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[Acute cholecystitis in periarteritis nodosa. 8 cases]
M Blidi1, N Quang Tri, P Cassan
1Service de Médecine Interne, Hôpital Avicenne, Bobigny.
Annales De Medecine Interne
|January 1, 1996
Summary
Acute cholecystitis in periarteritis nodosa is rare. Surgical treatment is recommended for gallstones or initial symptoms, while corticosteroid therapy may benefit non-lithiasic cases.
Area of Science:
- Gastroenterology
- Rheumatology
- Vascular Pathology
Background:
- Periarteritis nodosa (PN) is a systemic necrotizing vasculitis.
- Acute cholecystitis (AC) as a manifestation of PN is uncommon.
- Understanding the interplay between PN and AC is crucial for patient management.
Observation:
- This study analyzed 8 cases of AC associated with PN.
- Clinical and sonographic findings of AC in PN patients were similar to common cholecystitis.
- Gallbladder histology revealed PN-related vascular lesions in 7/8 cases.
Findings:
- AC was the initial sign of PN in 2 cases.
- Gallstones were absent in 2/8 cases (alithiasic cholecystitis).
- Surgical intervention was effective for lithiasic AC, while medical management with corticosteroids succeeded in alithiasic AC.
Implications:
- AC in PN patients warrants surgical treatment if gallstones are present or if AC is the presenting symptom.
- Alithiasic AC in PN may be effectively managed with corticosteroids.
- Medical treatment of underlying PN can benefit patients, challenging the notion of therapeutic abstention in some cases.