Perihepatic abscess formation in diabetes: a complication of silent gallstones
Forbes, L.E.; Bajaj, M.; McGinn, T.; Berlin, A.
American Journal of Gastroenterology 91(4): 786-788
1996
ISSN/ISBN: 0002-9270 PMID: 8677951 Document Number: 457460
Perforation of the gallbladder is a serious complication of acute cholecystitis, with significant morbidity and mortality rates. We present the case of a diabetic adult in whom the usual signs and symptoms of acute cholecystitis were obscured. A high index of suspicion at the time of admission prompted emergent evaluation. Computerized axial tomography revealed a large perihepatic abscess extending from a perforated gallbladder. Fourteen hundred milliliters of malodorous brown fluid were drained by ultrasound-guided percutaneous aspiration from the collection. Early clinical suspicion combined with conservative surgical management may prevent serious morbidity and/or mortality in diabetic patients with complicated cholecystitis.