Acute acalculous cholecystitis as an early manifestation of COVID-19: case report and literature review.

Acute acalculous cholecystitis as an early manifestation of COVID-19: case report and literature review.

Authors

  • Alessia D'Introno Internal Medicine Unit - Ostuni Hospital
  • Pietro Gatti Internal Medicine Unit, “Perrino” General Hospital, Brindisi
  • Giuseppe Manca General Surgery Unit, “Perrino” General Hospital, Brindisi
  • Alessandro D'Amuri Anatomical Pathology Unit, “Perrino” General Hospital, Brindisi
  • Salvatore Minniti Infectious Disease Unit, “Perrino” General Hospital
  • Emanuela Ciracì Internal Medicine Unit, Ostuni Hospital.

Keywords:

Coronavirus disease 2019, acute acalculous cholecystitis, laparoscopic cholecystectomy

Abstract

 Background: The novel coronavirus disease 2019 (COVID-19) has rapidly spread worldwide since the outbreak in Wuhan, China, in 2019, becoming a major threat to public health. The most common symptoms are fever, dry cough, shortness of breath, but subjects with COVID-19 may also manifest gastrointestinal symptoms, and in a few cases an involvement of the gallbladder has been observed.

Case report: Here we present a case of 50-year-old male with SARS-CoV-2 infection who had abdominal pain, vomiting and diarrhea without respiratory symptoms and was finally diagnosed as acute acalculous cholecystitis (AAC). Laparoscopic cholecystectomy was performed and found a gangrenous gallbladder; the real-time reverse transcription polymerase chain reaction SARS-CoV-2 nucleic acid assay of the bile was negative. We also made a review of the literature and try to understand the hypothetic role of SARS-CoV-2 in the pathogenesis of AAC.

Conclusions: We highlighted that it is noteworthy to look at gastrointestinal symptoms in patients with SARS-CoV-2 infection and take into account AAC as a possible complication of COVID-19. Although more evidence is needed to better elucidate the role of the pathogenic mechanisms of the SARS-CoV-2 in AAC, it is conceivable that the hepatobiliary system could be a potential target of SARS-CoV-2.

References

Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020;324(8):782-793.

Wong SH, Lui RN, Sung JJ. Covid-19 and the digestive system. J Gastroenterol Hepatol 2020;35(5):744-748.

Bruni A, Garofalo E, Zuccalà V, et al. Histopathological findings in a COVID-19 patient affected by ischemic gangrenous cholecystitis. World J Emerg Surg 2020;15:43.

Lovece A, Asti E, Bruni B, Bonavina L. Subtotal laparoscopic cholecystectomy for gangrenous gallbladderduring recovery from COVID-19 pneumonia. Int J Surg Case Rep 2020;72:335-338.

Mattone E, Sofia M, Schembari E, et al. Acute acalculous cholecystitis on a COVID-19 patient: a case report. Ann Med Surg (Lond) 2020;58:73-75.

Wahid N, Bhardwaj T, Borinsky C, Tavakkoli M, Wan D, Wong T. Acute Acalculous Cholecystitis During Severe COVID-19 Hospitalizations. Am J Gastroenterol 2020;115 (Suppl): S1563.

Scutari R, Piermatteo L, Ciancio Manuelli M, et al. Long-Term SARS-CoV-2 Infection Associated with Viral Dissemination in Different Body Fluids Including Bile in Two Patients with Acute Cholecystitis. Life (Basel). 2020;10(11):302.

Singh R, Domenico C, Rao SD, et al. Novel coronavirus disease 2019 in a patient on durable left ventricular assist device support. J Card Fail 2020;26:438–439.

Balaphas A, Gkoufa K, Meyer J, et al. COVID-19 can mimic acute cholecystitis and is associated with the presence of viral RNA in the gallbladder wall. J Hepatol. 2020;73(6):1566-1568.

Ying M, Lu B, Pan J, et al. COVID-19 with acute cholecystitis: a case report. BMC Infect Dis. 2020;20(1):437.

Asti E, Lovece A, Bonavina L. Gangrenous cholecystitis during hospitalization for SARS-CoV2 infection. Updates Surg. 2020 Sep;72(3):917-919.

Alhassan SM, Iqbal P, Fikrey L, et al. Post COVID 19 acute acalculous cholecystitis raising the possibility of underlying dysregulated immune response, a case report. Ann Med Surg (Lond). 2020;60:434-437.

Balmadrid B. Recent advances in management of acalculous cholecystitis [version 1; referees: 2 approved]. F1000Res. 2018;7:F1000 Faculty Rev-1660.

Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565-574.

Dai YJ, Hu F, Li H, Huang HY, Wang DW, Liang Y. A profiling analysis on the receptor ACE2 expression reveals the potential risk of different type of cancers vulnerable to SARS-CoV-2 infection. Ann Transl Med. 2020;8(7):481.

Gupta A, Madhavan MV, Sehgal K, et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26(7):1017-1032.

Karamyancorresponding VT. Between two storms, vasoactive peptides or bradykinin underlie severity of COVID‐19? Physiol Rep. 2021 Mar; 9(5): e14796.

Huffman JL, Schenker S. Acute Acalculous Cholecystitis: A Review. Clin Gastroenterol Hepatol. 2010;8(1):15-22.

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Published

29-06-2022

How to Cite

1.
Acute acalculous cholecystitis as an early manifestation of COVID-19: case report and literature review. Acta Biomed [Internet]. 2022 Jun. 29 [cited 2024 Mar. 29];93(S1):e2022207. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/12760