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Case 21 

Case 21
Chapter:
Case 21
Author(s):

Alissa J. Walsh

, Otto C. Buchel

, Jane Collier

, and Simon P.L. Travis

DOI:
10.1093/med/9780199557899.003.21
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date: 20 August 2019

The gastroenterology registrar was called to see a 38-year-old woman with multiple sclerosis, right upper quadrant pain, and fever. She had had cholecystitis a week earlier and a laparoscopic cholecystectomy 5 days ago. Histopathology had shown a gangrenous gallbladder with several areas of microperforation. Initially her recovery had been good, but on postoperative day 5 she developed severe right upper quadrant pain, back pain, and fevers. Her only medications were the oral contraceptive pill and interferon treatment for her multiple sclerosis. There was a family history of thrombosis, and prophylactic low molecular weight heparin had been given perioperatively.

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