Royal College of Surgeons in Ireland
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Transformation of acute cholecystitis to acute choledocholithiasis in COVID-19 patient

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journal contribution
posted on 2022-02-10, 07:29 authored by David Song, Harinivaas Shanmugavel Geetha, Andrew Kim, Tasur Seen, Talal Almas, Vikneswaran Raj NagarajanVikneswaran Raj Nagarajan, Noor Alsaeed, Jui Hsin Cheng, Joseph Lieber
The global pandemic of Coronavirus 2019 (COVID-19) or SARS-CoV-2 has numerous manifestations in different organ systems. It is known that SARS-CoV-2 infects the hepatobiliary system leading to presentations such as acute cholecystitis, choledocholithiasis and hepatitis. Although the exact mechanism of the underlying pathology is unknown, it is likely attributed by the tropism of the virus to the ACE2 receptors in the hepatocytes and bile duct cells resulting in a cytokine storm that precipitates as systemic symptoms from acute COVID-19 infection. In this case report we present a case of a 47-year-old male who presented with signs consistent with acute cholecystitis. It was confirmed on ultrasound and he was incidentally found to be positive for COVID-19 on routine surveillance testing. He was asymptomatic and was being prepped for cholecystectomy, but developed an acute elevation of liver enzymes suggesting choledocholithiasis. After endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy the patient experienced a rapid normalization of liver enzymes and improvement of his abdominal symptoms.



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Published Citation

Song D, et al. Transformation of acute cholecystitis to acute choledocholithiasis in COVID-19 patient. Ann Med Surg (Lond). 2021;71:102946.

Publication Date

14 October 2021

PubMed ID



  • Undergraduate Research


Elsevier B.V.


  • Published Version (Version of Record)