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Empyema of the gallbladder is a severe complication of acute cholecystitis. It is usually the result of acute obstruction of the cystic duct. There is an infection of the bile with pus. This is a surgical emergency. It requires antibiotics and removal of the gallbladder to reduce the risk of septic shock.
Gallstones are one of the most common biliary diseases. The stones formed in the gallbladder can cause some major complications like cholangitis, pancreatitis, and some cases severe infection of the gallbladder called empyema of the gallbladder. In this condition, the gallbladder is filled with pus. It mostly affects patients who are diabetes, immunosuppressant therapy, or hemoglobinopathies.
Nearly 5 percent of gallbladder infections are empyema infections. Here we describe a case where a patient with poorly controlled diabetes presented to our emergency room with severe abdominal pain, fever, and chills. He was seen and evaluated by MH Surgery Clinic surgeons.
During the evaluation, he was found to be in sepsis-related to empyema. He was immediately started on antibiotics and fluids. His blood sugar was very high so was his pain. He was managed by our surgeons at Surgical Gastroenterology Center in MH Surgery Clinic. He underwent a high-resolution computed tomography scan of the abdomen which confirmed severe infection of the gallbladder. He was immediately offered surgery. He was well resuscitated before the complex laparoscopic surgery. All this was only possible after careful and close evaluation of the investigations by MH Surgery Clinic Surgeons.
During the surgery, there was a severe infection of the gallbladder. The gallbladder was decompressed with a needle and this confirmed diagnosis of empyema. After careful evaluation of the disease and the anatomy, laparoscopic removal of the gallbladder was completed. All this was performed via a Minimally Invasive Advanced Surgery technique. The patient recovered extremely well and remained with significant low pain and was discharged home the following day.
In many patients, this diagnosis is not clearly identified or explained in detail to the patient. Some patients may develop sepsis and in some cases, there may be a need for open procedure when the disease is complicated. All cases need careful evaluation and management. Patients can present not only in sepsis but can sometimes present with severe pain only. Patients require careful evaluation and surgical correction which is available at Surgical Gastroenterology Center in MH Surgery Clinic.