Fatal reversal of the cholecystocardiac link

We report the case of a 6 year old female who presented to the emergency department with acute right upper quadrant pain and vomiting. Apart from the gastrointestinal system, examination of all other systems (including cardiovascular) was negative. An ultrasound was done and the diagnosis of acute acalculous cholecystitis was made. The patient did not respond to treatment, and after additional investigations, evidence of congestive heart failure with bilateral pulmonary effusions was seen. It was concluded that the patient's heart failure, although not apparent on initial examinations, was the etiology behind her initial gallbladder thickening and abdominal pain. This case reports an important etiology to be aware of in patients presenting with right upper quadrant pain which is unresponsive to treatment methods. Multiple extracholecystic disease entities such as congestive heart failure, must be placed in the list of differential diagnoses by the caring physician.
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research