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Chronic biliary colic associated with ketamine abuse
Ahmed Al-Nowfal1, Yahya A Al-Abed1
1Department of Surgery, Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex, UK.
Introduction:
Biliary colic is a common clinical presentation, with the majority of cases being related to gallstone disease. However, rarely, patients may present with biliary symptoms without evidence of gallbladder stones - referred to as acalculous gallstone disease. This case report details a rare case of chronic biliary colic associated with ketamine abuse.
Case Presentation:
A 24-year-old Caucasian female presented to the emergency department with a history of intermittent right upper quadrant pain associated with nausea and malaise. She had experienced bouts of similar symptoms three times a year for the past 4 years. Various investigations had been conducted during her multiple admissions, which showed possible dilatation of the common bile duct, with no evidence of gallstones.
Conclusion:
Patients can present with a dilated common bile duct and an acalculous cholecystitis. This requires considerable investigation, with an emphasis on drug history, especially with the current rise of recreational hallucinogenic drug abuse.