Langlois P, Bodin L, Bousquet J C, Rouby J J, Godet G, Davy-Mialou C, Wiart D, Cortez A, Chomette G, Grellet J
Gastroenterol Clin Biol. 1986 Mar;10(3):238-43.
Fifty cases of post-stress acute acalculous cholecystitis were observed during the past 9 years, mainly after major surgery or trauma. The apparently increasing incidence over the last 4 years (42 cases) could probably be explained by a better diagnostic approach of this condition by routine use of ultrasonography. No specific etiological factor could be found; however total parenteral nutrition and/or sepsis and/or use of narcotics could possibly play a role in the appearance of this complication. Although diagnosis can occasionally be suspected in the basis of abdominal and infectious signs, diagnosis was made primarily on the following ultrasonographic signs: enlarged gallbladder with thickened wall, sludge, and occasionally a double-wall aspect and a pericholecystic collection. In this series, most of the patients were treated by cholecystectomy, but a new therapeutic approach was used in 10 cases: percutaneous transhepatic drainage under sonographic control. Outcome is still poor, with a 50 p. 100 mortality rate.
在过去9年中观察到50例应激后急性非结石性胆囊炎患者，主要发生于大手术或创伤后。过去4年（42例）发病率明显上升，这可能是由于常规使用超声检查对该疾病有了更好的诊断方法。未发现特定的病因；然而，全胃肠外营养和/或败血症和/或使用麻醉品可能在这种并发症的发生中起作用。虽然有时可根据腹部和感染体征怀疑诊断，但主要根据以下超声征象进行诊断：胆囊增大、壁增厚、有胆泥，偶尔有双壁征和胆囊周围积液。在本系列中，大多数患者接受了胆囊切除术，但10例采用了新的治疗方法：在超声引导下经皮经肝引流。预后仍然很差，死亡率为50%。
