Coelho J C, Campos A C, Moreira M, Moss Júnior A A, Artigas G V
Department of Surgery, Federal University of Paraná, Curitiba, Brazil.
Int Surg. 1991 Jul-Sep;76(3):146-8.
Thirty-two patients with acute acalculous cholecystitis are presented. The age of the patients ranged from 1 to 80 years, with an average of 46.3 years. Acute acalculous cholecystitis occurred during the postoperative period in only four patients. Three patients were receiving total parenteral nutrition and 16 patients had one or more associated medical diseases. One patient had acute acalculous cholecystitis due to mechanical obstruction of the cystic duct caused by a diaphragmatic hernia. The most frequent signs and symptoms were right upper quadrant abdominal pain, nausea, vomiting, fever, abdominal mass, and jaundice. All patients were subjected to cholecystectomy. Nine (28.1%) gallbladder specimens had gangrene. Pericholecystic perforation was observed in four patients (12.5%) free perforation in one patient (3.1%), and empyema of the gallbladder in one patient (3.1%). Bacteria were cultured from 18 of 24 bile specimens. E. coli was the most common organism isolated. The overall postoperative mortality and complication rates were 15.6% and 40.6% respectively. The average hospital stay was 16.4 days.
本文报告了32例急性非结石性胆囊炎患者。患者年龄从1岁至80岁不等，平均年龄为46.3岁。仅4例急性非结石性胆囊炎发生在术后。3例患者接受全胃肠外营养，16例患者有一种或多种相关内科疾病。1例患者因膈疝导致胆囊管机械性梗阻而发生急性非结石性胆囊炎。最常见的体征和症状为右上腹疼痛、恶心、呕吐、发热、腹部肿块和黄疸。所有患者均接受了胆囊切除术。9份（28.1%）胆囊标本有坏疽。4例患者（12.5%）观察到胆囊周围穿孔，1例患者（3.1%）有游离穿孔，1例患者（3.1%）有胆囊积脓。24份胆汁标本中的18份培养出细菌。大肠杆菌是分离出的最常见微生物。术后总死亡率和并发症发生率分别为15.6%和40.6%。平均住院时间为16.4天。
