Hakala T, Nuutinen P J, Ruokonen E T, Alhava E
Department of Surgery, University Hospital of Kuopia, Finland.
Br J Surg. 1997 Sep;84(9):1249-52.
Acute acalculous cholecystitis is a well recognized complication of many acute illnesses. Ischaemia of the gallbladder seems to have an important role in its pathogenesis.
Microangiography was performed in 15 gallbladders immediately after cholecystectomy by infusing 10 per cent barium sulphate into the specimen. Five patients had symptomatic gallstone disease, five had acute gallstone-associated cholecystitis and five had acalculous cholecystitis. Sections for histological examination were taken from adjacent sides of the microangiography section. Filling of the vessels by contrast medium was compared with histological findings.
Microangiography of the gallbladder in acute gallstone-associated cholecystitis showed strongly dilated arterioles and regular filling of the capillary network, whereas in acalculous cholecystitis the capillary filling was poor and irregular.
Disturbed microcirculation may play an important role in the pathogenesis of acute acalculous cholecystitis.
急性非结石性胆囊炎是许多急性疾病公认的并发症。胆囊缺血似乎在其发病机制中起重要作用。
在胆囊切除术后立即对15个胆囊进行微血管造影，将10%的硫酸钡注入标本。5例患者有症状性胆结石病，5例有急性结石相关性胆囊炎，5例有非结石性胆囊炎。组织学检查切片取自微血管造影切片的相邻部位。将造影剂对血管的充盈情况与组织学结果进行比较。
急性结石相关性胆囊炎患者胆囊的微血管造影显示小动脉强烈扩张，毛细血管网充盈规则，而非结石性胆囊炎患者的毛细血管充盈不良且不规则。
微循环障碍可能在急性非结石性胆囊炎的发病机制中起重要作用。
