title: Bedside Endoscopic Ultrasound-guided Transgastric Gallbladder Aspiration and Lavage in a High-risk Surgical Case Due to Acute Cholecystitis Accompanied by Multiorgan Failure.
abstract: Cholangitis and cholecystitis are intra-abdominal infections that show poor prognosis upon progression to sepsis and multiorgan failure. Administration of antibiotics with high antimicrobial susceptibility and removal of infected bile at the initial treatment are important. After undergoing ERCP for diagnostic purposes, a 58-year-old man developed acute cholangitis and cholecystitis accompanied by rhabdomyolysis, multi-organ failure, and severe sepsis. Broad-spectrum antibiotics with bedside endoscopic nasobiliary drainage were administered, but clinical symptoms did not improve. Therefore, bedside EUS-guided transgastric gallbladder aspiration and lavage was performed, resulting in successful treatment of the patient. We report the above described case along with a discussion of relevant literature.
authors.affiliation: Department of Gastroenterology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: So Hee
authors.initials: SH
authors.lastname: Yun
authors.affiliation: Department of Gastroenterology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Moon Shik
authors.initials: MS
authors.lastname: Park
authors.affiliation: Department of Gastroenterology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Jae Un
authors.initials: JU
authors.lastname: Lee
authors.affiliation: Department of Gastroenterology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Min A
authors.initials: MA
authors.lastname: Yang
authors.affiliation: Department of Gastroenterology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Han
authors.affiliation: Department of Gastroenterology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Young Jae
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Gastroenterology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Geum Mo
authors.initials: GM
authors.lastname: Jeong
authors.affiliation: Department of Gastroenterology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Yong Keun
authors.initials: YK
authors.lastname: Cho
authors.affiliation: Department of Gastroenterology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Ji Woong
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Jin Woong
authors.initials: JW
authors.lastname: Cho
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde; D041881:Cholecystitis, Acute / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004322:Drainage; D004384:Duodenoscopy; D019160:Endosonography; D004926:Escherichia coli / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000473:pathology; D012206:Rhabdomyolysis / Q000150:complications / Q000175:diagnosis; D018805:Sepsis / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D007507:Therapeutic Irrigation; D014057:Tomography, X-Ray Computed
keywords: Cholangitis; Cholecystitis; Endosonography; Rhabdomyolysis; Sepsis