Simion N
Riviera Hospital, Montreux, Switzerland.
J Surg Case Rep. 2012 Feb 1;2012(2):4. doi: 10.1093/jscr/2012.2.4.
Acalculous cholecystitis is a relatively rare form of cholecystitis appearing in severely ill patients. We chose the case of a young patient under chemotherapy for myeloid leukaemia who developed a severe septic shock secondary to an alithiasic cholecystitis. Because of hemodynamic instability needing high-dose of vasoactive amines, percutaneous gallbladder drainage was done. After this intervention, the septic shock could be controlled, but a bleeding liver laceration was observed, fortunately without morbidity consequences. Abdominal infections are life-threatening complications in neutropenic patients. Neutropenic enterocolitis is the most important entity, but the acute cholecystitis, even rarer, had been described in several reports, suggesting that this infection could represent a difficult trap.
无结石性胆囊炎是一种相对罕见的胆囊炎形式,多见于重症患者。我们选择了一例正在接受髓系白血病化疗的年轻患者,该患者因无结石性胆囊炎继发严重感染性休克。由于血流动力学不稳定,需要大剂量血管活性胺类药物治疗,遂进行了经皮胆囊引流术。此次干预后,感染性休克得到控制,但发现肝脏有裂伤出血,所幸未造成不良后果。腹部感染是中性粒细胞减少患者的危及生命的并发症。中性粒细胞减少性小肠结肠炎是最重要的类型,但急性胆囊炎更为罕见,已有多篇报道,提示这种感染可能是一个棘手的问题。