Marbelization of the gallbladder, a variant of acute gangrenous cholecystitis

  • Ismail Burud Department of Surgery, International Medical University, Clinical campus, Seremban, 70300, Negeri Sembilan, Malaysia.
  • Mahadevan D. Tata Department of Surgery, CMH Specialist Hospital, Seremban, 70200, Negeri Sembilan, Malaysia.
  • Kogaan Selvaraja Department of Surgery, CMH Specialist Hospital, Seremban, 70200, Negeri Sembilan, Malaysia.
  • Sherreen Y. El Hariri Department of Surgery, International Medical University, Clinical campus, Seremban, 70300, Negeri Sembilan, Malaysia.
Keywords: gangrenous cholecystitis, emphysematous cholecystitis, marbleization of the gallbladder, acute cholecystitis

Abstract

Cholelithiasis can present from a milder form of biliary colic to a more severe and complicated one like empyema gallbladder and a lesser-known variant of gangrenous gallbladder called marbleization of the gallbladder. The clinical signs and symptoms are similar to acute cholecystitis. Diabetes mellitus could have a role in the process of marbleization. Diagnosing marbleization of the gall bladder is not easy preoperatively. Computerized tomography is a better diagnostic modality when compared to laboratory investigations. Urgent cholecystectomy is the only option, and there is no role of conservative treatment. We report a case of a 36-year-old man with newly diagnosed Diabetes Mellitus diagnosed initially as acute cholecystitis and managed conservatively. He did not respond to treatment and hence underwent cholecystectomy and intraoperatively was found to have marbleization of the gall bladder.

Published
2021-09-30

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print ISSN: 0016-9560