Imhof M, Raunest J, Ohmann C, Röher H D
Department of General and Trauma Surgery, Heinrich-Heine-University, Düsseldorf, Federal Republic of Germany.
World J Surg. 1992 Nov-Dec;16(6):1160-5; discussion 1166. doi: 10.1007/BF02067089.
Acute acalculous cholecystitis (AAC) is a well known complication in severely traumatized patients. Existing data of AAC originate from retrospective analyses and episodic case reports. In a prospective study 45 polytraumatized patients admitted to our intensive care unit from January 1989 to June 1990 were clinically and sonographically screened for this condition at defined time intervals. Trauma scoring was performed according to the injury severity score and polytrauma score. AAC was defined as a combination of hydrops of the gallbladder, an increased wall thickness (> 3.5 mm), and the demonstration of sludge. We were able to document this diagnostic triad in 8 (18%) of 45 patients. As a consequence early elective cholecystectomy was performed in 1 of the 8 patients. The remaining patients were treated conservatively. The incidence of AAC in severely traumatized patients is higher than figures so far published suggest. Ultrasound is a reliable method of early detection and follow-up of this complication.
急性非结石性胆囊炎（AAC）是严重创伤患者中一种众所周知的并发症。AAC的现有数据来源于回顾性分析和偶发性病例报告。在一项前瞻性研究中，于1989年1月至1990年6月入住我们重症监护病房的45例多发伤患者，在规定的时间间隔内接受了针对该病症的临床和超声检查。根据损伤严重程度评分和多发伤评分进行创伤评分。AAC被定义为胆囊积液、胆囊壁增厚（> 3.5毫米）以及出现胆泥的组合。我们在45例患者中的8例（18%）身上记录到了这一诊断三联征。因此，8例患者中有1例接受了早期择期胆囊切除术。其余患者接受保守治疗。严重创伤患者中AAC的发生率高于迄今已发表的数据所显示的数字。超声是早期检测和随访该并发症的可靠方法。
