case_images: PMC10656800_01
case_images: Abdominal computed tomography image of the patient.. The gallbladder wall is irregular and adhered to the duodenum (red circle).
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case_images: A computed tomography scan was performed to investigate the cause of the abdominal pain and displayed irregularities in gallbladder morphology and evidence of adhesion between the gallbladder and the duodenum (Figure 1).
case_images: Surgically removed gallbladder and gallstones.. Part of the removed gallbladder (left) and gallbladder stones (right) are shown.
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case_images: Therefore, a partial cholecystectomy was performed, and gallstones were removed (Figure 2).
case_images: Changes in white blood cell and C-reactive protein levels.. ICU: intensive care unit; ENBD: endoscopic nasobiliary drainage.. On day 9 of ICU admission, an ENBD was inserted, and the patient's inflammatory response subsequently decreased.
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case_images: On day 9 of ICU admission, owing to the recurrence of an increase of bile duct enzyme levels, endoscopic retrograde cholangiopancreatography (ERCP) was performed to investigate the cause (Figure 3).
case_images: Changes in biliary enzyme levels.. ERCP: endoscopic retrograde cholangiopancreatography; ICU: intensive care unit; ENBD: endoscopic nasobiliary drainage. ERCP was performed on day 9 after admission to the ICU, due to recurrence of the increase in biliary enzyme levels. Although there was no obvious obstruction of the biliary tract, bile sludge was observed. Therefore, an ENBD tube was inserted for drainage, and subsequently, biliary enzyme levels markedly decreased.
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case_images: Moreover, following the insertion of the ENBD tube, the infection gradually came under control, and the inflammatory response decreased (Figure 4).