Mentzer R M, Golden G T, Chandler J G, Horsley J S
Am J Surg. 1975 Jan;129(1):10-5. doi: 10.1016/0002-9610(75)90159-2.
There is ample evidence from this retrospective comparison to indicate that emphysematous cholecystitis does merit clinical distinction apart from acute cholecystitis. It is an acute infection of the gallbladder caused by a specific group of bacteria that may be aided by some aspect of local ischemia. Cholelithiasis does not seem to be a major factor in the pathogenesis of emphysematous cholecystitis, and this, in association with some dependence upon ischemia, may account for the predominance of this disease in males rather than females. Gangrene is a common feature of the pathologic process, and thus it is not surprising that the diagnosis of emphysematous cholecystitis implies a risk of gallbladder perforation that is five times that expected from ordinary acute cholecystitis. The key to identifying this disease is the plain abdominal roentgenogram which in most instances will make the diagnosis and provide an impetus for early operative intervention.
从这项回顾性比较中有充分证据表明，气肿性胆囊炎确实值得在临床上与急性胆囊炎区分开来。它是由一组特定细菌引起的胆囊急性感染，局部缺血的某些方面可能会助长这种感染。胆结石似乎不是气肿性胆囊炎发病机制中的主要因素，而这一点与对缺血的某种依赖相结合，可能解释了这种疾病在男性而非女性中更为常见的原因。坏疽是病理过程的一个常见特征，因此气肿性胆囊炎的诊断意味着胆囊穿孔风险是普通急性胆囊炎预期风险的五倍也就不足为奇了。识别这种疾病的关键是腹部平片，在大多数情况下，它将做出诊断并推动早期手术干预。
