Five patients who recovered from Covid-19 at Sir Ganga Ram Hospital developed gangrene of the gallbladder. The hospital’s medical experts believe that these are the first such cases in India.
The five patients, a woman and four men between the ages of 37 and 75, underwent treatment for Covid-19 between June and August at the hospital. They complained of pain in the right upper quadrant of the abdomen, fever, and vomiting. Two of the patients had diabetes, while one suffered from heart disease. Three patients had received steroid injections to control Covid-19 symptoms.
Dr. Anil Arora, President of the Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences at Sir Ganga Ram Hospital, said The Indian Express They successfully treated five patients suffering from gallbladder gangrene between June and August. The patients had recovered from Covid-19 and developed severe gallbladder inflammation without gallstones (acalculous cholecystitis), resulting in gangrene that required urgent surgery, he added.
Dr. Arora said that this could be the first report of a series of gallbladder gangrene cases in patients recovering from Covid-19 in India.
The median duration between the manifestation of Covid-19 symptoms and the diagnosis of acalculous cholecystitis was two months. The hospital confirmed the diagnosis using a CT scan and an abdominal ultrasound.
Gallbladder stone is a very common disease in North India, affecting around 8 percent of the general population. It causes 90 percent of cases of acute inflammation: cholecystitis. Only 10 percent of patients have acalculous cholecystitis – inflammation of the gallbladder without cystic duct obstruction or gallstones.
Dr. Arora said that patients suffering from acalculous cholecystitis underwent successful laparoscopy to remove necrotic perforated gallbladders. Acalculous cholecystitis with gangrenous gallbladder is a serious health hazard and has a high morbidity rate of between 30 and 60 percent, he added. The mortality rate is much higher than calculous cholecystitis.
Acalculous cholecystitis is generally seen in patients suffering from HIV, diabetes, total parenteral nutrition, vascular disease. People on long fasts, ICU patients, and those with an underlying history of burns, trauma, and sepsis can also suffer from the condition.
Doctors said the five patients who recovered from Covid-19 did not have these common predisposing factors.
Dr. Praveen Sharma, Senior Consultant in the Department of Gastroenterology, said The Indian Express that early diagnosis, as well as early intervention through broad-spectrum antibiotics, could prevent the burdensome complications of gangrene and gallbladder perforation.