A clinical case of parasitic phlegmonous cholecystitis caused by acute opisthorchiasis

Abstract

Clinical observation of a patient, I., 40 years old, who was diagnosed with acute phlegmonous parasitic cholecystitis of moderate severity caused by acute opisthorchosis, a hepatocholangial variant, and surgical intervention, laparoscopic cholecystectomy, was diagnosed in 1 surgical ward of 5 VCH FNG Russia. The question of diagnosis of opisthorchiasis has been studied in sufficient detail, but the initial manifestations of the disease may not have a typical clinical picture, which often causes some difficulties for the doctor. Developing against the background of the disease, damage to organs requires, among other things, surgical treatment, attention is drawn to the lack of tactics and technique of surgical interventions for opisthorchosis of the gallbladder. The sources of information do not have a characteristic description of the type of internal organs in case of their opisthorchosis lesion, which, when performing laparoscopy, indicated this pathology. In our clinical case, during surgery, a revision of the abdominal organs macroscopically revealed changes in the structure of the liver, marked adhesions in the upper floor of the abdominal cavity, which are also described by the authors on the sectional material. In the gallbladder, proliferation of the mucous membrane epithelium with the formation of papillomas, desquamation of epithelial cells and often adhesions between the gallbladder and surrounding organs, atrophy and eosinophilic infiltration of all layers of the gallbladder wall are noted. Severe fibrosis of the gallbladder is a common histological feature of cholecystitis among people with opisthorchiasis, which was confirmed histologically in the study of the patient's macropreparation.