Covid-19: Five recovered patients at Ganga Ram diagnosed with gallbladder gangrene; first such case in India

Five patients who recovered from Covid-19 at Sir Ganga Ram Hospital developed gallbladder gangrene. The hospital’s medical experts believe these to be 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 abdomen’s right upper quadrant of abdomen, fever, and vomiting. Two of the patients had diabetes, while one suffered from heart disease. Three patients had received steroid shots to manage the Covid-19 symptoms.

Dr. Anil Arora, Chairman of Sir Ganga Ram Hospital’s Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, told 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 inflammation of gallbladder without gallstones (acalculous cholecystitis), thus resulting in gangrene that required urgent surgery, he added.

Dr. Arora said that this could be the first report of such a series of cases of gallbladder gangrene in patients following recovery from Covid-19 in India.

The median duration between the manifestation of Covid-19 symptoms and acalculous cholecystitis diagnosis was two months. The hospital confirmed the diagnosis through CT scan and ultrasound of the abdomen.

Gallbladder stone is a very common disease in north India, affecting around 8 per cent of the general population. It causes 90 per cent of acute inflammation cases — cholecystitis. Only 10 per cent patients suffer from acalculous cholecystitis — inflammation of the gallbladder without cystic duct obstruction or gallstones.

Dr. Arora said the patients suffering from acalculous cholecystitis underwent successful laparoscopy to remove necrotic perforated gall bladders. Acalculous cholecystitis with gangrenous gallbladder is a serious health hazard and has a high morbidity rate between 30 and 60 per cent, he added. The mortality rate is much higher than calculous cholecystitis.

Acalculous cholecystitis is usually witnessed in patients who suffer from HIV, diabetes, total parenteral nutrition, vascular disease. People on prolonged fasts, patients in ICUs, and those with an underlying history of burns, trauma, and sepsis can also suffer from the condition.

The doctors said the five patients who recovered from Covid-19 did not have these common predisposing factors.

Dr. Praveen Sharma, a senior consultant in the Gastroenterology Department, told The Indian Express that timely diagnosis as well as early intervention through broad spectrum antibiotics could prevent onerous complications of gangrene and gallbladder perforation.