7o yr old obese male presented with DM,Hypertension high fever,he was Hospitalised and investigated. CBC-wbs count and ESR are elevated,Bl sugar was high,slight raise in the creatinine level , LFT repots showed mild derangement but not significant.U/S scan showed liver abscess,fatty liver and the GB was packed with stones,CECT shoed a fistulous tract between GB and liver abscess.
Soon after he was optimised,Lap chole was performed.Difficult procedure,hence GB was divided to get a better exposure of structures at the calott"S,pus started pouring out from the liver ..Cholecystectomy and liver abscess drainage was done.Recovered but developed breathing difficulty with R pleural effusion and mild ascites.WBC count remained elevated at 16000 but recovered after 10days and was discharged.Pl ease share your experiences and the literature.
https://www.sciencedirect.com/science/article/pii/S1743919111005917
Dear sir the literature above may help.
Cholecystohepatic fistula’ is a misnomer as fistulas form either between two hollow viscera or between a hollow viscus and the externa (i.e. the skin). This type of fistula is in effect a variant of type II perforation occurring in the presence of a partial or complete intrahepatic gallbladder rupturing ‘intrahepatically’, rather than intraperitoneally.
Thankyou very much ; Goor article but GB was neither Partially nor totally intrahepatic,
Thank you sir .I think here the chronic inflammation on the background of diseased liver lead to local spread of infection with formation of local abscess.(in difficult cholecystectomy the gallbladder severely adherents to underlying liver tissue, that apart from liver tissue is taken with gallbladder during removal) .anyway during cholecystectomy we face a lot of variation .
Greetings
- Badges
- Science topic
- Similar topics
- Physical Sciences
- Physical Phenomena
- Luminescence
- Fluorescence