Korean J Gastroenterol.  2014 Jun;63(6):378-381. 10.4166/kjg.2014.63.6.378.

Clinical Review and Case Report of Ceftriaxone-associated Gallbladder Pseudolithiasis in Adult

• Jung HK
• Lee DS

• KMID: 2234041
• DOI: http://doi.org/10.4166/kjg.2014.63.6.378

Abstract

Although ceftriaxone can be used safely in most instances, it can sometimes induce biliary sludge or stone formation. Most of the patients remain asymptomatic and children are more susceptible to develop this condition, but adults can be affected as well. Because sludge or stones disappear after discontinuing ceftriaxone, this condition is referred to as ceftriaxone-associated pseudolithiasis. A 54-year-old woman was admitted to a local clinic for management of ileus. During admission, she had received ceftriaxone and metronidazole, and had been on nil per os for the past 6 days. She was then referred to our hospital for cholecystectomy due to persistent right upper quadrant pain. Although imaging studies showed gallbladder sludge, pseudolithiasis was suspected because of ceftriaxone administration history and prolonged fasting. After careful watch-and-wait, the condition resolved spontaneously after ceftriaxone discontinuation. Our clear understanding on ceftriaxone-associated gallbladder pseudolithiasis allowed us to avoid an unnecessary cholecystectomy. Herein, we report the case of a 54-year-old woman with ceftriaxone-associated gallbladder pseudolithiasis that was successfully managed by ceftriaxone discontinuation alone.

Keyword

Ceftriaxone; Gallbladder; Pseudolithiasis

MeSH Terms

Adult
Aged
Anti-Bacterial Agents/*adverse effects
Ceftriaxone/*adverse effects
Cholecystectomy
Cholecystolithiasis/*diagnosis/epidemiology/etiology
Female
Gallbladder/ultrasonography
Humans
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed
Anti-Bacterial Agents
Ceftriaxone

Figure

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  Fig. 1. Initial CT scan shows mild gallbladder wall thickening.

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  Fig. 2. Initial abdominal ultrasonogram shows gallbladder sludge and diffuse gallbladder wall thickening.

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  Fig. 3. Follow-up abdominal ultrasonogram shows a normal appearing gallbladder without sludge or stones.

Reference

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