Acute Acalculous Cholecystitis Caused by Giardia lamblia

Hiromichi Araki; Shuya Shimizu; Katsumi Hayashi; Tomonori Yamada; Atsunori Kusakabe; Hiroshi Kanie; Yusuke Mizuno; Issei Kojima; Akitoshi Saitou; Kazuhiro Nagao; Yuka Suzuki; Tadashi Toyohara; Takanori Suzuki; Erika Uchida; Konomu Uno; Takahiro Nakazawa

doi:10.2169/internalmedicine.56.8087

CASE REPORTS

Acute Acalculous Cholecystitis Caused by Giardia lamblia

Hiromichi Araki, Shuya Shimizu, Katsumi Hayashi, Tomonori Yamada, Atsunori Kusakabe, Hiroshi Kanie, Yusuke Mizuno, Issei Kojima, Akitoshi Saitou, Kazuhiro Nagao, Yuka Suzuki, Tadashi Toyohara, Takanori Suzuki, Erika Uchida, Konomu Uno, Takahiro Nakazawa

Author information

Hiromichi Araki
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Shuya Shimizu
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Katsumi Hayashi
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Tomonori Yamada
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Atsunori Kusakabe
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Hiroshi Kanie
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Yusuke Mizuno
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Issei Kojima
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Akitoshi Saitou
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Kazuhiro Nagao
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Yuka Suzuki
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Tadashi Toyohara
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Takanori Suzuki
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Erika Uchida
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Konomu Uno
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan
Takahiro Nakazawa
Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Japan

Keywords: Giardia lamblia, acute acalculous cholecystitis, biliary giardiasis, metronidazole

JOURNAL OPEN ACCESS

2017 Volume 56 Issue 13 Pages 1657-1662

DOI https://doi.org/10.2169/internalmedicine.56.8087

Details

Abstract

We report a case of a 70-year-old man with acute acalculous cholecystitis caused by Giardia lamblia. Contrast-enhanced computed tomography (CT) showed distention of the gallbladder due to a pericholecystic abscess without gallstones. Magnetic resonance cholangiopancreatography and drip infusion cholecystocholangiography-CT demonstrated a stricture of the hilar bile duct and cystic duct obstruction. We conducted transpapillary bile duct brush cytology and a biopsy of the hilar bile duct stricture; numerous active trophozoites of Giardia lamblia were observed without malignant findings. We considered this bile duct lesion to be biliary giardiasis. Biliary giardiasis should be taken into consideration when diagnosing acute acalculous cholecystitis.

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