Thinking ahead: gallbladder intussusception following transperitoneal percutaneous cholecystostomy tube placement

BMJ Case Rep. 2021 Feb 9;14(2):e238885. doi: 10.1136/bcr-2020-238885.

Abstract

Percutaneous cholecystostomy (PC) is a common minimally invasive, image-guided procedure performed primarily on high-risk patients with acute cholecystitis for gallbladder decompression. Herein, we present a case of a patient undergoing PC placement using a transperitoneal approach. On subsequent upsizing attempts, the gallbladder fundus was found to invaginate during advancement of replacement drains, causing gallbladder intussusception. The use of a balloon and locked pigtail catheter were required to reposition the gallbladder to proper position. The patient's planned percutaneous cholecystoscopy was delayed by 4 weeks until intended upsizing could be performed. This case demonstrates the advantage of achieving transhepatic gallbladder access to support tract formation and limit procedural complications.

Keywords: biliary intervention; gastrointestinal surgery; interventional radiology; pancreas and biliary tract; radiology.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Cholecystitis, Acute / diagnostic imaging
  • Cholecystitis, Acute / surgery*
  • Cholecystostomy / methods*
  • Female
  • Fluoroscopy
  • Humans
  • Intussusception / diagnostic imaging
  • Intussusception / etiology*
  • Intussusception / surgery*