title: Perihepatic abscess formation in diabetes: a complication of silent gallstones.
abstract: Perforation of the gallbladder is a serious complication of acute cholecystitis, with significant morbidity and mortality rates. We present the case of a diabetic adult in whom the usual signs and symptoms of acute cholecystitis were obscured. A high index of suspicion at the time of admission prompted emergent evaluation. Computerized axial tomography revealed a large perihepatic abscess extending from a perforated gallbladder. Fourteen hundred milliliters of malodorous brown fluid were drained by ultrasound-guided percutaneous aspiration from the collection. Early clinical suspicion combined with conservative surgical management may prevent serious morbidity and/or mortality in diabetic patients with complicated cholecystitis.
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Forbes
authors.forename: M
authors.initials: M
authors.lastname: Bajaj
authors.forename: T
authors.initials: T
authors.lastname: McGinn
authors.forename: A
authors.initials: A
authors.lastname: Berlin
mesh_terms: D002764:Cholecystitis / Q000150:complications*; D002769:Cholelithiasis / Q000150:complications*; D048909:Diabetes Complications; D004322:Drainage; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008875:Middle Aged; D012422:Rupture, Spontaneous