Vázquez-Rodríguez Juan Gustavo, Chiñas-Velázquez Soledad
Unidad Médica de Alta Especialidad Hospital de Ginecología y Obstetricia 3, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México, D.F., Mexico.
Cir Cir. 2007 Nov-Dec;75(6):435-42.
Preeclampsia-eclampsia is a hypertensive disease of pregnancy with systemic complications. Studies regarding ultrasonographic characteristics of biliary gallbladder are limited. We undertook this study to determine the ultrasonographic biliary gallbladder characteristics in patients with preeclampsia-eclampsia.
This was a case series comprised of 115 women studied who were diagnosed with preeclampsia-eclampsia during pregnancy or the postpartum period. In all patients an ultrasonographic biliary gallbladder exam was carried out. Statistical analysis was performed with ANOVA test using SPSS software.
We included 93 pregnant (80.87%) and 22 women in the immediate postpartum period (19.13%). Maternal age was 27.18 +/- 5.71 years, parity was 1.86 +/- 1.16, pregnancy age was 32.57 +/- 4.15 weeks, epigastric pain was present in 23 patients (20%), and two patients (1.72%) had history of inflammatory gallbladder disease. The main diagnosis was uncomplicated severe preeclampsia (73.06%), complicated severe preeclampsia was found in 19.99%, eclampsia in 5.21% and recurrent severe preeclampsia was present in 1.74%. According to the ultrasonographic findings we established five groups as follows: (A) wall edema (62 cases), (B) normal appearance (45 cases), (C) lithiasis (5 cases), (D) undetermined (2 cases) and (E) gallbladder polyp (1 case). The gallbladder size was similar in all cases (length 71.97 +/- 9.76 mm, transverse 27.31 +/- 6.6 mm). Regarding gallbladder wall thickness, we found a mean 6.21 +/- 2.96 mm in the edema group, 2.06 +/- 0.25 mm in the normal appearance group, 3.0 +/- 1.0 mm in the lithiasis group and 2 mm in the gallbladder polyp group. The gallbladder content was anechoic in 102 patients (88.69%), with biliary sludge in 11 women (9.57%) and undetermined in 2 cases (1.74%).
The most frequent ultrasonographic biliary gallbladder characteristics in patients with preeclampsia-eclampsia were reduced biliary gallbladder, thick walls secondary to edema, "double border" appearance and anechoic content.
子痫前期-子痫是一种妊娠期高血压疾病，伴有全身并发症。关于胆囊超声特征的研究有限。我们进行这项研究以确定子痫前期-子痫患者的胆囊超声特征。
这是一个病例系列，包括115名在孕期或产后被诊断为子痫前期-子痫的女性。所有患者均进行了胆囊超声检查。使用SPSS软件通过方差分析进行统计分析。
我们纳入了93名孕妇（80.87%）和22名产后即刻的女性（19.13%）。产妇年龄为27.18±5.71岁，产次为1.86±1.16，孕周为32.57±4.15周，23名患者（20%）有上腹部疼痛，2名患者（1.72%）有胆囊炎病史。主要诊断为单纯性重度子痫前期（73.06%），复杂性重度子痫前期占19.99%，子痫占5.21%，复发性重度子痫前期占1.74%。根据超声检查结果，我们将患者分为以下五组：（A）壁水肿（62例），（B）外观正常（45例），（C）结石（5例），（D）未明确（2例）和（E）胆囊息肉（1例）。所有病例的胆囊大小相似（长度71.97±9.76mm，横径27.31±6.6mm）。关于胆囊壁厚度，我们发现水肿组平均为6.21±2.96mm，外观正常组为2.06±0.25mm，结石组为3.0±1.0mm，胆囊息肉组为2mm。102名患者（88.69%）的胆囊内容物为无回声，11名女性（9.57%）有胆泥，2例（1.74%）未明确。
子痫前期-子痫患者最常见的胆囊超声特征是胆囊缩小、因水肿导致的壁增厚、“双边”外观和无回声内容物。
