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Cirujano general

versão impressa ISSN 1405-0099

Resumo

JOSE-RAMIREZ, Hernán et al. Acute amoebic cholecystitis as differential diagnosis of gallbladder cancer. Report of an unusual case. Cir. gen [online]. 2016, vol.38, n.1, pp.22-27.  Epub 20-Fev-2020. ISSN 1405-0099.

Gallbladder cancer is the most common malignant tumor of the gastrointestinal tract. It is considered highly lethal. The percentage of patients diagnosed with cancer after a simple cholecystectomy is 0.5-1.5%. The differential diagnosis includes benign conditions such as inflammatory and infectious biliary processes, including hydrocholecyst, pyocholecyst, and cholangitis, as well as parasitic infections such as E. histolytica (Entamoeba histolytica). The most common clinical manifestation of amebiasis is acute colitis. Only 10% of the subjects infected develop symptoms. The complications classify as intestinal and extraintestinal. Among the intestinal complications are hemorrhage, toxic megacolon, appendicitis, severe ulcerations, intestinal perforations, and ameboma. A small subpopulation develops severe extraintestinal amebiasis. Extraintestinal manifestations include, apart from hepatic abscess, pulmonary, cardiac, cutaneous and NS affections, with an elevated mortality rate ranging from 4 to 14%. Hepatic abscess is the most common extraintestinal manifestation, and there are reports even of an amebic spleen abscess; the finding of an amoebian abscess in the gallbladder has only been reported twice previously, and even though it is considered extremely rare, it must be considered as a differential diagnosis of gallbladder cancer.

Palavras-chave : Gallbladder cancer; differential diagnosis; amebiasis; extraintestinal amebiasis; amebic hepatic abscess; gallbladder abscess.

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