95-year-old woman in critical condition due to necrotizing cholecystitis.

(Dan Tri Newspaper) - A 95-year-old woman was admitted to the hospital in critical condition due to necrotizing cholecystitis and severe infection. Doctors at Hong Ngoc General Hospital promptly provided emergency care and successfully treated her.

Critically ill due to necrotizing cholecystitis and severe infection caused by gallstones.

The patient, Mrs. NTO (95 years old), was admitted to Hong Ngoc General Hospital's emergency room with a persistent high fever above 39 degrees Celsius for several days, severe pain around the navel and right lower rib area, abdominal distension, and frequent vomiting.

According to the family, the patient had a history of gallstones for many years but had never received treatment because there were no obvious symptoms before. Recently, the pain became severe, and medication was no longer effective, forcing the family to bring the patient to the hospital for examination and emergency treatment.

At Hong Ngoc General Hospital, test results showed alarmingly high levels of all indicators; specifically, the CRP (coronavirus) index, which assesses the level of inflammation, increased 42 times, and the level of sepsis increased more than 30 times the normal level.

Simultaneously, abdominal CT scans revealed a dilated common bile duct measuring up to 10 cm, with three gallstones at the distal end, the largest measuring 6 mm. The gallbladder was distended, with edematous walls, a 9 mm stone lodged in the neck of the gallbladder, and fluid in the gallbladder lumen with surrounding fatty infiltration. The doctor diagnosed necrotizing cholecystitis due to gallstones, common bile duct stones with biliary tract infection, a particularly dangerous condition in the elderly.

Image of gallstones in the common bile duct and gallbladder neck (Photo: BVCC).

"The patient's condition is very serious; the gallbladder is severely inflamed and necrotic, accompanied by prolonged fluid accumulation and pressure throughout the bile ducts. The risk of complications such as peritonitis, abscess formation, pus pockets, sepsis, etc., is very high."

"Even in young people, this is already a very serious condition, and for very elderly patients with poor health and multiple underlying conditions like patient O, it becomes even more dangerous," said Dr. Do Tuan Anh, Department of Gastrointestinal Surgery, Hong Ngoc General Hospital, the doctor who directly treated patient O.

Multidisciplinary collaboration and step-by-step intervention saved the life of a 95-year-old woman.

Recognizing this as a particularly severe case, the medical team at Hong Ngoc General Hospital quickly organized a multidisciplinary consultation involving Gastrointestinal Surgery, Gastroenterology, Interventional Radiology, and Anesthesia and Resuscitation specialists to conduct a comprehensive clinical examination, screen for underlying conditions, assess potential risks, and develop the safest treatment plan for the elderly patient.

"The patient's condition is very serious, so medication alone will not be effective; surgical intervention is definitely necessary. Because the patient is elderly, every step of the treatment must be carefully planned and implemented safely," emphasized Dr. Do Tuan Anh during the consultation.

Accordingly, after thorough consultation, the medical team decided to choose the percutaneous bile drainage method under ultrasound guidance to remove all accumulated bile fluid, immediately relieving biliary tract pressure.

Under ultrasound guidance, the Interventional Radiology team quickly performed aspiration and drainage of 520ml of cloudy green fluid, rapidly reducing pressure in the gallbladder and bile ducts, and improving the inflammatory condition.

Following drainage, inflammatory markers improved significantly, and the patient continued with intensive medical treatment. After two days, the patient's condition stabilized, and the medical team proceeded with cholecystectomy combined with choledochotomy to remove stones and place a Kehr drain.

"In cases of severe necrotizing cholecystitis with complex inflammatory adhesions, open surgery allows doctors to proactively control the damage and is safer than laparoscopic surgery. Especially in elderly patients, this method shortens the surgical and anesthesia time, thereby reducing the risk of complications during and after surgery," explained Dr. Do Tuan Anh.

Dr. Do Tuan Anh and his team performed laparoscopic cholecystectomy on patient O (Photo: Provided by the hospital).

After 60 minutes of intervention, Dr. Do Tuan Anh and his team proceeded to remove the entire necrotic inflamed gallbladder, and simultaneously opened the common bile duct to remove a 6mm gallstone, safely inserting a Kehr drain.

With the application of the Enhanced Recovery After Surgery (ERAS) model, just two days after the intervention, Ms. O's health recovered well, she experienced little pain, and was able to sit up and eat light meals. Eight days after surgery, Ms. O's surgical wound was dry and healing well, she had a good appetite, no longer had abdominal pain, and was discharged from the hospital.

Based on the above case, doctors advise that elderly people who are diagnosed with gallstones should be monitored and treated early to avoid the disease progressing and causing dangerous complications. At the same time, old age does not mean the loss of treatment opportunities; with timely and appropriate intervention, patients can still recover well and return to normal life.

People needing consultation, examination, and treatment for gallstones at Hong Ngoc General Hospital can contact the hotline at 0911 908 856 - 0912 002 131.

Source: https://dantri.com.vn/suc-khoe/cu-ba-95-tuoi-nguy-kich-vi-viem-tui-mat-hoai-tu-20260207114343247.htm