title: [A case of perforated xanthogranulomatous cholecystitis presenting as biloma].
abstract: 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.
authors.affiliation: Departments of Internal Medicine, Pathology and Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Yeon Jeong
authors.initials: YJ
authors.lastname: Ahn
authors.forename: Tae Hyo
authors.initials: TH
authors.lastname: Kim
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Moon
authors.forename: Su Nyoung
authors.initials: SN
authors.lastname: Choi
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Woon Tae
authors.initials: WT
authors.lastname: Jung
authors.forename: Ok Jae
authors.initials: OJ
authors.lastname: Lee
authors.forename: Gyung Hyuck
authors.initials: GH
authors.lastname: Ko
mesh_terms: D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D002763:Cholecystectomy; D002764:Cholecystitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D004322:Drainage; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis; D006099:Granuloma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014973:Xanthomatosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D001663:Bilirubin