de la Peña A, Yuste J R, Beloqui O, Prieto J
Departamento de Medicina Interna, Facultad de Medicina, Universidad de Navarra.
Rev Med Univ Navarra. 1995 Jul-Sep;39(3):126-9.
We describe the case of a 51 year-old man affected of relapsing bouts of abdominal pain and hematuria, who began acutely with pain in the right upper quadrant, fever, hematuria, arthralgias and purpura on the lower extremities; ultrasonography revealed the existence of acalculous cholecystitis. The lack of response to intravenous antibiotherapy and the clinical association of cholecystitis to the renal, cutaneous and articular manifestations, oriented to the diagnosis of Schöenlein-Henoch vasculitis; thereafter, the response to steroids was successful and immediate. The etiologic diagnosis of this case of acalculous cholecystitis based on clinical aspects, avoid the surgical therapy and the possible morbidity that this procedure can produce.
我们描述了一名51岁男性的病例,该患者反复出现腹痛和血尿,起病急,表现为右上腹疼痛、发热、血尿、关节痛以及下肢紫癜;超声检查显示存在非结石性胆囊炎。静脉抗生素治疗无效,且胆囊炎与肾脏、皮肤及关节表现相关,这提示了 Schönlein-Henoch 血管炎的诊断;此后,对类固醇治疗反应良好且迅速。基于临床症状对该例非结石性胆囊炎进行病因诊断,避免了手术治疗及其可能带来的并发症。