Alithiasic cholecystitis treated by percutaneous cholecystostomy in a patient with severe septic shock and neutropenia

Abstract

Acalculous cholecystitis is a relatively rare form of cholecystitis appearing in severely ill patients. We chose the case of a young patient under chemotherapy for myeloid leukaemia who developed a severe septic shock secondary to an alithiasic cholecystitis. Because of hemodynamic instability needing high-dose of vasoactive amines, percutaneous gallbladder drainage was done. After this intervention, the septic shock could be controlled, but a bleeding liver laceration was observed, fortunately without morbidity consequences. Abdominal infections are life-threatening complications in neutropenic patients. Neutropenic enterocolitis is the most important entity, but the acute cholecystitis, even rarer, had been described in several reports, suggesting that this infection could represent a difficult trap.