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Elkbuli A, Meneses E, Kinslow K, et al. Huge gangrenous gallbladder presenting as gastro-esophageal reflux disease successfully treated by laparoscopic cholecystectomy: Case report and literature review. Int J Surg Case Rep. 2020;76:315-319doi: 10.1016/j.ijscr.2020.09.193.
Elkbuli, A., Meneses, E., Kinslow, K., McKenney, M., & Boneva, D. (2020). Huge gangrenous gallbladder presenting as gastro-esophageal reflux disease successfully treated by laparoscopic cholecystectomy: Case report and literature review. International journal of surgery case reports, 76315-319. https://doi.org/10.1016/j.ijscr.2020.09.193
Elkbuli, Adel, et al. "Huge gangrenous gallbladder presenting as gastro-esophageal reflux disease successfully treated by laparoscopic cholecystectomy: Case report and literature review." International journal of surgery case reports vol. 76 (2020): 315-319. doi: https://doi.org/10.1016/j.ijscr.2020.09.193
Elkbuli A, Meneses E, Kinslow K, McKenney M, Boneva D. Huge gangrenous gallbladder presenting as gastro-esophageal reflux disease successfully treated by laparoscopic cholecystectomy: Case report and literature review. Int J Surg Case Rep. 2020;76:315-319. doi: 10.1016/j.ijscr.2020.09.193. Epub 2020 Oct 02. PMID: 33068857; PMCID: PMC7567173.
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Int J Surg Case Rep. 2020;76:315-319. doi: 10.1016/j.ijscr.2020.09.193. Epub 2020 Oct 02.

Huge gangrenous gallbladder presenting as gastro-esophageal reflux disease successfully treated by laparoscopic cholecystectomy: Case report and literature review.

International journal of surgery case reports

Adel Elkbuli, Evander Meneses, Kyle Kinslow, Mark McKenney, Dessy Boneva

Affiliations

  1. Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA. Electronic address: [email protected].
  2. Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA.
  3. Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA; Department of Surgery, University of South Florida, Tampa, FL, USA.

PMID: 33068857 PMCID: PMC7567173 DOI: 10.1016/j.ijscr.2020.09.193

Abstract

INTRODUCTION: Gallbladder disease is a common surgical pathology. Gallstones can remain asymptomatic or develop into an acute cholecystitis and need for surgical intervention. Significant enlargement of the gallbladder well beyond the normal volume is rare. Such "giant" gallbladders can affect feasibility of subsequent management options.

PRESENTATION OF CASE: An 80-year-old female presented to the emergency department with a two-day history of acute on chronic gastric reflux with nausea and vomiting. On examination, she had right upper quadrant abdominal pain. CT imaging identified an enormous gallbladder creating mass effect and compression on the distal stomach. She underwent successful laparoscopic cholecystectomy and was discharged from the hospital the next day, doing well. On two-week follow up, her reflux symptoms had completely resolved and she had no complaints.

DISCUSSION: Giant gallbladders are a rare entity. Our patient's case is unique in both its occurrence as well as presentation with predominant reflux symptoms secondary to mass effect by the enlarged gallbladder. Current cholecystitis grading systems do not utilize size as a means of predicting severity and risk of operative complications or difficulty of procedure. Laparoscopic cholecystectomy was a successful approach in managing this extreme pathology.

CONCLUSION: Updated classifications systems that include size and mass effect as a predictive measure are needed to better assess surgical outcomes, especially in "giant" gallbladder disease. Despite the large size and potential mass effect on surrounding structures, laparoscopic cholecystectomy can still be attempted if no other contraindications exist.

Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Keywords: Acute cholecystitis; Case report; Gastro-esophageal reflux; Giant gallbladder; Laparoscopic cholecystectomy; Mass effect

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