COVID‐19 cases are increasing daily worldwide. With such emerging disease, the medical community should be aware of atypical clinical presentations in order to help with correct diagnosis, and to take the proper measures to isolate and treat patients to avoid healthcare professionals being infected and to limit its spread (SARS‐CoV‐2). Thrombogenesis in COVID‐19 has been described in few cases, but a thrombosis of a large digestive vessel has not been documented so far. Mesenteric ischemia due to an obstruction of a large vessel may be a new presentation of COVID‐19 infection.
Introduction
Although the symptoms attributed to gall stones resolve in most patients after cholecystectomy, some may have symptoms that persist or recur. It is known as the post-cholecystectomy syndrome (PCS). The aim of this case was to describe the diagnostic difficulties encountered and to discuss the main etiologies of this entity.
Case report
A 54-year-old man presented for a recurrent right upper quadrant pain despite laparoscopic cholecystectomy five years ago. Imaging showed cystic lesion at the gallbladder fossa with gallstones. We decided to reoperate the patient by laparoscopic approach. It turned to be a residual gallbladder with stones inside. It was confirmed by histopathology. He was asymptomatic after a follow-up of 2 years.
Discussion
The PCS should not be trivialized. Most of the causes are allocated to extra biliary etiologies. They must be ruled out first as most of them can be controlled with medication. There are etiologies for which re-operation can be necessary.
Conclusion
The indication of cholecystectomy must be taken wisely otherwise surgery will not solve the problem. Even though patient may complain of persistence or recurrence of the pain. In this case, it can be a real challenge for both diagnosis and treatment.
COVID-19 cases are increasing worldwide. With such emerging disease the
medical community should be aware of atypical clinical presentations in
order to help with correct diagnosis, and to take the proper measures to
isolate and treat patients to avoid healthcare professionals being
infected and to limit its spread (SARS-CoV-2).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.