Cytomegalovirus cholecystitis

Published: 04/02/2012

Authors: Callaghan CJ, Freeman S, Drage M, Watson CJE and Huguet EL

A 41-year-old renal transplant recipient presented acutely with severe abdominal pain. An abdominal CT showed significant upper abdominal free fluid causing compression of the liver, with intravascular contrast medium entering a distended gallbladder (arrowed). Laparotomy revealed bleeding from the gallbladder which had ruptured into the peritoneal cavity, causing a haemoperitoneum. Cholecystectomy was performed, the gallbladder mucosa showing widespread ulceration. Histological examination confirmed the clinical diagnosis of cytomegalovirus (CMV) cholecystitis. The patient made a full recovery after treatment with ganciclovir. CMV infection is common in immunosuppressed transplant recipients, but usually occurs in the lungs, liver or bowel.