Castana O, Rempelos G, Anagiotos G, Fonia E, Kiskira O
Department of Plastic and Reconstructive Surgery, Evangelismos General Hospital of Athens, Greece.
Ann Burns Fire Disasters. 2009 Mar 31;22(1):48-50.
The aim of this study is to draw attention to acute acalculous cholecystitis, a rare complication that may occur during the post-burn period (usually within 20-30 days). A 42-yr-old male patient, the victim of 35% TBSA high-voltage electrical burns that caused the amputation of both upper extremities by day 45 post-burn, was brought to our operating theatre suffering from acute acalculous cholecystitis. Mild epigastric pain followed by reflex nausea, vomiting, and pain that shifts to the upper quadrant and considerably increases during the post-burn period should make the therapist think of acalculous cholecystitis and react immediately with an urgent operation. Diagnosis of acute acalculous cholecystitis in a burn patient depends on recognizing a combination of signs and symptoms which are often attributed to other problems. Once diagnosed, the best choice of treatment for acalculous cholecystitis is cholecystectomy in an otherwise clinically stable patient.
本研究的目的是引起人们对急性非结石性胆囊炎的关注,这是一种可能在烧伤后发生的罕见并发症(通常在20 - 30天内)。一名42岁男性患者,烧伤面积达35%的体表总面积,为高压电烧伤,在烧伤后第45天导致双上肢截肢,因急性非结石性胆囊炎被送至我们的手术室。轻度上腹部疼痛,随后出现反射性恶心、呕吐,且疼痛转移至上腹象限并在烧伤后显著加剧,这应使治疗师想到非结石性胆囊炎,并立即进行紧急手术。烧伤患者急性非结石性胆囊炎的诊断取决于识别一系列体征和症状,而这些体征和症状常常被归因于其他问题。一旦确诊,对于临床状况稳定的患者,非结石性胆囊炎的最佳治疗选择是胆囊切除术。