Authors: Hoi Soo Yoon Kook Jin Chung
Publish Date: 2011/08/12
Volume: 22, Issue: 6, Pages: 493-495
Abstract
A 65yearold man presented with uncontrolled severe low back pain and both leg pain VAS 9 due to failed back surgery syndrome confirmed by magnetic resonance imaging We prescribed transdermal fentanyl patch 25 μg/h for pain relief and at 2 weeks later symptom was lessened VAS 4 But after 1 month he was admitted to our emergency department for nausea vomiting and right upper quadrant RUQ pain occurring 3 days and aggravating 4 h before arrival He used 2 patches 50 μg/h without prescription for the purpose of relieving breakthrough pain for 2 weeks After subsidence of pain he applied TDF with same dose On physical examination and radiologic assessment he was diagnosed as acute acalculous cholecystitis To the best of authors’ knowledge there have been no reports about acute acalculous cholecystitis after abuse of TDF On the diagnosis of acute acalculous cholecystitis AAC laparoscopic cholecystectomy was performed Gangrenous change of GB was found on pathologic specimen Severe abdominal pain was relieved after surgery Acute acalculous cholecystitis can occur as a rare complication after abuse of TDF
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