A severe case of xanthogranulomatous cholecystitis along with a review of CT indications for nonoperative management including percutaneous drainage.
BACKGROUND
Xanthogranulomatous cholecystitis is a rare but severe presentation of cholecystitis characterized by extensive inflammation of the gallbladder wall with characteristic histopathological features. Frequently, the inflammatory mass resembles gallbladder cancer macroscopically, which further complicates therapeutic decisions.


METHODS
We report a case of xathogranulomatous cholecystitis with characteristic computed tomography findings, which was managed by percutaneous drainage of the gallbladder, giving the opportunity for a delayed elective cholocystectomy with an excellent postoperative outcome.


CONCLUSIONS
Recent studies give emphasis on certain criteria for the differential diagnosis of xanthogranulomatous cholecystitis against carcinoma. Characteristic computed tomography features are usually sufficient to establish the diagnosis with safety and decide a nonoperative management of the disease in the acute phase. Percutaneous gallbladder drainage is regarded as a safe and an efficient method for the initial treatment of severe cases.
Propedeutical Department of Surgery, Medical School, Aristotle University, Hippokrateion Hospital, Thessaloniki, Greece. psarras_k@yahoo.com
Kyriakos
K
Psarras
Minas E
ME
Baltatzis
Nikolaos
N
Symeonidis
Efstathios T
ET
Pavlidis
Aikaterini
A
Miha
Theodoros E
TE
Pavlidis
Athanasios K
AK
Sakantamis
D002763:Cholecystectomy / Q000379:methods; D002764:Cholecystitis / Q000000981:diagnostic imaging* / Q000628:therapy; D004322:Drainage / Q000379:methods*; D005260:Female; D006099:Granuloma / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D014973:Xanthomatosis / Q000000981:diagnostic imaging* / Q000628:therapy