A Difficult Differential Diagnosis of Acute Cholecystitis in a Patient With Steroid-induced Diabetes

Abstract

An impairment of gallbladder motility due to autonomic neuropathy may cause cholestasis and result in gallbladder stone formation. Diabetes is one of risk factors for acute cholecystitis. Diabetes and steroid use are associated with the susceptibility to bacterial infections, we are apt to diagnose steroid-induced diabetic patients manifesting symptoms of cholecystitis as having acute bacterial infective cholecystitis. Here, we report a very rare steroid-induced diabetic patient complicated with gallbladder torsion-induced necrotizing cholecystitis due to a floating gallbladder.KeywordsCholecystitis; Diabetes; Floating gallbladder; Torsion

Relationship Between Diabetes and Acalculose Cholestitis in the Elderly

“…Although infection is not the primary cause of acute cholecystitis, it develops in 50% of patients. The susceptibility of diabetic individuals to infection due to a weakened immune system increases the risk of cholecystitis (23). In our study, when the LFT of diabetic patients (AST, ALT, GGT) were evaluated by the correlation test compared with those with acalculous cholecystitis without diabetes, higher significant correlation data were found.…”

“…While there was a moderate positive correlation between CRP and AST levels in DM+ patients, a low positive correlation was found between CRP and AST levels in DM patients. We believe that the reason for this is that infection parameters tend to increase in patients with DM (23). CRP is a positive acute phase reactant and is expected to increase in infective cases.…”