2017 Volume 37 Issue 4 Pages 661-665
An acute abdomen is sometimes accompanied by ischemic heart disease. In such cases, doctors must determine the most suitable treatment policy while facing the difficulty of determining the level of priority required for the treatment of each condition. We report a case of acute cholecystitis accompanied by unstable angina in which the treatment plan was quite difficult to determine. A 79-year-old man presented with a chief complaint of chest pain while resting. Based on detailed laboratory investigations, he was diagnosed as having unstable angina and acute cholecystitis and was transferred to a specialized facility to prioritize the treatment of angina. However, based on various test results, the patient was found to be ineligible for emergency catheter testing; he was then re-transferred to our hospital to receive treatment for the acute cholecystitis first. An abdominal computed tomography scan revealed the presence of emphysema in the gallbladder and the biliary tract, and a diagnosis of emphysematous cholecystitis was confirmed. Emergency surgery was planned, and an open cholecystectomy was performed. During the postoperative period, multidisciplinary systemic management was initiated with the patient admitted to the intensive care unit. The patient's recovery was satisfactory, and he was discharged after his condition improved.
