Iannuzzi C, Belghiti J, Erlinger S, Menu Y, Fékété F
Digestive Surgery Service, Hôpital Beaujon, Clichy, France.
Arch Surg. 1990 Sep;125(9):1211-3. doi: 10.1001/archsurg.1990.01410210137021.
Four patients with acquired immunodeficiency syndrome developed severe abdominal pain and fever due to acute acalculous cholecystitis. In all patients, preoperative laboratory data showed elevation of alkaline phosphatase and gamma-glutamyltransferase levels. Endoscopic or intraoperative cholangiography showed signs of intrahepatic and extrahepatic cholangitis. Cholecystectomy was performed and prompt relief of symptoms was achieved in all patients; no postoperative complication was observed. One patient did not develop any recurrence during an 18-month period of follow-up; two patients died 2 and 3 months after the operation. One patient developed recurrent abdominal pain and cholestasis 4 months after the operation, with dilatation of the common bile duct and papillary stenosis due to progression of cholangitis. These observations suggest that cholangitis is frequently associated with cholecystitis in patients with the acquired immunodeficiency syndrome. Its pathogenesis is not known.
4例获得性免疫缺陷综合征患者因急性非结石性胆囊炎出现严重腹痛和发热。所有患者术前实验室数据显示碱性磷酸酶和γ-谷氨酰转移酶水平升高。内镜或术中胆管造影显示肝内和肝外胆管炎的征象。所有患者均接受了胆囊切除术，症状迅速缓解；未观察到术后并发症。1例患者在18个月的随访期间未复发；2例患者在术后2个月和3个月死亡。1例患者术后4个月出现复发性腹痛和胆汁淤积，因胆管炎进展导致胆总管扩张和乳头狭窄。这些观察结果表明，胆管炎在获得性免疫缺陷综合征患者中常与胆囊炎相关。其发病机制尚不清楚。
