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Korean J Gastroenterol  <  Volume 53(4); 2009 <  Articles

Korean J Gastroenterol 2009; 53(4): 261-264  
A Case of Actinomycosis of Gallbladder Presenting as Acute Cholecystitis
Jae Hoon Lee, Eui Tae Hwang, Ki Hoon Kim, Hyang Jeong Jo, Tae Hyeon Kim, Suck Chei Choi, Chang Soo Choi
Departments of Internal Medicine and Pathology*, Wonkwang University College of Medicine, Iksan, Korea. cscmed@wku.ac.kr
Published online: April 25, 2009.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Actinomycosis is a chronic suppurative and granulomatous disease, characterized by the formation of abscess, draining sinuses, abundant granulation, and dense fibrous tissue. Actinomycosis of the gallbladder is extremely rare. We report a case of an 56-years old man who abruptly presented with right upper quadrant abdominal pain. Abdominal CT showed that the gallbladder had 2 cm sized stone and an edematous thick wall. Our preoperative diagnosis was acute calculous cholecystitis. After the management of acute cholecystitis, laparoscopic cholecystectomy was performed but converted to open surgery due to severe adhesion to liver and greater omentum. Partial cholecystectomy was performed. Histologic section of the gallbladder showed sulfur granule with gram-positive branching bacilli compatible with actinomyces. After cholecystectomy, the patient received intravenous penicillin G for 2 weeks, followed by oral penicillin for 3 months.
Keywords: Actinomycosis,Gallbladder,Cholecystitis


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