2026 Volume 40 Issue 1 Pages 118-125
The patient was a 69-year-old male who had been undergoing hemodialysis for chronic diabetic renal failure. He also had a history of surgery for coronary artery disease and is currently being treated for peripheral arterial disease. CTRX was administered at a dosage of 2g/day because of leg cellulitis. He complained of epigastralgia at 15 days after the start of CTRX treatment. US and CT revealed the high density structures in the gallbladder and abnormally thick gallbladder wall. A diagnosis of CTRX-associated pseudolithiasis with acute cholecystitis was made. PTGBD was performed to improve his general condition, and laparoscopic cholecystectomy was subsequently performed. Histopathological diagnosis of acute gangrenous cholecystitis was obtained.
We suggest that CTRX should be cautiously administered in a patient with renal impairment, especially in hemodialysis patients with renal failure. In addition, clinicians should be aware of the possibility to cause severe biliary disorder, such as acute gangrenous cholecystitis that requires surgical treatment when CTRX is administered in patients with risk factors.
