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Gallstone disease presenting as septicaemic shock
The British Journal of Surgery
|February 1, 1978
Summary
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.