Viebahn R, Maurer F, Weise K
Berufsgenossenschaftliche Unfallklinik, Universität Tübingen.
Aktuelle Traumatol. 1993 Feb;23(1):32-5.
Among the patients of the Accident Hospital of the Co-operative Trade Association Tübingen, there were 11 cases of acute cholecystitis between 1985 and 1991. Acute cholecystitis occurred after polytrauma (n = 5), multiple fractures (n = 2), head injury (n = 1), fracture of femoral neck (n = 1) or elective hip surgery (arthrodesis, total hip replacement) (n = 2). The mean age was 57 (16-89) years, acute cholecystitis was confirmed 27 (6-54) days after trauma of surgery. 7 cases presented as acute acalculous cholecystitis, whereas in 4 cases of acute cholecystitis cholecystolithiasis was present. 9 patients were treated via cholecystectomy; one juvenile paraplegic recovered after conservative treatment, one 82-year old female was in too bad condition for surgery so that percutaneous cholecystostomy had to be performed prior to cholecystectomy. 10 patients recovered without complication, one 89-year old multi-morbid male died after cholecystectomy. Analysis of the clinical course prior to the occurrence of acute cholecystitis showed a high incidence of shock, frequent blood transfusion, long-time respiratory therapy and parenteral nutrition as well severe trauma, and high cumulation of opiate therapy in this group of patients. Diagnosis was confirmed by ultrasound in all patients, clinical symptoms and laboratory data being mostly unspecific.
在图宾根合作贸易协会事故医院的患者中，1985年至1991年间有11例急性胆囊炎患者。急性胆囊炎发生于多发伤后（n = 5）、多处骨折后（n = 2）、头部受伤后（n = 1）、股骨颈骨折后（n = 1）或择期髋关节手术（关节固定术、全髋关节置换术）后（n = 2）。平均年龄为57（16 - 89）岁，急性胆囊炎在创伤或手术后27（6 - 54）天得到确诊。7例表现为急性非结石性胆囊炎，而4例急性胆囊炎患者存在胆囊结石。9例患者接受了胆囊切除术；1例青少年截瘫患者经保守治疗后康复，1例82岁女性病情太差无法进行手术，因此在胆囊切除术之前不得不进行经皮胆囊造瘘术。10例患者康复且无并发症，1例89岁患有多种疾病的男性在胆囊切除术后死亡。对急性胆囊炎发生前的临床病程分析显示，该组患者中休克发生率高、频繁输血、长时间呼吸治疗和肠外营养以及严重创伤，并且阿片类药物治疗累积量高。所有患者均通过超声确诊，临床症状和实验室数据大多无特异性。
