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Research Paper | Surgery | India | Volume 12 Issue 4, April 2023

Gangrenous Cholecystitis Masquerading as Intestinal Obstruction, A Silent Killer

Dr. D. Ramesh | Dr. Goddanti Apoorva

Abstract: Gangrenous cholecystitis is a severe complication of acute cholecystitis, defined as necrosis of the gallbladder wall as a result of ischemia due to progressive vascular insufficiency. We present to you an unusual case of a 50 year old diabetic male who presented to the Emergency room with complaints of abdominal distension and obstipation for 8 days and on examination, his abdomen was tense with diffuse tenderness and sluggish bowel sounds. Routine blood workup and imaging was done-with lab parameters within normal range and Ultrasonography showing dilated small and large bowel loops with no transition point. Patient was managed conservatively initially, with a provisional diagnosis of Adynamic Intestinal obstruction, but deteriorated after 48 hours, following which he was scheduled for Exploratory Laparotomy-which revealed gangrenous gallbladder and significantly dilated small bowel loops with no mechanical cause of obstruction. This case therefore emphasizes the need for including gangrenous cholecystitis amongst the list of differentials for acute abdomen with normal lab values, and the course of management decided on a case-case basis.

Keywords: Gangrenous cholecystitis, Adynamic Intestinal Obstruction, acute cholecystitis, asymptomatic gangrenous gallbladder

Edition: Volume 12 Issue 4, April 2023,

Pages: 860 - 863