Research Information System
2nd Southeast European Congress of Emergency and Disaster Medicine 20 - 22 July 2019 İstanbul, İstanbul, Turkey, 20 - 22 June 2019, pp.114
Introduction
Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a multisystemic disorder characterized by
multiple cysts in both kidneys (1.) Even though age-related non-genetic renal cysts with normal renal
function are seen, bilateral multiple renal cysts should suggest an underlying hereditary disease (2).
Clinically, renal blood flow reduction as a result of kidney enlargement, urinary system or cyst infections,
hematuria, hemorrhage, nephrolithiasis and end-organ damage as a result of hypertension is
seen. Major non-renal complications are a cerebral aneurysm, hepatic and pancreatic cysts, cardiac
valve diseases, colonic diverticulum, inguinal hernia(3). In addition, the incidence of cancer increases
in these patients (4). In our case, we presented the clinical picture of renal cysts causing choledochal
canal and gallbladder compression.
Case
A 68-year-old man was admitted to our emergency department with nausea, vomiting and abdominal
pain. The arterial blood pressure was 130/80 mmHg, pulse 78 beats/min. and no fever. He had been
by-pass 17 years ago and had rectal cancer surgery 7 months ago. On physical examination, there was
only mild tenderness and distension in the right upper quadrant and epigastric region. Laboratory Tests:
Wbc:17.9 103
/L, Hemoglobin:11.6g/dL, Urea:92 mg/dL, creatinine:1.59mg/dL, sodium (Na):123 mmol/L,
potassium:4.3mmol/L, C-reactive protein: 218 mg/L, aspartate aminotransferase:59U/L, alanine
aminotransferase:117 U/L, amylase:79 U/L, lipase: 13 U/L, gamma-glutamyl transferase:148 U/L, total
bilirubin:1.53mg/dL, direct bilirubin:1.03 mg/dL, glucose:107 mg/dl. Abdominal ultrasonography
revealed normal and multiple renal cysts. In abdominal tomography, cysts are seen to compress the
gallbladder and bile duct (Figure 1). After the patient was consulted to the urology specialist, he was
hospitalized for further examination and treatment.
Conclusion
The patients with polycystic kidney disease may also mimic acute cholecystitis due to the big size of the
cysts. So, these patients should be closely monitored due to their complications.
Computed tomography scan showing the compression of renal cysts into the
gallbladder
Keywords: Polycystic Kidney Disease; Abdominal pain; Cholecystitis