Tanaka M, Takahashi H, Yajima Y, Okamura K, Kosaka A, Mizumoto R
Department of Surgery, Matsusaka City Hospital, Mie, Japan.
Surg Today. 1997;27(4):360-3. doi: 10.1007/BF00941814.
A 79-year-old man was admitted to our hospital because of severe epigastric pain. Ultrasonography and computed tomography revealed a slightly distended gallbladder with a small amount of free intraabdominal fluid. At emergency laparotomy, perforation of the gallbladder was recognized and thus a cholecystectomy was performed. Histopathologically, localized necrosis was seen at the site of perforation: however, the inflammation of the surrounding tissue was mild and no thrombus was detected within the intramural vessels. In addition, the gallbladder contained no stones and a bile culture was negative. Postoperatively, the diagnosis of idiopathic perforation of the gallbladder was established. The findings of this case help to emphasize the importance of considering this disorder in elderly patients presenting with peritonitis of unknown origin.
一名79岁男性因严重上腹部疼痛入院。超声检查和计算机断层扫描显示胆囊轻度扩张，腹腔内有少量游离液体。在急诊剖腹手术中，发现胆囊穿孔，因此进行了胆囊切除术。组织病理学检查显示，穿孔部位可见局限性坏死；然而，周围组织的炎症较轻，壁内血管内未检测到血栓。此外，胆囊内无结石，胆汁培养阴性。术后确诊为特发性胆囊穿孔。该病例的发现有助于强调在不明原因腹膜炎的老年患者中考虑这种疾病的重要性。
