A Case of Eosinophilic Cholecystitis associated with Eosinophilic Cholangitis and Pancreatitis

Kim, Yeong Muk; Lee, Dong Yun; Lee, Joon Sang

Abstract

Eosinophilic cholecystitis is a rare form of cholecystitis which was first described by the French workers in 1949. Histologically, it is characterized by a dense, transmural leukocyte infiltration and is composed of more than 90% eosinophils. Eosinophilic cholecystitis is usually unsuspected and indistinguishable from calculous cholecystitis. The etiology of eosinophilic cholecystitis is unknown. The several possible reasons are a local eosinophilic inflammatory reaction to gallstone or parasites, a manifestation of eosinophilic gastroenteritis, a systemic hypereosinophilic syndrome, or an allergic hypersensitivity response to drugs or other immunogens. In reviewing the literatures, twelve cases of eosinophilic cholecystitis were reported subsequently. Among the cases, 5 cases were eosinophilic cholecystitis and cholangitis with extrahepatic obstruction. We experienced the case in a 30-year-old man who complained of high fever and right upper quadrant pain. He was diagnosed as having eosinophilic cholecystitis and cholangitis and received cholecystectomy. Here, we present an unusual case of eosinophilic cholecystitis. By the pathological observation, eosinophilic infiltration of all three layers of gall bladder wall was associated with cholangitis, pancreatitis and peripheral eosinophilia.