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An Unusual Case of Gallbladder Disease

Arindam Purkayastha, MD; Madhukar Saran, MD; Ernest Gerfin, MD
JAMA. 1980;243(20):2031. doi:10.1001/jama.1980.03300460015015.
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To the Editor.—  We had a case involving a 59-year-old woman admitted for elective cholecystectomy. The patient was known to have chronic gallbladder disease proved by findings from a previous oral cholecystogram that showed no definite visualization of the gallbladder. Ultrasound examination of the gallbladder showed the gallbladder to be small and shrunken, and strong echoes coming from it indicated the presence of stones, giving an impression of chronic cholecystitis and cholelithiasis. Incidentally noted was that the patient was a mild diabetic and hypertensive, but her condition was well controlled with medication.Routine laboratory investigations included a complete blood cell count, urinalysis, chest roentgenogram, ECG, and 12-factor automated chemical analysis, results of which were all within normal limits. Results of an upper gastrointestinal series were also reported as showing the esophagus to have tertiary waves and a small hiatal hernia. Protrusion of the antral mucosa into the base of the


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