Perera Marlon, Pham Toan, Toshniwal Sumeet, Lennie Yasmin, Chan Steven, Houli Nezor
Department of Surgery, Western Health, Footscray, Melbourne, VIC 3012, Australia.
Case Rep Surg. 2013;2013:263046. doi: 10.1155/2013/263046. Epub 2013 Jul 16.
Introduction. Concomitant cholecystitis and gallstone pancreatitis is an infrequent clinical encounter, reported sparsely in the literature. Concurrent acute cholecystitis and pancreatitis complicated by gall bladder perforation has not been reported before. Presentation of Case. We report a 39-year-old female presenting with concomitant cholecystitis and acute pancreatitis, complicated by gallbladder perforation. Discussion. There is much controversy surrounding the timing of cholecystectomy following gallstone pancreatitis, with the recent literature suggesting that "early" operation is safe. In the current case, gallbladder perforation altered the "routine" management of gallstone pancreatitis and posed as a management dilemma. Conclusion. Clinical judgement dictated timing of operative management and ultimately cholecystectomy was performed safely.
引言。胆囊炎与胆石性胰腺炎并存是一种罕见的临床情况,文献报道较少。急性胆囊炎与胰腺炎并发且伴有胆囊穿孔此前未见报道。病例介绍。我们报告一名39岁女性,患有胆囊炎与急性胰腺炎并存,并伴有胆囊穿孔。讨论。胆石性胰腺炎后胆囊切除术的时机存在诸多争议,近期文献表明“早期”手术是安全的。在本病例中,胆囊穿孔改变了胆石性胰腺炎的“常规”处理方式,造成了处理上的困境。结论。临床判断决定了手术处理的时机,最终安全地实施了胆囊切除术。