Acute Cholecystitis after Cholecystectomy: Case Report

Introduction: In the presence of complicated acute cholecystitis with a high risk of biliary tract injury, the laparoscopic technique of choice is the subtotal cholecystectomy. It is a safe and useful surgical procedure when the anatomical distortion hinders a total cholecystectomy. However, the presence of a vesicular remnant after performing a reconstituting technique can lead to the formation of cholelithiasis and acute cholecystitis of the remnant in a postoperated patient. Case presentation: It is a 51-year-old female patient who was admitted to the emergency room due to abdominal pain located in the mesogastrium and irradiating to the right hypochondrium, it was characteristic of biliary colic, with a pain scale chart of 9/10 points. It was triggered after eating copious foods, accompanied by nausea and vomit. Her surgical history was remarkable for a cholecystectomy 10 years prior to her admission. The laboratory tests and imaging studies suggested the presence of gallbladder remnant cholecystitis after a reconstituting subtotal cholecystectomy. The patient received surgical treatment by a total laparoscopic cholecystectomy with satisfactory results. Conclusion: A high level of suspicion of gallbladder remnant cholecystitis in patients that present to the emergency room for abdominal pain and a history of a reconstituting subtotal cholecystectomy has to be maintained. In these cases, surgical treatment by laparoscopic or open cholecystectomy has to be offered to the patient. 102 British Journal of Gastroenterology 2019; 1(1): 102 105 . doi: 10.31488/bjg.1000102