PubMed · 10366293
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A W Majeed, A G Johnson. 1999. Cholecystokinin provocation tests.. https://doi.org/10.1136/gut.44.4.579c
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We report on a 58 year-old male who presented with nausea, a painful tumor palpable in the upper right epigastrium, moderate fever without leukocytosis. Both ultrasonic scan and subsequent computerized tomography lead to the primary diagnosis of a malignant tumor of the gall bladder infiltrating the liver and inducing an intrahepatic abscess formation in segments 4b and 3. The patient was scheduled for emergency operation, i.e. abscess drainage, cholezystectomy, and hemihepatectomy. However, at operation a purulent chronic cholezystitis was found without involvement of the liver itself. Consequently, a cholezystectomy was necessary and performed. Histological examination of the gall bladder revealed no signs of malignancy. The patient had an uneventful recovery and was discharged on post-operative day seven. This case report shows the difficulties in the differential diagnosis of inflammable processes and malignancies, which affect the gall bladder and adhering structures. A chronic inflammable process can mimic solid tumors. Despite cost-effective diagnostic tools the correct diagnosis was finally found by surgery.
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