Acute cholecystitis after colonoscopy: a case series

The Role of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Acute Cholecystitis After a Routine Colonoscopy: A Case Report

Colonoscopy (CLN) is a common procedure for colon cancer screening and diagnosing various conditions. Acute cholecystitis (AC), though rare, has been reported as a complication. We present a 66-year-old female on semaglutide for obesity who developed AC within 72 hours post-CLN. Considering the increasing use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and their impact on gallbladder motility, these medications may contribute to this complication. Future research is crucial to investigate whether a washout period for GLP-1 agonists before CLN is needed to reduce the risk of AC, if such a risk exists.

Acute Cholecystitis, A Rare Complication Following Routine Colonoscopy: Case Series and Literature Review

Colonoscopy is a commonly performed low-risk gastrointestinal procedure that may rarely result in a serious complication. Patients presenting with abdominal pain and fever after colonoscopy may have acute cholecystitis. The underlying mechanisms are unclear. Such patients usually present within 72 hours of the procedure. Treatment includes intravenous antibiotics and cholecystectomy. We present our experience of two such cases; a 56-year-old man and a 21-year-old man, both of whom developed acute calculus cholecystitis within 48 hours after a routine colonoscopy. Their symptoms resolved after cholecystectomy.

Postcolonoscopy Appendicitis: A Review of 57 Cases

The purpose of this study is to review the cases of postcolonoscopy appendicitis (PCA) reported in the literature. A comprehensive search using PubMed, EMBASE, Scopus, and Google Scholar identified 57 cases. The median age at presentations of PCA was 55 years. PCAs typically occurred during the first 24 hours after colonoscopy, and the majority developed after diagnostic colonoscopy. Clinical presentations were similar to those with common acute appendicitis, though with a high perforation rate. Most patients were correctly diagnosed using ultrasound or computed tomography scan. Treatment included open appendicectomy, laparoscopic appendicectomy or cecotomy, radiologic drainage of the abscess, nonoperative treatment with antibiotics. In addition to barotrauma, fecalith impaction into the appendiceal lumen, direct trauma to the appendiceal orifice, and underlying ulcerative colitis, a pre-existing subclinical disease of the appendix seems to play an important role in the pathogenesis. For PCA, timely diagnosis and management are crucial to attain a satisfactory outcome.

Acute Cholecystitis as a Complication after Colonoscopy: A Case Report and Literature Review

Acute cholecystitis after colonoscopy is a rare event, with less than 10 cases described in the literature. We report the case of a male patient with silent gallstones who underwent colonoscopy for follow-up of his Crohn's disease. The colonoscopy revealed erosions in the terminal ileum, from which biopsies were taken. A sessile polyp 4 mm in diameter at the recto-sigmoid junction was also removed. Less than 24 h after the colonoscopy, the patient complained of upper right quadrant pain, nausea and vomiting. Based on the clinical findings, laboratory data and ultrasonography, we diagnosed acute cholecystitis and excluded any complication after the colonoscopy. Laparoscopic cholecystectomy was performed and the patient was discharged.

LEARNING POINTS

Cholecystitis following colonoscopy can be a rare complication or a coincidence.Rarely, manoeuvres during colonoscopy may dislodge small gallstones which then obstruct the bile duct causing acute cholecystitis.Imaging and the clinical picture help to differentiate bowel perforation, a fairly common early event after colonoscopy, from other complications.

Acute cholecystitis after a colonoscopy

Acute cholecystitis after a colonoscopy is a rare event, and only eight documented cases are reported in the literature. A 35-year-old male underwent a screening colonoscopy. There was a 5-mm sessile polyp in the sigmoid colon, which was removed by using a hot snare polypectomy. Forty-eight hours after the colonoscopy, the patient visited our emergency department with epigastric pain and fever. Based on the clinical findings, laboratory data and radiologic imaging, our diagnosis was acute cholecystitis. Because no previous cases of this type have been reported to date in Korea, we publish the details of our patients who presented with a postcolonoscopy complication diagnosed as acute cholecystitis.

[A case of acute cholecystitis after colonoscopy]

A 43-year-old man, who received total gastrectomy five years ago for advanced gastric cancer, underwent a screening colonoscopy and abdominal CT scan. Abdominal CT scan revealed no abnormal findings. Colonoscopy revealed polyps at the rectum, which were removed by polypectomy. The patient did not complain of abdominal pain or discomfort throughout the procedure. But, he developed right upper quadrant abdominal pain on the next day after colonoscopy. Abdominal CT scan revealed the distended gallbladder with mild wall thickening and suspicious sandy stones or sludge in the gallbladder. The patient underwent an open cholecystectomy. Pathology was compatible with acute cholecystitis. We should be aware of and consider cholecystitis in the differential diagnosis for patients with abdominal pain after colonoscopy.