HIDA scan showing non-accumulation of the isotope within the gallbladder.

HIDA scan showing non-accumulation of the isotope within the gallbladder.

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Introduction: Epstein Barr virus (EBV) is a human herpes virus 4, transmitted through intimate contact between susceptible persons and asymptomatic EBV shedders. It usually presents with fever, pharyngitis and lymphadenopathy. Majority of individuals with primary EBV infection recover uneventfully. Acute Acalculous Cholecystitis (AAC) is usually s...

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... tomo- graphy showed mild gallbladder distension, mild gallbladder wall thickening (2.5 mm) and mild pericholecystic fluid collection with no layering stones, sludge or biliary ductal dilation. Hepatobiliary imino- diacetic acid (HIDA) scan showed non-accumulation of the isotope within the gallbladder which confirmed the presence of AAC [6], [ Fig. ...

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Epstein-Barr virus (EBV) is a member of the herpes virus family and is characterized by fever, lymphadenopathy, and sore throat. In this report, we present a 20-year-old woman with a four-day history of fever, chills, nausea, vomiting, jaundice and abdominal pain, and a diagnosis of acalculous cholecystitis, acute hepatitis with hemolytic anemia du...

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... Acute acalculous cholecystitis, even complicated by perforation, often occurs in postsurgical adults while in children it is often caused by infectious disease or immune-mediated disorders. Moreover, it can be associated with cardiovascular diseases, in particular with coronary artery disease and in children with Kawasaki Disease [1][2][3][4]. The etiology of acalculous cholecystitis is often unknown, even though it has been correlated with biliary hypokinesia and local ischemia [5][6][7][8]. ...
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Axial MR image demonstrating multiple small gallbladder polypoid lesions characterized by contrast enhancement in a 78-year-old male hospitalized for acute chest pain due to coronary artery disease who showed fever and emesis during hospitalization and had signs of acute acalculous cholecystitis at computed tomography. Given the overall clinical conditions and the MR features, the inflammatory origin of the polyps was considered. The patient underwent cholecystectomy and the histological diagnosis of gallbladder inflammatory pseudopolyps was confirmed. This rare entity represents 5–10% of all gallbladder polyps, and their differentiation from benign and malignant tumors might be challenging especially in acalculous patients, thus surgery is often performed.
... 2-10% of all cases of acute cholecystitis [1,2]. AAC has a higher risk of gallbladder perforation and necrosis compared to the more typical ACC and the mortality rate associated with AAC is reported to be 30% [2,[5][6][7]. If the treatment is delayed, the mortality increases to more than 50% [8], so early diagnosis and treatment are important. ...
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Introduction and importance Acute acalculous cholecystitis (AAC) is associated with a high mortality rate. AAC caused by metastasis to the gallbladder is rare. We report a case of AAC caused by gallbladder metastasis due to the peritoneal dissemination of gastric cancer. Case presentation An 84-year-old male visited our hospital because of epigastric pain. Ultrasonography and computed tomography revealed swelling and thickening of the gallbladder wall, but stones were not observed in the gallbladder. We performed emergency surgery with a diagnosis of acute cholecystitis. Laparoscopy revealed the presence of many nodules around the abdominal cavity including the hepatoduodenal ligament. Inflammation of Calot’s triangle was severe, so we performed subtotal cholecystectomy. We also resected one of the peritoneal nodules. Macroscopically, there were no stones in the gallbladder and histopathological examination revealed acute cholecystitis and existence of adenocarcinoma involving the subserosa of the gallbladder wall and the resected peritoneal nodule. After surgery, esophagogastroduodenoscopy revealed Borrmann type II lesions at the antrum and gastric biopsy showed adenocarcinoma. He was diagnosed with advanced gastric cancer with peritoneal dissemination. His postoperative course was good. Clinical discussion The cases of AAC caused by gallbladder metastasis have been little reported in the literature. This case is advanced gastric cancer with peritoneal dissemination and AAC was thought to be caused by peritoneal dissemination from operative and histopathological findings. We successfully treated this rare case of AAC with laparoscopic surgery. Conclusion Although metastasis to the gallbladder is rare, it is necessary to be aware of this possibility when treating AAC.
... Histology findings were not reported [10]. e second patient who underwent surgery was a 25-years-old immunocompromised female [33]. e postoperative course was uncomplicated. ...
... Another patient who also received corticosteroids improved rapidly [29]. In the second patient who underwent surgery, operation improved her symptoms [33]. ...
... In cases of acalculous cholecystitis due to EBV infection, the pathophysiology still remains obscure. Direct invasion of the gallbladder, as EBV can infect epithelial cells, has been proposed, but this theory has not been clearly proved in the few cases that surgery was performed [10,23,33,42]. Fretzayas et al. based on scintigraphic data proposed that cholecystitis due to EBV infection may not represent a true cholecystitis, but rather a billiary dyskenisia [43]. is theory is not fully accepted, as in many cases, there was just a mild elevation of ALP and bilirubin, not compatible with severe biliary pathology [23]. ...
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The most common cause of acute cholecystitis (ACC) is cholelithiasis. Acute acalculous cholecystitis (AAC) is well documented in the literature related with critical illness, but viral causes such as cytomegalovirus (CMV) and Epstein–Barr virus (EBV) have also been reported. We present a rare manifestation of EBV infection, reporting a case of a 15-year-old female suffering from acute acalulous cholecystitis, and we review the relevant literature. Clinicians should be aware of this rare complication of EBV infection and properly exclude it in young patients with cholecystitis.
... The incidence of ACC occurrence was only established for hospitalised children. The observation of home-treated patients is required.Our analysis did not confirm a predominance of females in the group with cholecystitis as highlighted in previous articles.17 In general, cholecystitis represents a problem in the elderly population. ...
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Epstein-Barr Virus (EBV) is estimated to infect greater than 98% of adults worldwide and is one of the most common human viruses. EBV infection can lead to acute infectious mononucleosis characterized by fever, fatigue, malaise, sore throat, and lymphadenopathy. Elevated liver function tests (LFTs) and hepatosplenomegaly may also be present. This infection usually lasts over a period of weeks or months and is self-limited. Infected individuals, however, may suffer rare complications. Acute acalculous cholecystitis (AAC) is an atypical complication of infectious mononucleosis. The case of a young healthy adolescent female with primary EBV infection complicated by AAC is reported. Providers should be aware that many pediatric and adult cases of AAC due to EBV resolve with conservative treatment. Surgical intervention has not been described as necessary or indicated in the context of AAC caused by EBV and should only be considered in severe cases that are not responding to conservative therapy.