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Abstract

Background: Eosinophilic cholecystitis (EC) is a rare inflammatory condition of the gallbladder characterized by dense eosinophilic infiltration, with an incidence ranging from 0.25% to 6.4% of all cholecystitis cases. Its pathogenesis remains poorly understood, potentially involving allergic, autoimmune, or idiopathic mechanisms, with gallstones present in a minority of cases.
Case Presentation: This case report describes a 25-year-old female presenting with postprandial right upper quadrant pain and gallstones, diagnosed with EC following laparoscopic cholecystectomy. Histo-pathological examination revealed over 90% eosinophilic infiltration and a strawberry-like mucosal appearance, with no systemic eosinophilic disorders identified.
Discussion: A comprehensive literature review of 20 studies (1979–2024) synthesizes EC’s clinical and pathological spectrum, highlighting its association with systemic conditions such as hyper-eosinophilic syndrome, eosinophilic granulomatosis with polyangiitis, parasitic infections, and drug-induced reactions. Approximately 30% of cases involved gallstones, suggesting a multifactorial etiology. Laparoscopic cholecystectomy was the primary treatment, with systemic therapies like corticosteroids or antiparasitic agents used for underlying conditions. This case and review underscore EC’s diagnostic challenges, emphasizing the need for histo-pathological confirmation and multidisciplinary management to address its heterogeneous presentations. Further research is essential to elucidate EC’s mechanistic pathways and optimize therapeutic approaches.