McDermott M W, Scudamore C H, Boileau L O, Snelling C F, Kramer T A
Can J Surg. 1985 Nov;28(6):529-33.
The authors present four cases of acute acalculous cholecystitis complicating major burn injury and review the recent literature on acalculous cholecystitis. All patients were men and ranged in age from 22 to 40 years. The mean extent of the burn was 50% of the total body surface area, with an average 29% third-degree component. All four patients survived. Because of their severity, major burn injuries expose patients to many risks, including acute acalculous cholecystitis. Recent experimental evidence supports a vascular insult through the activation of Factor XII pathways as the initial event. A diagnosis is made on clinical grounds, supported by laboratory and ultrasonographic findings, in a patient with a burn covering more than 30% of the total body surface area and who has signs of acute cholecystitis. Cholecystectomy is the treatment of choice; tube cholecystostomy is reserved for critically ill patients.
作者报告了4例并发严重烧伤的急性非结石性胆囊炎病例，并回顾了近期有关非结石性胆囊炎的文献。所有患者均为男性，年龄在22至40岁之间。烧伤的平均面积为全身表面积的50%，其中平均三度烧伤面积为29%。所有4例患者均存活。由于严重程度高，严重烧伤会使患者面临许多风险，包括急性非结石性胆囊炎。最近的实验证据支持通过激活因子XII途径导致的血管损伤是初始事件。对于烧伤面积超过全身表面积30%且有急性胆囊炎体征的患者，根据临床情况并结合实验室和超声检查结果做出诊断。胆囊切除术是首选治疗方法；胆囊造瘘术则适用于重症患者。
