Large liver abscess and cholecystogastric fistula secondary to emphysematous cholecystitis

• Díaz Martínez, J. ^[1] ; Merlin Gallegos, A. ^[1] ; Pérez Hernández, J.L. ^[1]
  1. [1] Hospital General Regional Cuernavaca, Mexico. Hepato-Pancreato-Biliary Surgery
• Localización: Revista española de investigaciones quirúrgicas, ISSN 1139-8264, Vol. 23, Nº. 2, 2020, págs. 73-75
• Idioma: inglés
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• Resumen

  • Background. Emphysematous cholecystitis is a rare variant of acute cholecystitis. The association of emphysematous cholecystitis with a liver abscess is rare, and its association with cholecystogastric fistula is exceptional.Case Presentation. An 81-year-old woman with a long history of 2-type diabetes and systemic arterial hypertension presented to the emergency department with a 12-day course of antibiotic treatment for liver abscess and emphysematous cholecystitis without receiving surgical treatment. CT scan showed a large liver abscess in segment IVb and V, gallbladder with wall thickening. Surgical treatment was performed, finding large hepatic abscess and cholecystogastric fistula secondary to emphysematous cholecystitis. E. coli was obtained in the culture, and the findings were confirmed in the histopathological report.Conclusion. The cholecystogastric fistula with a large hepatic abscess in a patient with emphysematous cholecystitis is exceptional.