Acute Cholecystitis After a Colonoscopy
A 35-year-old male underwent a screening colonoscopy. A 5-mm-sized sessile polyp was noted in the sigmoid colon. After informed consent had been obtained, an uneventful hot snare polypectomy was performed. About 48 hours after the procedure, the patient visited the emergency room with epigastric pain. Physical examination revealed right upper quadrant and epigastric tenderness. The patient had a blood pressure of 150/90 mmHg, a heart rate of 105 beats/min, a respiratory rate of 22 times/min, and a body temperature of 38.5℃. Peripheral blood tests showed white blood cell, 13,300 mm2; neutrophils, 75.0%; hemoglobin, 17.0 g/dL; and platelets, 309,000 mm2. Blood biochemistry showed total bilirubin 1.7 mg/dL; serum glutamic oxalacetic transaminase, 42 IU/L; serum glutamic pyruvic transaminase, 115 IU/L; alkaline phosphatase, 263 IU/L; blood urea nitrogen, 5.9 mg/dL; creatinine, 1.1 mg/dL; and C-reactive peptide, 29.3 mg/dL.\nOn a plain radiograph, no intraperitoneal air was seen. Abdominal computed tomography showed a 1-cm-sized gallstone in the gallbladder neck, which had a thickened wall and pericholecystic inflammation (). The patient was treated with intravenous antibiotics, and his symptoms and lab findings were improved within 3 days. He was discharged 7 days after admission and was given oral antibiotics; he planned to undergo a cholecystectomy.