Molenat F, Boussuges A, Valantin V, Sainty J M
Service de Réanimation Médicale et d'Hyperbarie, Hôpital Salvator, Marseille, France.
Intensive Care Med. 1996 Apr;22(4):356-8. doi: 10.1007/BF01700459.
Patients in the intensive care unit (ICU) have many risks factors for gallbladder stasis or acute acalculous cholecystitis (ACC), including fasting, total parenteral nutrition, sedation, mechanical ventilation, infection and shock. We have performed a prospective study to estimate the prevalence of ultrasonographic gallbladder abnormalities in 30 consecutive medical ICU patients during the first 2 days of their stay in the ICU. Two patients had previously undergone cholecystectomy and were excluded from the study. Seventeen (61%) of the remaining 28 patients presented with gallbladder abnormalities. Considering three major criteria of ACC, 14 patients (50%) presented with either sludge (25%), wall thickening (22%) or hydrops (11%). However, none of the patients needed a surgical procedure during the study because of gallbladder disease. We conclude that an important proportion of ICU patients presented with gallbladder abnormalities shown by ultrasonography and that this may have implications for establishing a diagnosis of ACC using ultrasonographic criteria.
重症监护病房（ICU）的患者存在胆囊淤滞或急性非结石性胆囊炎（ACC）的多种风险因素，包括禁食、全胃肠外营养、镇静、机械通气、感染和休克。我们进行了一项前瞻性研究，以评估30例连续入住医学ICU的患者在入住ICU的头2天内超声检查发现的胆囊异常的患病率。两名患者此前已接受胆囊切除术，被排除在研究之外。其余28例患者中有17例（61%）出现胆囊异常。根据ACC的三个主要标准，14例患者（50%）出现了胆囊淤泥（25%）、胆囊壁增厚（22%）或胆囊积水（11%）。然而，在研究期间，没有患者因胆囊疾病需要进行手术。我们得出结论，相当一部分ICU患者经超声检查显示有胆囊异常，这可能对使用超声标准诊断ACC有影响。
