Symptomatic Cholelithiasis of a Remnant Gallbladder after Open Cholecystectomy.

Authors:
Cameron P Upchurch
Cameron P Upchurch
Vanderbilt University Medical Center
Nathan L Haas
Nathan L Haas
University of Michigan
Ann Arbor | United States
Jeffrey Compton
Jeffrey Compton
University of Michigan
Ann Arbor | United States

J Emerg Med 2018 09 23;55(3):e71-e73. Epub 2018 Jun 23.

Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan.

Background: Recurrent abdominal pain, particularly in the right upper quadrant (RUQ) in a patient with a history of cholecystectomy, known as postcholecystectomy syndrome, requires a broad differential diagnosis. Pathology of a retained gallbladder remnant is an exceedingly rare etiology of this pain.

Case Report: A 49-year-old woman who had previously undergone an open cholecystectomy presented to the emergency department with several hours of postprandial RUQ pain and emesis. Liver function tests and lipase were not significantly elevated. RUQ ultrasonography revealed a cystic structure containing a stone with mild prominence of the common bile duct at 7 mm, and magnetic resonance cholangiopancreatography confirmed the presence of a remnant gallbladder without common bile duct obstruction. Her pain subsided, she tolerated a diet, and was discharged with a referral for an elective cholecystectomy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Abdominal pain is the most common chief complaint of patients presenting to the emergency department in the United States, and emergency physicians routinely encounter patients with postcholecystectomy syndrome. Emergency physicians should not exclude the possibility of remnant gallbladder pathology, such as symptomatic cholelithiasis or cholecystitis, in patients presenting with symptoms concerning for biliary colic, even if the patient has undergone previous cholecystectomy.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jemermed.2018.05.028DOI Listing
September 2018
17 Reads

Publication Analysis

Top Keywords

remnant gallbladder
12
open cholecystectomy
8
emergency department
8
patients presenting
8
postcholecystectomy syndrome
8
abdominal pain
8
emergency physicians
8
symptomatic cholelithiasis
8
common bile
8
bile duct
8
cholecystectomy
5
emergency
5
routinely encounter
4
ruq ultrasonography
4
elevated ruq
4
encounter patients
4
structure stone
4
lipase elevated
4
stone mild
4
cystic structure
4

Similar Publications