Acute acalculous cholecystitis following the bite of Indian saw-scaled viper

Nalawade, A. B., Krishnan, A., Khare, M. S. and Karnad, D. R. (2006) Acute acalculous cholecystitis following the bite of Indian saw-scaled viper. Journal of Postgraduate Medicine, 52 2: 151-152.

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Author Nalawade, A. B.
Krishnan, A.
Khare, M. S.
Karnad, D. R.
Title Acute acalculous cholecystitis following the bite of Indian saw-scaled viper
Journal name Journal of Postgraduate Medicine   Check publisher's open access policy
ISSN 0022-3859
Publication date 2006-04
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 52
Issue 2
Start page 151
End page 152
Total pages 2
Place of publication Ghatkopar East, Mumbai, Maharastra, India
Publisher Medknow Publications and Media
Language eng
Formatted abstract
A 27year-old man was bitten on the left foot by a saw-scaled viper. Twelve hours later he developed local pain, swelling and hematuria. On admission to the hospital 24 hours later, he had anuria and jaundice. He had tachycardia, normal blood pressure and normal systemic examination.

Acute acalculous cholecystitis occurs in 1.5% of critically ill patients due to stasis of bile and ischemia of the gallbladder wall from hypotension and microcirculatory thrombosis. Predisposing conditions include sepsis, severe falciparum malaria, total parenteral alimentation and positive pressure ventilation; our patient had none of these. The exact mechanism of acalculous cholecystitis in our patient is not clear. When radiolabelled venom is administered by parenteral injection, a large proportion of it is excreted by the hepatobiliary route. Phospholipase A2, which causes local inflammation and necrosis, may play an important role in the pathogenesis by converting phospholipids in bile into toxic fatty acids and lysolecithin. Microcirculatory thrombosis secondary to DIC may also have contributed by causing gallbladder ischemia.
Q-Index Code CX
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Published under "Letters".

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Fri, 08 Apr 2011, 15:31:34 EST by Dr Anand Krishnan on behalf of Anaesthesiology and Critical Care - PAH