Owen Charles C, Jain Rajeev
Department of Medicine, Presbyterian Hospital of Dallas, 8230 Walnut Hill Lane, Suite 610, Dallas, TX 75231, USA.
Curr Treat Options Gastroenterol. 2005 Apr;8(2):99-104. doi: 10.1007/s11938-005-0001-4.
Acute acalculous cholecystitis is defined as acute inflammation of the gallbladder in the absence of gallstones. Patients are usually critically ill with atherosclerotic heart disease, recent trauma, burn injury, surgery, or hemodynamic instability. The presentation of acute acalculous cholecystitis may be insidious, characterized by unexplained fever, leukocytosis, hyperamylasemia, or abnormal aminotransferases, and patients often lack right upper quadrant tenderness. Diagnostic evaluation includes ultrasonography, computerized tomography, and cholescintigraphy. Given the high mortality of untreated disease, definitive treatment consists of cholecystectomy or, in poor surgical candidates, cholecystostomy. Endoscopic therapy with nasobiliary drainage and lavage is an effective treatment option in patients unable to tolerate surgery or cholecystostomy.
急性非结石性胆囊炎被定义为在无胆结石情况下胆囊的急性炎症。患者通常患有严重的动脉粥样硬化性心脏病、近期创伤、烧伤、手术或血流动力学不稳定。急性非结石性胆囊炎的表现可能较为隐匿，其特征为不明原因的发热、白细胞增多、高淀粉酶血症或转氨酶异常，且患者通常缺乏右上腹压痛。诊断评估包括超声检查、计算机断层扫描和胆囊闪烁显像。鉴于未经治疗的疾病死亡率较高，确定性治疗包括胆囊切除术，对于手术条件较差的患者，则行胆囊造口术。对于无法耐受手术或胆囊造口术的患者，鼻胆管引流和灌洗的内镜治疗是一种有效的治疗选择。
