Trombotik trombositopenik purpura seyrinde akut akalkülöz kolesistit: Olgu sunumu
Acute acalculous cholecystitis in the course of thrombotic thrombocytopenic purpura: A case report
- Ana Sayfa
- Sayılar
- Trombotik trombositopenik purpura seyrinde akut akalkülöz kolesistit: Olgu sunumu...
Özet
Akut akalkülöz kolesistit (AKK), safra kesesi tasi yoklugunda meydana gelen safra kesesinin akut inflamasyonudur ve bütün akut kolesistit vakalari nin %2-12’sini olusturur. AKK ile iliskili durumlarda safra kesesinde staz ve iskemi meydana gelmekte ve lokal inflamatuvar bir yanit gelismektedir. Mikroanjiopati ve AKK birlikteligini bildiren yayinlar mevcuttur. Bu yazimizda, trombotik trombositopenik purpura tanisiyla izlenirken sag üst kadran agrisi, ates, bulanti, kusma sikayetleri gelisen, lökositoz, karaciger fonksiyon testlerinde yükselme saptanan ve batin ultrasonografisinde AKK ile uyumlu görünüm tespit edilen bir olgu sunulmaktadi r. Laparoskopik kolesistektomi uygulanan ve postoperatif dönemde, klinik ve laboratuvar olarak tam düzelme saglanan olgunun trombotik trombositopenik purpura klinigi de kayboldu. Hasta halen sorunsuz olarak takibimiz altindadir.
Abstract
Acute acalculous cholecystitis is an acute inflammation of the gallbladder with no existence of any stone. It accoundts for 2-12% of all acute cholecystitis. It is a local inflammatory response to ischemia or stasis caused by many pathogenetic factors. Microangiopathy is a very rare cause of acute acalculous cholecystitis and there are few case reports in the literature. We here present a case with acute acalculous cholecystitis in the course of thrombotic thrombocytopenic purpura with the complaints of abdominal pain at right upper region, fever, nausea, vomitting, slight increase in the liver function tests, and leukocytosis. Upper abdominal ultrasonographic examination revealed the sonographic findings of acute acalculous cholecystitis. We started the appropriate treatment and laparoscopic cholecystectomy was applied. After operation, both acute acalculous cholecystitis and thrombotic thrombocytopenic purpura resolved. The patient is still well and under follow-up
