Madl C, Grimm G, Mallek R, Schneeweiss B, Druml W, Laggner A N, Lenz K
Allgemeines Krankenhaus Wien, University of Vienna, Austria.
Intensive Care Med. 1992;18(4):245-6. doi: 10.1007/BF01709841.
In the presence of ascites ultrasound is not appropriate to distinguish between gallbladder perforation and acute acalculous cholecystitis. However, the correct and early diagnosis of gallbladder perforation is important for the treatment and prognosis. We report 4 critically ill patients with ascites. All patients had evidence of gallbladder perforation by ultrasound and underwent cholecystectomy: 2 patients had gallbladder perforation, but 2 had acalculous cholecystitis without perforation. Markedly elevated serum alkaline phosphatase was the only discriminating finding indicating gallbladder perforation.
在存在腹水的情况下，超声不适用于区分胆囊穿孔和急性非结石性胆囊炎。然而，胆囊穿孔的正确早期诊断对于治疗和预后很重要。我们报告了4例伴有腹水的危重症患者。所有患者经超声检查均有胆囊穿孔的证据并接受了胆囊切除术：2例患者有胆囊穿孔，但2例为无穿孔的非结石性胆囊炎。血清碱性磷酸酶显著升高是提示胆囊穿孔的唯一鉴别性发现。
