2017 Volume 31 Issue 5 Pages 867-873
71 year-old male admitted to hospital due to stomach pain, diarrhea and vomiting, and diagnosed as acalculous cholecystitis by image and blood examinations. Contrast CT revealed wall thickness of gallbladder (GB) with contrast-enhanced cystic duct, which was suspected as carcinoma of cystic duct. On 13th hospital day, we performed cholecystectomy because GB was damaged during ERCP. Pathological diagnosis was eosinophilic cholecystitis without any malignant cell in GB wall and with eosinophilic infiltration in submucosa and muscularis propria. The patient suffered liver dysfunction with peripheral eosinophilia and perivascular dermatitis after surgery, which was cured with steroid administration.
Eosinophilic cholecystitis is a rare entity that presents with symptoms of normal acute cholecystitis. Its incidence is reported 0.84% of all acute cholecystitis. Although there have been some reported etiologies such as hypersensitivity to bile acid, local inflammation from gallstones, drug-induced reaction (e.g. herbal medicine) and parasite, definite causes are not elucidated. Here we reported a case of esosinophilic cholecystitis. Clinical course involved hepatobiliary dysfunction, marked peripheral eosinophilia and perivascular dermatitis with exclusive eosinophilic infiltration after cholecystectomy.
