1.A Case of Perforated Xanthogranulomatous Cholecystitis Presenting as Biloma.
Yeon Jeong AHN ; Tae Hyo KIM ; Sung Won MOON ; Su Nyoung CHOI ; Hyun Jin KIM ; Woon Tae JUNG ; Ok Jae LEE ; Gyung Hyuck KO
The Korean Journal of Gastroenterology 2011;58(3):153-156
Xanthogranulomatous cholecystitis is an unusual inflammatory disease of the gallbladder characterized by severe proliferative fibrosis and the accumulation of lipid-laden macrophages in areas of destructive inflammation. Its macroscopic appearance may occasionally be confused with gallbladder carcinoma. We present a case of perforated xanthogranulomatous cholecystitis presenting as biloma. An 80-year-old woman was referred to our hospital with a 1-week history of abdominal pain and febrile sensation. Abdominal CT showed a biloma in the subhepatic area. The follow-up CT showed that the biloma increased in size. Therefore, ultrasonography-guided aspiration was performed. The aspirated fluid/serum bilirubin ratio was greater than 5, which was strongly suggestive of bile leakage complicated by perforated cholecystitis. She underwent a laparoscopic cholecystectomy with cyst aspiration and adhesiolysis. A histological diagnosis of perforated xanthogranulomatous cholecystitis was made.
Aged, 80 and over
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Bilirubin/blood
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Cholecystectomy
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Cholecystitis/*diagnosis/pathology/ultrasonography
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Drainage
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Female
;
Gallbladder Neoplasms/diagnosis
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Granuloma/*diagnosis/pathology/ultrasonography
;
Humans
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Tomography, X-Ray Computed
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Xanthomatosis/*diagnosis/pathology/ultrasonography