Case Report

First Schistosomal Cholecystitis Complicated by Cholangitis and Liver Abscess: Case Report and Review of Literature

Table 1

Summary of characteristics of current case and other reported cases of gallbladder schistosomiasis identified from the review of the literature.

StudySexAgepHLEAPresentationDPELabsUSCTOthersSurgeryIntra-opHistoF Up

Current study
Qatar
2020
M46 yDMYesRUQ pain1 dEpigastric tendernessWBC: 17.4, Hb: 14.4, bili: 47, direct bili: 35, ALT: 156 U/L, AST: 182 U/L, lipase: 106 IU, CA 19-9: 303 U/ml, IgE: 432 units/L, postop positive S serology1st US: GS, Di IHBD, CBD: 7 mm
2nd US: new liver collection  cm
Newly developed liver abscessMRCP: acute Chol, Cholang. ERCP: cholang, no filling defect, possibly narrow distal CBDLap CholeOmental adhesions to the GB which was densely adherent to the liverChronic Chol, Gr Inf secondary to SPrazi 40 mg/kg divided into 3 doses

Hedfi 2019
Tunisia
[4]
F51 yDysLNoHepatic colic2 mNNThin-walled GB, GS 10 mmNRNRLap CholeSlightly thick-walled GB, fine cystic ductCalcified S ova in the wall of GB stained positively for periodic acid-SchiffCT urography: N

Majrashi 2018
Saudi
[20]
M50 yDMYesElective surgery for biliary colic9 yRUQ tendernessPositive S serology postop others: NWall thickness (4 mm), GS 8 mmURNRLap CholeThick wall GB, with necrotic spots, firmly attached to the liver bedGr Inf around calcified S. haematobium eggsReferred to ID team

Azoulay 2016
France
[15]
M53 yNRYesElective after 2 episodes of Chol, recent 4 kg weight loss5 mNNHyperechogenic thick GB wall, no GSThick GB wall 12 mm, contained calcifications and lesion protruding into GB and the liver, increased density of peri-vesicular fat, enlarged 2 hilar LN’s (7 mm)NRLap to open radical Chole (en bloc omental adhesions and LN resection)Tense retraction of the right colon, duodenum, and omentum to the inferior aspect of the liver hampered Lap GB explorationAcute and chronic Chol with dense fibrosis, S eggs in GB wallSingle dose of 2.4 mg of Prazi 15 d after surgery
Manes 2014
Greece
[19]
M77 yNRYesElective 3 months after Chol3 mRUQ tendernessNThick-walled GB (6.8 mm)
GS 1.7 cm impacted at GB neck
NRNRLap converted to open CholeGB inflamed and thick with necrotic spots and wood-like consistencyGr Inf around calcified S. mansoni eggsPrazi 20 mg/kg every 4 h for 3 doses

Sharara 2001
Lebanon
[8]
F47 ySmokerNoRUQ discomfort3 dRUQ tendernessAEC: 660/mm3
UA: Mic hem
Thick GB wall, 1 cm echogenic structure without acoustic shadow at GB fundusMarkedly thick GB wall, 2 hypodense liver lesionsNRLap CholeThick nondistended gallbladder firmly adherent to the liver surface and an enlarged cystic LN, no GSGr Inf around multiple S eggs, with the lateral spine, likely S mansoniPrazi 20 mg/kg every 4 h for 3 doses

Bakhotma 1996
Saudi
[21]
M30 yNRRUQ pain, HUNRNRUA: S. haematobiumGSNRNRLap CholeThickened wallChronic Chol with S. infectionPrazi, received before surgery

Al-Saleem 1989
Iraq
[7]
M27 yNRYesBiliary colic, hematemesis2 mEnlarged spleen down to the pelvisNRHuge spleen, thick GB wall, no GSNROGD: varices lower two-thirds of the esophagusL, CholeHuge spleen, cirrhotic liver, GB grey, irregular in thickness, infiltrating into the liver bed. Thick cystic ductExtensive S fibrosisNR

Al-Saleem 1989
Iraq
[7]
M25 yNRYesEpigastric pain2 mNRNRThick GB wall, large GSNRNRCholeThick walled grey GB, the fibrosis so deep into the bed, thickened fibrotic, and calcified cystic ductExtensive fibrocalcific GB S, due to S mansoniNR

Al-Saleem 1989
Iraq
[7]
M62 yChildhood HUYesRUQ painNRNRNRGSNRNRCholeThick-walled grey GB, attached tightly to the liver and infiltrating itExtensive fibrocalcific GB S, due to S haematobiumNR
Al-Saleem 1989
Iraq
[7]
M33 yChildhood HUYesDull epigastric pain3 mNRNRLarge GSNRNRL, CholeThick-walled grey GB, with extensive fibrosisFibrocalcific GB S, due to S. haematobiumNR

Al-Saleem 1989
Iraq
[7]
F40 yObeseYesDull RUQ pain13 mNo tendernessNRThick GB wall, large GSNRNRCholeThick-walled grey GB, GSFibrocalcific GB S, due to S haematobiumNR

Al-Saleem 1989
Iraq
[7]
M55 yNRYesRUQ discomfort radiated to Rt shoulder, N&V14 mRUQ tendernessNRThick GB wall, large GSNRNRNRPancreatic tumour with multiple hepatic secondaries, thick-walled GB with stonesBiopsy showed extensive fibrosis, ova of S. haematobiumNR

Rappaport 1975
US
[6]
M51NRNRRUQ pain, N&V, diarrheaFew dRUQ tendernessNNRNRIVP: NCholeFibrotic liver, focally mildly thickened GBGr Inf, S. mansoniNR

For space considerations, only the first author is cited. AEC: absolute eosinophil count; Bili: bilirubin umol/L; CBD: common bile duct; Chol: cholecystitis; Cholang: cholangitis; Chole: cholecystectomy; D: duration of symptoms; d: days; Di: dilated; DM: diabetes mellitus; DysL: dyslipidemia; F: female; F Up: follow-up treatment; GB: gallbladder; Gr: granulomatous; GS: gall stone/s; Hb: hemoglobin g/dl; HU: hematuria; ID: infectious diseases; IHBD: intrahepatic bile ducts; Inf: inflammation; Intra-op: intraoperative findings; IVP: intravenous pyelogram; L: laparotomy; Lap: laparoscopic; LEA: lived in an endemic area; LN’s: lymph nodes; M: male; m: month/s; Mic: microscopic; N: normal; NR: not reported; N&V: nausea and vomiting; OGD: oesophagogastroduodenoscopy; PE: physical examination; post-op: postoperative; Prazi: praziquantel; Rt: right; RUQ: right upper quadrant; S: schistosoma/l; UA: urine analysis; UR: unremarkable; WBC: white blood cells K/uL; y: year/s.