PDF(Pubmed)
Abstract：
Cholangiocarcinoma of the common bile duct (CBD) presenting as empyema of the gallbladder is a rare entity that poses a risk of septicemia, septic shock, peritonitis, and abscess formation. This case report describes an elderly female presenting with pain in the right hypochondrium, a positive Murphy\'s sign, and a history of regurgitation and constipation. It highlights the value of imaging in the early diagnosis of this rare presentation of underlying malignancy. The most common cause of empyema of the gallbladder is acute cholecystitis, followed by gallbladder neck obstruction by a calculus. This report discusses the important role of imaging supported by clinical history, examination, laboratory tests, and histopathological findings to diagnose this rare presentation of empyema of the gallbladder as a complication of underlying cholangiocarcinoma. Additionally, it briefly discusses the change in the management line for cholangiocarcinoma patients with complications such as gallbladder perforation and septicemia. The study concludes that the possibility of underlying bile duct malignancy cannot be overlooked in patients with similar symptoms, particularly among the elderly.
摘要：
胆总管胆管癌（CBD）表现为胆囊脓胸是一种罕见的实体，具有败血症的风险，感染性休克,腹膜炎,和脓肿形成。该病例报告描述了一名老年女性，其右侧软骨下出现疼痛，墨菲的积极迹象，有反流和便秘史.它强调了影像学在早期诊断这种罕见的潜在恶性肿瘤中的价值。胆囊脓胸的最常见原因是急性胆囊炎，接着是胆囊颈部结石阻塞.本报告讨论了临床病史支持的影像学的重要作用，考试,实验室测试,和组织病理学发现，以诊断这种罕见的胆囊脓胸为潜在胆管癌的并发症。此外,简要讨论了胆管癌合并胆囊穿孔、败血症等并发症患者治疗路线的改变。该研究得出的结论是，在症状相似的患者中，潜在的胆管恶性肿瘤的可能性不可忽视。尤其是老年人。
