대장 내시경 후에 발생한 급성 담낭염은 매우 드문 증례로 알려져 있다. 그러나 담낭염의 위험인자를 가진 환자에서 대장 내시경 후에 복통이 발생했을 경우, 반드시 담낭염을 감별진단해야 한다. 아직까지 정확한 발생 원인에 대해 밝혀진 바는 없으나 대장 내시경 전처치 과정에서 발생한 탈수, 대장 내시경에 의한 대장 점막 손상 등이 보고되었다. 저자들은 대장 내시경후 복통의 원인중 드문 질환인 급성 담낭염을 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다.
Acute cholecystitis after colonoscopy is very rare, and has not been extensively studied. A 51-year-old male with history of acute cholecystitis caused by common bile duct stones 1 year ago underwent screening colonoscopy. Colonoscopy was performed without difficulty and showed normal findings. Two days after colonoscopy, right upper quadrant abdominal pain and fever were developed. Abdominal computed tomography showed an enlargement of gallbladder with diffuse wall thickening and gallstones in the neck of gallbladder. The findings were consistent with that of acute cholecystitis as post-colonoscopy complication. Although its pathophysiology is uncertain, possible causes including dehydration of patient, concentration of bile and bacterial translocation were suggested in previous reports. Due to its rarity, it is hard to suspect an acute cholecystitis as primary complication of colonoscopy. Thus acute cholecystitis should be considered in differential diagnosis of patients with abdominal pain and fever after colonoscopy, particularly those who with history of gallstones.