Bengaluru: Maiya Multispeciality Hospital, Jayanagar, successfully treated a 78-year-old male patient suffering from acute calculous cholecystitis complicated by severe comorbidities and a sudden gastrointestinal bleed. Rapid intervention and coordinated multidisciplinary care enabled the patient to make a full recovery.

High-Risk Patient With Multiple Comorbidities

The patient, Sundar Raju R, arrived with severe abdominal pain for five days. His medical history—diabetes, hypothyroidism, peripheral vascular disease, reactive airway disease, and daily blood thinner use—placed him at extremely high risk for surgery. Early signs of sepsis added to the complexity, and surgery was deferred for blood thinner discontinuation.

During evaluation, he developed massive haematemesis and was shifted to the ICU.

An emergency endoscopy by Dr. Ravindranath revealed nearly 2 litres of aspirated gastric contents. He was stabilised and started on infusion therapy. A repeat endoscopy after 48 hours showed candidiasis, for which targeted antifungal treatment was initiated. “The haematemesis episode was critical. Quick ICU action and timely endoscopy were essential in preventing a fatal outcome and allowing us to continue his treatment safely.” said Dr. Ravindranath, Gastroenterologist.

Dr. Shivakumar, Interventional Radiologist said “Given his age and multiple comorbidities, immediate surgery was too risky. The CT-guided cholecystostomy provided a safe and effective way to control the infection and stabilise him.”

“I faced severe pain and life-threatening complications. The doctors and nurses acted quickly and treated me with great care. I am alive today because of their dedication.” said Sundar Raju R.

The successful outcome was the result of coordinated efforts by a multidisciplinary medical team, including Dr. Sagar, Dr. Niranjan, and Dr. Raghuveer Karanth, whose clinical expertise and continuous monitoring played a key role in managing the patient’s complex condition.

Given the patient’s fragile condition, Interventional Radiologist Dr. Shivakumar performed a CT-guided percutaneous cholecystostomy under local anaesthesia—successfully managing the gallbladder infection without requiring immediate high-risk surgery.

The patient later developed pleural effusion, hypotension, and tachycardia, all of which were managed promptly with noradrenaline support, albumin transfusion, and escalated antibiotics. Within 24 hours, his condition stabilised. He resumed diet, the drain was removed, and he was discharged with follow-up instructions.