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老年女性急性结石性胆囊炎合并胰腺炎的保守治疗:一例报告

Conservative management of acute calculous cholecystitis complicated by pancreatitis in an elderly woman: A case report.

作者信息

Walczak-Galezewska Marta K, Skrypnik Damian, Szulinska Monika, Skrypnik Katarzyna, Bogdanski Pawel

机构信息

Department of Internal Diseases, Metabolic Disorders and Hypertension Department of Education and Obesity Treatment and Metabolic Disorders, Poznań University of Medical Sciences, ul. Szamarzewskiego Institute of Human Nutrition and Dietetics, Poznań University of Life Sciences, ul. Wojska Polskiego, Poznań, Poland.

出版信息

Medicine (Baltimore). 2018 Jun;97(25):e11200. doi: 10.1097/MD.0000000000011200.

Abstract

RATIONALE

Acute calculous cholecystitis is a prevalent disease whose diagnosis and management still face significant debate. Although the overall incidence of gallstone disease is 18.8% in European women aged 30 to 69 years, there is little data and experience in managing acute calculous cholecystitis in populations over 80 years old. The incidence of acute cholecystitis among the elderly is probably increasing. For the reason, we here highlight the advantages and disadvantage of various treatment and management opens based on a 96-year-old patient.

PATIENT CONCERNS

We present a rare case in which a 96-year-old woman suffered from abdominal pain, nausea, and lack of appetite for over a month.

DIAGNOSES

She was diagnosed with acute calculous cholecystitis and pancreatitis.

INTERVENTIONS

She was successfully treated without surgery, regaining her physical health after 5 months.

OUTCOMES

The question of how to manage acute calculous cholecystitis is extremely difficult in many aspects. The patient of very advanced age presented in this paper, not very well diagnosed and with a life-threating condition, survived because of careful treatment and reasonable decision-making.

LESSONS

The take-away from this case is that, in a high-risk senile patient, strict conservative therapy of cholecystitis may be successful, as it can avoid the complications of surgery and leave the patient with a good quality of life.

摘要

理论依据

急性结石性胆囊炎是一种常见疾病,其诊断和治疗仍存在重大争议。尽管在欧洲30至69岁女性中胆石病的总体发病率为18.8%,但在80岁以上人群中,关于急性结石性胆囊炎的治疗数据和经验较少。老年人急性胆囊炎的发病率可能正在上升。因此,我们在此以一名96岁患者为例,重点介绍各种治疗和管理方法的优缺点。

患者情况

我们介绍一个罕见病例,一名96岁女性腹痛、恶心、食欲不振持续一个多月。

诊断

她被诊断为急性结石性胆囊炎和胰腺炎。

干预措施

她未经手术成功治愈,5个月后恢复了身体健康。

结果

在很多方面,如何治疗急性结石性胆囊炎的问题极其困难。本文中这位高龄患者,诊断情况不佳且病情危及生命,但由于精心治疗和合理决策得以存活。

经验教训

该病例的启示是,在高危老年患者中,胆囊炎的严格保守治疗可能会成功,因为它可以避免手术并发症,使患者保持良好的生活质量。

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本文引用的文献

1
2016 WSES guidelines on acute calculous cholecystitis.2016年WSES急性结石性胆囊炎指南。
World J Emerg Surg. 2016 Jun 14;11:25. doi: 10.1186/s13017-016-0082-5. eCollection 2016.

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