Acute Acalculous Cholecystitis with Amyloid Deposite within the Wall of Gallbladder observed in a Chronic Hemodialysis Patient

Masaki Kikkawa¹⁾²⁾, Mutumi Nozue¹⁾ and Hitoshi Kotanagi²⁾

Department of Surgery, Shonai Amarume Hospital¹⁾
Department of Surgery, Akita Red Cross Hospital²⁾

A 56-year-old man undergoing hemodialysis 4 years due to chronic renal failure, presented with fever and upper right abdominal pain after a meal, a positive Murphy sign, and leucocytosis and liver dysfunction in blood tests. Ultrasonography and computed tomography showed slight gallbladder swelling and gallbladder wall thickening. No signs indicated gallstones. He was diagnosed with acute acalculous cholecystitis, treated conservatively, and discharged, but the upper right abdominal pain continued to occur frequently. Laparoscopic cholecystectomy conducted 4 months after he was first seen, found no stones in the gallbladder. Histological examination of the resected specimen showed amyloid deposits in the gallbladder wall. His symptoms disappeared postoperatively. Examination of the amyloid deposit in several tissues produced negative results. Case in which amyloid deposits apparently lead to acute cholecystitis are very rare.

Key words
acute acalculous cholecystitis, amyloidosis of gallbladder

Reprint requests
Masaki Kikkawa Department of Surgery, Akita Red Cross Hospital
222-1 Naeshirosawa, Kamikitade-Saruta, Akita, 010-1495 JAPAN

Accepted
March 25, 2009

To read the PDF file you will need Abobe Reader installed on your computer.