title: A Difficult Differential Diagnosis of Acute Cholecystitis in a Patient With Steroid-induced Diabetes.
abstract: An impairment of gallbladder motility due to autonomic neuropathy may cause cholestasis and result in gallbladder stone formation. Diabetes is one of risk factors for acute cholecystitis. Diabetes and steroid use are associated with the susceptibility to bacterial infections, we are apt to diagnose steroid-induced diabetic patients manifesting symptoms of cholecystitis as having acute bacterial infective cholecystitis. Here, we report a very rare steroid-induced diabetic patient complicated with gallbladder torsion-induced necrotizing cholecystitis due to a floating gallbladder.
  
  
  BACKGROUND
  Cholecystitis; Diabetes; Floating gallbladder; Torsion.
authors.affiliation: Department of Internal Medicine, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba 272-8516, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Masui
authors.forename: Akahito
authors.initials: A
authors.lastname: Sako
authors.forename: Naonori
authors.initials: N
authors.lastname: Tsuda
authors.forename: So
authors.initials: S
authors.lastname: Nishimura
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Seyama
authors.forename: Masato
authors.initials: M
authors.lastname: Nishida
authors.forename: Junichi
authors.initials: J
authors.lastname: Shindo
authors.forename: Takaaki
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kaneko
authors.forename: Hidekatsu
authors.initials: H
authors.lastname: Yanai