Table of Contents
ISRN Gastroenterology
Volume 2011 (2011), Article ID 201529, 4 pages
http://dx.doi.org/10.5402/2011/201529
Case Report

Acalculous Cholecystitis in a Patient with Hepatocellular Carcinoma on Sorafenib

Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera Wakayama City, Wakayama 641-0012, Japan

Received 9 October 2010; Accepted 4 November 2010

Academic Editor: A. A. te Velde

Copyright © 2011 Mariko Sanda et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 67-year-old woman with compensated cirrhosis type B associated with hepatocellular carcinoma was started on sorafenib for multiple pulmonary metastases. The patient developed right upper quadrant pain and high fever 4 weeks later. Imaging revealed marked enlargement of the gallbladder without calculi. Following percutaneous transhepatic gallbladder aspiration, her symptoms resolved, but the gallbladder remained enlarged. Laparoscopic cholecystectomy was performed. Arteriolar occlusion with intimal thickening in the muscular layer of the gallbladder was seen sporadically. The fact that this patient had no risk factors for acalculous cholecystitis suggested that the cholecystitis resulted from ischemia, implying a strong causal relationship with sorafenib.