Intermittent Complete Heart Block in Acute Calculous Cholecystitis

The aim of this case report is to present a case of a 24-year old male patient with known cholelithiasis who was presented to the emergency department with acute calculous cholecystitis. The patient was in-itially in sinus rhythm, but during observa-tion converted into a complete heart block. A temporary heart pacemaker was in-serted prior to an emergency laparoscopic cholecystectomy. Postoperatively, the pa-tient converted back to sinus rhythm and made a complete recovery. Considering the patient’s age, normal cardiac workup and that his arrhythmia disappeared after the removal of his gallbladder, it was pos-tulated that this patient had a case of car-dio-biliary reflex. Special attention must be given to patients with acute cholecystitis and electrocardiographic changes. Acute cholecystitis is a treatable cause of a newly diagnosed atrioventricular block, thus im-mediate cholecystectomy should not be deferred.

Atrioventricular block, cholecys-titis, gallstones, cardio-biliary reflex

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