Infection of the left sided gallbladder simulating liver abscess and gastric antral tumor

Kim, J W; Ahn, J S

Abstract

The left sided gallbladder, being a rare occurrence, may create diagnostic problem especially when it becomes infected. Recently, we have experienced 2 cases of infection of the left sided gallbladder at the Department of Radiology, St. Mary's Hospital, Catholic Medical College. Case I was a 32-year-old housewife with dyspepsia, epigastric pain and recurring bouts of high fever of 2 months duration. Under the provisional diagnosis of liver abscess liver scan was performed which revealed well defined cold area in the left lobe supporting the provisional diagnosis. Tender cystic mass was aspirated and pus was drained. The injected air at the occasion of aspiration outlined well defined cystic structure. Because aspiration failed to control the symptoms, laparotomy wasperformed. Surgeon found a left sided gallbladder which was empyematous. Case II was a 38-year-old business man admitted to the hospital because of tender ill defined mass in mid epigastrium. The patient was febrile (39.4 C)and anemic. An upper GI series disclosed an irregular filling defect involving the antrum of the stomach. The masswas primarily extrinsic but was closely fixed to the gastric wall. Surgical intervention revealed chronic cholecystitis and pericholecystitis with thick adhesion to the distal stomach.