Retrohepatic Cholecystitis in a Human Immunodeficiency Virus-Infected Patient

A 48-year-old male patient with HIV and HCV described abdominal pain in the right hemiabdomen for the previous 72 h and a fever of 38.5 °C. Examination: hepatomegaly, pain and abdominal guarding in the right hypochondrium and flank. Work-up: leukocytes 17 200 (90% neutrophils); Quick 55%; total bilirubin 7.68 mg/dL; GPT 114 UI/L and PCR 14.4 mg/dL. Ultrasound: hyperechogenic mass measuring 8×4.7 cm in liver segment 7 (Fig. 1). CT: in the lateral retrohepatic region, image measuring 18 cm×80 cm×110 cm with water density and bubbles in its interior, suggestive of a gall bladder in an ectopic location with signs of acute emphysematous cholecystitis (Fig. 2). Treatment with antibiotics was initiated and percutaneous cholecystostomy was performed.

Fig. 1

Fig. 2