Leukocytosis of Unknown Origin: Gangrenous CholecystitisReport as inadecuate




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Case Reports in MedicineVolume 2013 2013, Article ID 418014, 4 pages

Case Report

Department of Medicine, Trinitas Regional Medical Center, Seton Hall University Health Sciences, Elizabeth, NJ 07202, USA

Department of Hospital Medicine, Institute of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, OH 44195, USA

Department of Hospital Medicine, Institute of Medicine, Cleveland Clinic, Cleveland, OH 44195, USA

Department of Pulmonary, Critical Care and Environmental Medicine, Tulane University Health Sciences Center, New Orleans, LA 70112, USA

Received 26 January 2013; Revised 23 February 2013; Accepted 11 March 2013

Academic Editor: Gianfranco D. Alpini

Copyright © 2013 Amara Jyothi Nidimusili et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There have been case reports where patients admitted with acute cholecystitis, who were managed conservatively, had subsequently developed GC gangrenous cholecystitis. The current case is unique, since our patient denied any prior episodes of abdominal pain and the only tip off was leukocytosis. A high index of suspicion is essential for the early diagnosis and treatment of GC. GC has a mortality rate of up to 22% and a complication rate of 16–25%. Complications associated with GC include perforation, which has been reported to occur in as many as 10% of cases of acute cholecystitis. The radiological investigations may not be conclusive. Ultrasonography usually serves as the first-line imaging modality for the evaluation of patients with clinically suspected acute cholecystitis. However, CT can play an important role in the evaluation of these patients if sonography is inconclusive. There is a need for an early if not urgent surgical intervention in acute cholecystitis whether laparoscopic or open surgery in order to decrease the time elapsed from the start of symptoms to admission and treatment.





Author: Amara Jyothi Nidimusili, M. Chadi Alraies, Naseem Eisa, Abdul Hamid Alraiyes, and Khaldoon Shaheen

Source: https://www.hindawi.com/



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