Bedside Endoscopic Ultrasound-guided Transgastric Gallbladder Aspiration and Lavage in a High-risk Surgical Case Due to Acute Cholecystitis Accompanied by Multiorgan Failure

• Published in: The Korean journal of gastroenterology Vol. 65; no. 6; pp. 370 - 374
• Main Authors: Yun, So Hee, Park, Moon Shik, Lee, Jae Un, Yang, Min A, Han, Sang Hoon, Lee, Young Jae, Jeong, Geum Mo, Cho, Yong Keun, Kim, Ji Woong, Cho, Jin-Woong
• Format: Journal Article
• Language: English
• Published: Korea (South) 대한소화기학회 01.06.2015
• Subjects: Cholangiopancreatography, Endoscopic Retrograde; Cholecystitis, Acute - complications; Cholecystitis, Acute - diagnosis; Cholecystitis, Acute - diagnostic imaging; Drainage; Duodenoscopy; Endosonography; Escherichia coli - isolation & purification; Humans; Male; Middle Aged; Multiple Organ Failure - pathology; Rhabdomyolysis - complications; Rhabdomyolysis - diagnosis; Sepsis - diagnosis; Sepsis - etiology; Sepsis - microbiology; Therapeutic Irrigation; Tomography, X-Ray Computed; 내과학; Sepsis; Rhabdomyolysis; Endosonography; Cholecystitis; Cholangitis
• ISSN: 1598-9992; 2233-6869
• DOI: 10.4166/kjg.2015.65.6.370

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.