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Gallstone disease presenting as septicaemic shock
Insights
Gallstones can cause life-threatening septicaemic shock, even when undiagnosed. Prompt medical management, including dialysis for kidney failure, led to survival in three critical cases.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Nephrology
Background:
- Septicaemic shock is a severe complication of infections, potentially leading to organ failure.
- Gallstones (cholelithiasis) are common but rarely present with overwhelming sepsis.
- Undiagnosed gallstones pose a significant risk for severe systemic infections.
Observation:
- Three patients presented with undiagnosed gallstones complicated by septicaemic shock.
- Clostridium welchii was identified in blood cultures of one patient and bile in another.
- Two patients experienced acute renal failure necessitating dialysis.
Findings:
- All three patients with severe gallstone-induced sepsis and renal failure survived.
- Early diagnosis and intervention were crucial for positive outcomes.
- Effective management strategies for this rare presentation were employed.
Implications:
- Highlights the critical need to consider gallstones in patients with unexplained sepsis.
- Emphasizes the importance of timely diagnosis and multidisciplinary management for gallstone-related emergencies.
- Suggests that prompt treatment can improve survival rates in severe cases of gallstone-induced septicaemia.
Abstract:
Three patients are described who were admitted to hospital with septicaemic shock due to gallstones, but in none of whom had the presence of gallstones, been diagnosed previously. All 3 had positive blood cultures, Clostridium welchii being isolated in one patient (in another patient this organism was isolated from the bile). Two patients had renal failure requiring dialysis. All 3 patients survived. The management of this serious presentation of gallstones, hitherto poorly described in British literature, is discussed.