Acute Gangrenous Cholecystitis During Pregnancy: A Case Report.

Acute cholecystitis is one of the most common nonobstetric surgical emergencies during pregnancy. Progression to gangrenous cholecystitis is rare but is associated with significant maternal and fetal morbidity. We report the case of a 26-year-old primigravida at 25 weeks' gestation who presented with severe right upper quadrant pain, fever, and vomiting. Laboratory evaluation revealed elevated serum inflammatory markers. Transabdominal ultrasonography demonstrated gallbladder wall thickening, pericholecystic fluid, and biliary sludge. Despite 24 h of conservative management, her clinical condition deteriorated. Following multidisciplinary consultation, urgent open retrograde cholecystectomy was performed, revealing a gangrenous gallbladder. Postoperative recovery was uneventful, and she subsequently delivered a healthy term infant. Early recognition and timely surgical intervention are essential in the management of complicated biliary disease during pregnancy. This case highlights the importance of multidisciplinary care and supports current recommendations for operative management of severe or complicated acute cholecystitis during pregnancy.