<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2184-0628</journal-id>
<journal-title><![CDATA[Gazeta Médica]]></journal-title>
<abbrev-journal-title><![CDATA[Gaz Med]]></abbrev-journal-title>
<issn>2184-0628</issn>
<publisher>
<publisher-name><![CDATA[Círculo Médico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2184-06282022000300248</article-id>
<article-id pub-id-type="doi">10.29315/gm.v1i1.582</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Colecistite Aguda Alitiásica: A Propósito de uma Causa Inusitada]]></article-title>
<article-title xml:lang="en"><![CDATA[Acute Acalculous Cholecystitis: About an Unusual Cause]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guimarães]]></surname>
<given-names><![CDATA[Maria João]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carvalho]]></surname>
<given-names><![CDATA[Ana Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gonçalves]]></surname>
<given-names><![CDATA[Sameira]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Dinis]]></surname>
<given-names><![CDATA[João]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Aces Alto Ave USF Novo Cuidar ]]></institution>
<addr-line><![CDATA[Fafe ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Senhora da Oliveira Serviço de Cirurgia Geral ]]></institution>
<addr-line><![CDATA[Guimarães ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>09</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>09</month>
<year>2022</year>
</pub-date>
<volume>9</volume>
<numero>3</numero>
<fpage>248</fpage>
<lpage>254</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2184-06282022000300248&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2184-06282022000300248&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2184-06282022000300248&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo A colecistite aguda alitiásica é uma doença inflamatória aguda da vesícula biliar, sem evidência de cálculos e com patogénese multifatorial. Observa-se sobretudo em pacientes com múltiplas comorbilidades ou estados de imunossupressão, encontrando-se associada a maior morbilidade e mortalidade, comparativamente com a entidade litiásica. Doente, género feminino, 50 anos de idade, com infeção recente por SARS-CoV-2 recorreu a teleconsulta por epigastralgia com irradiação dorsal, com quatro dias de evolução, associado a náuseas, com melhoria sintomática naquele dia. Solicitados estudo analítico, ecografia abdominal e endoscopia digestiva alta urgentes. A ecografia demonstrou &#8220;colecistite aguda alitiásica&#8221;. Referenciada ao serviço de urgência com consequente colecistectomia por laparotomia, após conversão de laparoscopia, revelando perfuração pilórica por espinha de peixe com inflamação vesicular por contiguidade. A colecistite aguda alitiásica representa 2% a 15% dos casos de colecistite aguda, ocorrendo sobretudo acima dos 60 anos e no género masculino. A doente em causa não apresentava o biótipo, as comorbilidades e a apresentação clínica típicos desta patologia. A infeção recente por SARS-CoV-2 levantou a suspeita de um papel etiológico, contraposto após a cirurgia. A ingestão de corpos estranhos é considerada comum, mas apresenta maioritariamente um curso benigno, com complicações em menos de 1% dos casos. A doente apresentava escassos fatores predisponentes à ingestão de corpos estranhos. Uma tomografia computorizada no período pré-cirúrgico poderia ter esclarecido a etiologia e contribuído para a orientação do procedimento. Eis um caso clínico de uma patologia invulgar, de etiologia rara, numa doente atípica, com um desfecho bem-sucedido, em plena pandemia COVID-19.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Acute acalculous cholecystitis is an acute inflammation of the gallbladder in the absence of gallstones and with multifactorial pathogenesis. Mainly seen in patients with multiple comorbidities or immunosuppressive states, being associated with greater morbidity and mortality compared to the lithiasic entity. Patient, female, 50 years old, with recent SARS-CoV-2 infection. Used teleconsultation for epigastric pain with dorsal irradiation, with four days of evolution, associated with nausea, with symptomatic improvement that day. An urgent abdominal ultrasound, analytical study and upper digestive endoscopy were requested. The ultrasound showed &#8220;acute acalculous cholecystitis&#8221;. She was referred to the emergency department, with subsequent laparotomy revealing a pyloric perforation caused by a fishbone with contiguity vesicular inflammation. Acute acalculous cholecystitis comprises from 2%-15% of all cases of acute cholecystitis and occurs mainly over the age of 60 and in males. Our patient did not have the typical biotype, comorbidities and clinical features of this pathology. Recent SARS-CoV-2 infection has raised suspicion of a possible etiological role, opposed after surgery. Ingestion of foreign bodies is considered common, mostly presenting a benign course, with complications in less than 1% of cases. The patient presented few predisposing factors of foreign bodies ingestion. A computerized tomography scan in the pre-surgical period could have clarified the etiology and contributed to guide the procedure. Here is a clinical case of an unusual pathology, of rare etiology, in an atypical patient, with a successful outcome in the middle of the COVID-19 pandemic.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Colecistite Acalculosa/diagnóstico por imagem]]></kwd>
<kwd lng="pt"><![CDATA[Colecistite Acalculosa/etiologia]]></kwd>
<kwd lng="pt"><![CDATA[Corpos Estranhos/complicações]]></kwd>
<kwd lng="pt"><![CDATA[Peixes]]></kwd>
<kwd lng="en"><![CDATA[Acalculous Cholecystitis/diagnostic imaging]]></kwd>
<kwd lng="en"><![CDATA[Acalculous Cholecystitis/etiology]]></kwd>
<kwd lng="en"><![CDATA[Fishes]]></kwd>
<kwd lng="en"><![CDATA[Foreign Bodies/complications]]></kwd>
</kwd-group>
</article-meta>
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<year>2015</year>
<volume>2015</volume>
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