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[胆汁性腹膜炎:诊断与治疗方面]

[Biliary peritonitis: diagnostic and therapeutic aspects].

作者信息

Bélemlilga Gueswendé Larba Hermann, Ouédraogo Souleymane, Yabré Nassirou, Kéita Namori, Tiendrébéogo Lazare, Zaré Cyprien, Zida Maurice

机构信息

Centre Hospitalier Universitaire SourôSanou, Bobo Dioulasso, Burkina Faso.

Centre Hospitalier Universitaire de Ouahigouya, Burkina Faso.

出版信息

Mali Med. 2023;38(3):15-17.

Abstract

AIMS

The aim was to describe the diagnostic and therapeutic aspects of biliary peritonitis.

PATIENTS AND METHODS

This was a descriptive cross-sectional study with retrospective collection over a period of 10 years including patients operated on for biliary peritonitis.

RESULTS

We collected 10 cases of biliary peritonitis with an average age of 38 years with a sex ratio of 2.3. Two patients presented with an abdominal contusion following a road traffic accident. Maximum abdominal pain in the right hypochondrium was present in three patients, signs of peritoneal irritation in all patients, positive Widal and Felix serodiagnosis in eight patients. At midline laparotomy, the gallbladder was perforated in three patients, gangrenous in five, phlegmonous in one, sclero-atrophic in one. Cholecystectomy was performed in all patients. Biliary peritonitis was of traumatic origin in two patients, and typhoid in eight. Postoperatively, there were four cases of sepsis and three cases of parietal suppuration. Three patients died.

CONCLUSION

Biliary peritonitis discovered during laparotomies for peritonitis, was secondary to typhoid cholecystitis, and had a high morbidity and mortality.

摘要

目的

描述胆汁性腹膜炎的诊断和治疗方面。

患者与方法

这是一项描述性横断面研究,回顾性收集了10年间接受胆汁性腹膜炎手术的患者资料。

结果

我们收集了10例胆汁性腹膜炎患者,平均年龄38岁,男女比例为2.3。2例患者在道路交通事故后出现腹部挫伤。3例患者右上腹疼痛最为剧烈,所有患者均有腹膜刺激征,8例患者肥达氏反应和费利克斯血清诊断呈阳性。在正中剖腹手术中,3例患者胆囊穿孔,5例坏疽,1例蜂窝织炎,1例硬化萎缩。所有患者均行胆囊切除术。2例患者胆汁性腹膜炎起源于外伤,8例起源于伤寒。术后,有4例发生败血症,3例发生腹壁化脓。3例患者死亡。

结论

在腹膜炎剖腹手术中发现的胆汁性腹膜炎继发于伤寒性胆囊炎,发病率和死亡率高。

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