture, so he was treated initially for urinary tract infection.

Abdominal ultrasonography showed a small hypoechoic liver lesion and thick-walled gallbladder with stones. Further evaluation of the liver lesion confirmed liver hemangioma. He was discharged but was readmitted with right upper quadrant pain and fever. He was not jaundiced or tachycardic but was pyrexial (temperature 38.5C) and the gallbladder was palpable and tender. The leukocyte count was normal but liver enzymes were moderately elevated. Plain abdominal X-ray and computed tomographic (CT) scan were performed [Figure - 1],[Figure - 2].


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   References Top

1.Alvarez C, Hunt K, Ashley SW, Reber HA. Emphysematous cholecystitis after ERCP. Dig Dis Sci 1994;39:1719-23.  Back to cited text no. 1  [PUBMED]  
2.Garcia-Sancho Tellez L, Rodriguez-Montes JA, Fernandez de Lis S, Garcia-Sancho Martin L. Acute emphysematous cholecystitis. Report of twenty cases. Hepatogastroenterology 1999;46:2144-8.  Back to cited text no. 2    
3.Moanna A, Bajaj R, del Rio C. Emphysematous cholecystitis due to Salmonella derby. Lancet Infect Dis 2006;6:118-20.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Wu CS, Yao WJ, Hsiao CH. Effervescent gallbladder: Sonographic findings in emphysematous cholecystitis. J Clin Ultrasound 1998;26:272-5.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]
5.Bennett GL, Balthazar EJ. Ultrasound and CT evaluation of emergent gallbladder pathology. Radiol Clin North Am 2003;41:1203-16.  Back to cited text no. 5  [PUBMED]  
6.Bouras G, Lunca S, Vix M, Marescaux J. A case of emphysematous cholecystitis managed by laparoscopic surgery. JSLS 2005;9:478-80.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]
7.Vingan HL, Wohlgemuth SD, Bell JS 3 rd . Percutaneous cholecystostomy drainage for the treatment of acute emphysematous cholecystitis. AJR Am J Roentgenol 1990;155:1013-4.  Back to cited text no. 7    
8.Gill KS, Chapman AH, Weston MJ. The changing face of emphysematous cholecystitis. Br J Radiol 1997;70:986-91.  Back to cited text no. 8  [PUBMED]  [FULLTEXT]

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Correspondence Address:
Abdul-Wahed N Meshikhes
Department of Surgical Specialties, King Fahad Specialist Hospital, Dammam, Eastern Province
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.33472

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