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Query: UMLS:C0008325 (cholecystitis)
 3,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twelve patients developed acute cholecystitis complicating trauma. Acute acalculus cholecystitis was present in 11 patients. Nine patients died. A review of 20 reports comprising 98 patients shows 86.7% had acute acalculus cholelithiasis, and 61.1% had necrosis, gangrene, and/or perforation of the gallbladder. The overall mortality was 33.3% and only 16.1% of patients treated by cholecystectomy died. The etiology of acute cholecystitis complicating trauma is multifactorial. Gallstones are present infrequently whereas shock, increased bile pigment load, drugs, surgery, and (other) trauma are common precursors. Diagnosis is difficult and depends upon clinical suspicion and the physical examination. Immediate surgical intervention is required. Cholecystectomy is the procedure of choice. We recommend cholecystectomy at initial laparotomy whenever there is evidence of trauma to the gallbladder, or if the right or common hepatic artery is ligated for hepatic bleeding.
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PMID:Acute cholecystitis complicating trauma. 75 68

Hepatic dysfunction is a common finding in patients with sickle cell disease but viral hepatitis appears to be an unusual complication in the adult SS patient. Only five cases of viral hepatitis were recorded in 378 admissions for SS crisis. In contrast, hepatic crisis occurred as a distinct event in 9% of 88 patients with sickle cell anemia. This entity must be differentiated from acute cholecystitis or viral hepatitis. Transiently abnormal results of hepatitic function tests were observed in another 26 patients with extrahepatic crisis. Cirrhosis is relatively common and often the terminal event in SS disease. Choledocholithiasis and cholecystitis are infrequent complications despite the prevalence of gallstones in SS anemia.
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PMID:Sickle cell hepatopathy. 87 Sep 77

A study of the results of surgical treatment of patients with acute cholecystitis showed that cholecystectomy is a safe procedure for the majority of patients during their initial hospitalization and avoids the risk of recurrent attacks and readmissions. Cholecystostomy has a limited place in the treatment of older patients with systemic disease and advanced local disease. Early aggressive management of acute cholecystitis will probably reduce complications of cholecystitis and reduce the need for cholecystostomy.
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PMID:Surgical treatment of acute cholecystitis. 92 Oct 79

From their experimental findings in 120 rabbits, the authors conclude that, at first, cholecystitis is usually an aseptic lesion and infection occurs only secondarily. In a large number of cases the initial physiopathological mechanism is that of inflammation which may be due to mechanical causes such as obstruction of the gall bladder siphon and vasomotor phenomena under autonomic control. The histological lesions and course are comparable to those observed in clinical medicine. The interest of this experimental study is to compare the pathology of acute cholecystitis with pancreatitis and Reilly's syndrome and Gregoire and Couvelaire's theory of visceral apoplexy.
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PMID:[Experimental study of anatomo-pathological and physiopathological manifestations of acute cholecystitis]. 96 37

A 25-year-old secundipara developed acute gangrenous cholecystitis coupled with suppurative cholangitis on the fourth pureperal day. The patient recovered after cholecystectomy and choledochotomy. It is pointed out that cholelithiasis is not rare in pregnancy but acute cholecystitis is very rare, especially in the puerperium. For this reason the diagnosis is difficult, yet the final issue depends on its early establishment and also on the early surgical intervention.
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PMID:[Acute gangrenous cholecystitis with suppurative acute cholangitis in the 1st days of the puerperium]. 102 35

Gallium has been shown to accumulate in metabolically active tissue including sites of infection. The purpose of this study was to evaluate gallium scanning in cholecystitis. Ten patients with cholecystitis were studied using conventional gallium scanning techniques. Five patients with acute cholecystitis showed intense gallium accumulation in the gallbladder area. One of five patients with chronic cholecystitis showed significant accumulation in the gallbladder. The limitations of this method are mainly the need for serial scanning to rule out gallium accumulation in the hepatic flexure of the colon and also the failure to detect consistently a chronically diseased fibrotic gallbladder. We conclude that gallium scanning of the gallbladder is an important adjunctive study in the evaluation of cholecystitis.
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PMID:Gallium gallbladder scanning in cholecystitis. 111 Apr 20

During the period from 1963 to 1970, 318 patients were subjected to early operation for acute cholecystitis. Cholecystostomy was performed in 25 cases (7.8 percent). Despite advanced age and associated serious illnesses, cholecystostomy was an effective and definitive method of treatment. Many of these patients are likely to succumb from intercurrent disease before they develop further stones or cholecystitis. A planned cholecystostomy may be the operation of choice for poor-risk patients with acute cholecystitis.
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PMID:Cholecystostomy for acute cholecystitis. 114 38

Infusion tomography of the gallbladder has proved to be more specific in the detection of pathologic disease as compared with conventional roentgenologic examinations by showing the wall of the organ instead of the contents. Infusion tomography of the gallbladder has been a useful initial procedure in patients with acute cholecystitis and in those with obstructive jaundice. It has helped to confirm diagnosis in patients with chronic lithiasic cholecystitis and nonvisualized gallbladder or with gallstones with documented on oral or intravenous studies. Infusion tomography of the gallbladder can be done on an emergency basis; it requires no prior preparation of the patient and usually yields an answer within 30 minutes. No significant complications have resulted from the high dose of iodized contrast material. There have been only two false results, one negative and one positive, so the procedure can be regarded as a highly reliable one.
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PMID:Infusion tomography of the gallbladder. 116 59

Data from retrospective review of 16 patients treated for acute cholecystitis indicate that the cause of this disease is different in children than in adults. The incidence of acute acalculous cholecystitis is higher in children. Congenital abnormalities of the gallbladder or bile ducts were not found in our patients. Cultures of the bile failed to establish a relationship with preceding infection, although infection seems to be an important etiologic factor. Diagnosis should be based on clinical signs and cholecystography. Early cholecystectomy is the treatment of choice. In patients with jaundice, operative choledochography is recommended.
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PMID:Acute cholecystitis in children. 120 67

The management of patients with acute calculous cholecystitis has changed during recent years. The etiology of acute cholecystitis is still not fully understood. Infection of bile is relatively unimportant since bile and gallbladder wall cultures are sterile in many patients with acute cholecystitis. Ultrasonography is first choice for diagnosis of acute cholecystitis and cholescintigraphy is second best. Percutaneous puncture of the gallbladder that can be used for therapeutic drainage has also diagnostic qualities. Early cholecystectomy under antibiotic prophylaxis is the treatment of choice, and has been shown to be superior to delayed surgery in several prospective trials. Mortality can be as low as 0.5% in patients younger than 70-80 years of age, but a high mortality has been reported in octogenerians. Selective intraoperative cholangiography is now generally accepted and no advantage of routine cholangiography was shown in clinical trials. Percutaneous cholecystostomy can be successfully performed under ultrasound guidance and has a place in the treatment of severely ill patients with acute cholecystitis. Laparoscopic cholecystectomy can be done safely in patients with acute cholecystitis, but extensive experience with this technique is necessary. Endoscopic retrograde drainage of the gallbladder by introduction of a catheter in the cystic duct is feasible but data are still scarce.
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PMID:Acute calculous cholecystitis. What is new in diagnosis and therapy? 129 90


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