Nikhinson R A, Dudnikova G Iu, Voĭtovich Iu M
Klin Med (Mosk). 1991 Feb;69(2):84-6.
The analysis of 682 case histories of males suffering from acute cholecystitis suggested a conclusion on occasional deviations in clinical manifestations of the disease in males. Various combinations of complications are not a rare finding making the diagnosis problematic. Acute destructive process in the gall bladder occurs in the presence of chronic inflammatory and infiltrative alterations in the hepatopancreatoduodenal area. Clinically, general symptoms of endotoxicosis dominate, local signs presenting indistinctly. Late diagnosis results in late surgical treatment: 9.2% of the admitted patients only are operated on within 24 hours since hospitalization. The authors hold that choledochotomy is indicated to 50.7% of the patients. Lethal postoperative outcome was registered in 2.2% of those operated on. The deaths were attributed to cardiovascular and hepatic failure.
对682例男性急性胆囊炎病例史的分析表明,该病在男性中的临床表现偶尔会出现偏差。各种并发症的组合并不罕见,这使得诊断存在问题。胆囊的急性破坏性病变发生在肝胰十二指肠区域存在慢性炎症和浸润性改变的情况下。临床上,内毒素血症的全身症状占主导,局部体征不明显。诊断延迟导致手术治疗延迟:入院患者中只有9.2%在住院后24小时内接受手术。作者认为,50.7%的患者需要进行胆总管切开术。接受手术的患者中有2.2%出现术后死亡。死亡原因是心血管和肝功能衰竭。