A 43-year-old woman was admitted to the institution due to severe colic pain in the right hypochondrium radiating to the back, nausea and vomiting, sub-jaundice, choluria, hypocholia and chills.
Physical examination revealed mild pain and defense in the right hypochondrium, abdominal distension and jaundice.
Ultrasound reports a great difficulty in evaluating the vesicular fossa that ascribes to existing meteorism and a gallbladder with thickened walls and acoustic shadows compatible with lithiasis.
You can't assess the bile duct or pancreas.
The laboratory showed a frank leukocytosis, elevated bilirubin to bilirrubin, elevated direct bilirubin five times the normal alkaline phosphatase, and a significant transaminase elevation.
With diagnosis of skeletal syndrome, the patient underwent laparotomy in which, despite a thorough examination, the gallbladder cannot be found.
The extrahepatic bile duct is released throughout its course and a puncture cholangiography is performed in which, except for a significant dilatation of the gallbladder and a panlitiasis of the gallbladder, which is not objective.
1.
Choledochoduodenostomy was performed and 8 liters of different sizes were extracted.
The patient had a good evolution and was discharged.
Asymptomatic two months after surgery.
