First case of post-Covid gallbladder gangrene reported in India

New Delhi: In the first such instance in the country, a Delhi hospital reported five cases of gall bladder gangrene among patients who recovered from COVID-19 and surgically treated them.

The cases were treated at Sir Ganga Ram Hospital here.

Prof Dr Anil Arora, Chairman, Institute of Liver, Gastroenterology and Pancreatobiiliry Sciences, Sir Ganga Ram Hospital said they have successfully treated five patients of gall bladder gangrene between June and August this year who had recovered from COVID-19 infection.

“They reported severe inflammation of gall bladder without gall stones (acalculous cholecystitis) resulting in gangrene of gall bladder requiring urgent surgery,” he said.

Dr Arora said such random cases have been reported for the first time in India.

“To the best of our knowledge, this is the first time five cases have been reported from India in which the gall bladder gangrene had occurred in patients after recovery from COVID-19. The patients were between 37 and 75 years and one of them was a woman. All patients had fever and pain in the right upper quadrant of the abdomen and nausea. Two of these patients had diabetes and one also had heart disease. Three patients had received steroids for the management of COVID-19 symptoms.” he said.

“The median duration between COVID-19 symptoms and diagnosis of acalculous cholecystitis was two months. Diagnosis in these patients was confirmed using ultrasound and CT scan of the abdomen which showed gall bladder wall oedema and gangrene in all with concomitant gall bladder perforation in four patients. All these patients successfully underwent laparoscopic removal of necrotic perforated gall bladders,” Dr Arora explained.

Dr Praveen Sharma, Senior Consultant, Gastroenterology Department, Sir Ganga Ram Hospital, said that timely diagnosis is the key to prevention of the condition.

“In this smouldering pandemic, a high index of suspicion of this entity in a patient with fever and right upper quadrant pain especially with a history of recent recovery from COVID-19 infection besides timely diagnosis and early intervention with broad-spectrum antibiotics may prevent the development of onerous complication of gangrene and perforation of the gall bladder,” Dr Sharma said.