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

A case of unusual cholecystitis that developed on completion of interleukin-2 and lymphokine-activated killer cell therapy is described. A 62-year-old man was treated with interleukin-2 and lymphokine-activated killer cells for disseminated renal cell carcinoma. During the course of the immunotherapy, his serum alkaline phosphatase level increased, as did the peripheral eosinophil count (0.31). Subsequently, clinical and radiologic evidence of acute cholecystitis was noted. The removed gallbladder showed acalculus cholecystitis with extensive diffuse infiltrates of numerous eosinophils and T lymphocytes, but sparse polymorphonuclear leukocytes. The authors name this unusual cholecystitis acalculus lymphoeosinophilic cholecystitis and believe it to be associated with interleukin-2 and lymphokine-activated killer cell therapy. The pathogenic relationship is discussed.
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PMID:Acalculus lymphoeosinophilic cholecystitis associated with interleukin-2 and lymphokine-activated killer cell therapy. 222 49

A 48-year-old man developed progressively more severe epigastric pain, pain on pressure in the right upper abdomen and fever up to 38.6 degrees C so that acute cholecystitis was suspected. Ultrasound did not demonstrate a gall-bladder but a sickle shaped, dense echo with a distal adjoining echo-free zone. Computed tomography revealed air in the gall-bladder lumen as well as intramural and pericholecystic air pockets, findings pathognomonic for emphysematous cholecystitis. In addition pneumoperitoneum was diagnosed. Subsequent cholecystectomy intraoperatively revealed a gangrenous, nonperforating gall-bladder in which E. coli was demonstrated. During the first postoperative week, there were no complications under transitory antibiotic treatment with tobramycin and ticarcillin with clavulanic acid. Then, an abscess developed in the residual gall bladder bed; this abscess was cured after drainage, local irrigation and re-initiation of antibiotic treatment. The patient was finally discharged well.
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PMID:[Acute emphysematous cholecystitis as a cause of pneumoperitoneum]. 222 58

Surgery for acute cholecystitis has become the most frequent abdominal surgery in most hospitals, yet aspects of its management remain controversial. The aim of this study was to focus on the recent trends by demonstrating the principal differences between 2 series of patients operated on during 10-year intervals. Two hundred fifty-six consecutive operations for acute cholecystitis were performed from 1970 to 1977 (group O) and were compared to 260 cases operated from 1980 to 1987 (group N). Thirty-six variables were recorded in each case. All data obtained were computer recorded and analyzed. Several trends were observed in group N: 1. The population was significantly older with a higher proportion of males and diabetics. 2. There was a marked increase in common bile duct stones, acalculous cholecystitis, and gangrenous changes in the gallbladder. 3. There was a significant increase in patients operated on within 48 hours of admission. 4. There was a significant increase in the number of patients without previous history of biliary symptoms. 5. There was a significant decrease in the rate of wound infections and no statistically significant differences in mortality (N: 3.0%, O: 2.7%). 6. A decrease of the average postoperative hospital stay of 3.2 days was observed. In spite of the older and sicker population in group N, no significant increase in mortality occurred and the postoperative hospital stay was reduced.
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PMID:Changing trends in surgery for acute cholecystitis. 189 45

Findings from studies showing an increased incidence of gallstones in diabetic patients do not control for other variables, such as obesity. There is no proof that diabetic patients have more gallstones. Gallstones do not cause diabetes mellitus. The principal gallbladder pathologic feature in diabetic patients is a functional deficit of uncertain etiologic factors, creating a large, flaccid, poorly emptying organ. Bile acid and lipid composition are usually increased in diabetic patients. Cholecystitis seems to be a more serious disease in diabetic patients, with worse infectious sequelae and more rapid disease progression. This conclusion has not been examined statistically. Even with modern care, the complication rate for operations upon the biliary tract in patients with diabetes is increased. Those with diabetes are generally older than other patients requiring cholecystectomy. Systemic changes of aging partly explain increased morbidity and mortality. Diabetic patients with symptomatic gallbladder disease usually require operation. Risk of cholecystectomy in diabetic patients is similar to that in nondiabetics. Prophylactic cholecystectomy for diabetic patients with "silent" gallstones was formerly recommended because of an apparent high risk of cholecystitis. Until the natural history of gallstones in those with diabetes has been defined, such patients should be considered in danger of serious illness. The risk of acute cholecystitis in diabetic patients with stones is probably significant enough to warrant the performance of early cholecystectomy.
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PMID:Gallstones, cholecystitis and diabetes. 224 90

The estimated percentage of non calculous cholecystitis is 2-14%. In most cases it is difficult to identify the cause and in very few cases it is possible to establish the etiology. Few cases are secondary to bacterial infections and the cause is very rarely a parasitic infection. We present a case of acute cholecystitis secondary to Entamoeba histolytica infection; the frequency, etiopathogenic mechanism and treatment are discussed.
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PMID:[Acute, non-lithiasic, amebic cholecystitis]. 225 93

One hundred and eighty-nine patients with acute cholecystitis or cholangitis requiring antibacterial therapy and surgery were randomly allocated in a prospective open study to receive either iv or oral pefloxacin (800 mg per day) or a combination of iv or oral ampicillin (4 g per day) and gentamicin (240 mg per day im). Ninety-two patients had to be withdrawn from the efficacy analysis, mainly because of negative baseline culture, but occasionally because of isolation of bacteria resistant to the study drugs. In the 97 evaluable patients (90 with cholecystitis and 7 with cholangitis) the clinical cure rates were excellent and similar for both groups: 49/50 (98%) for pefloxacin and 45/47 (95.7%) for the combination; the respective bacteriological success rates were 100% and 91.5%. Three patients in the pefloxacin group and six patients in the ampicillin-gentamicin group reported mild and transient side effects.
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PMID:Prospective randomized comparison of pefloxacin and ampicillin plus gentamicin in the treatment of bacteriologically proven biliary tract infections. 225 44

On the grounds of literature data and their own experience, the authors came to the conclusion that clear-cut identification of the character of the pathological process is of principal importance in deciding on the time of operative intervention for acute cholecystitis. Patients with a pronounced clinical picture of acute cholecystitis and those with signs of peritonitis must be operated on as emergencies, "postponed" operations produce poor results. Indications for an emergency operation in patients with acute cholecystitis complicated by obstructive jaundice and other conditions must be considered individually. An emergency operation is carried out if there are signs of circumscribed peritonitis, in all other cases detoxication therapy is applied for 2-3 days and is followed by operation. Patients with exacerbation of chronic frequently recurring calculous cholecystitis should be operated on in a planned order.
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PMID:[Disputable problems of surgical tactics in acute cholecystitis]. 228 47

A total of 412 patients with acute cholecystitis have been treated for the period 1980-1988. At different terms after the onset of the disease 136 patients have been operated. Acute calculus-free cholecystitis was found in 17 patients (12.5 per cent). The diagnosis rested on the clinical course, echographic examination, intraoperative and histologic finding. Most informative was echography--in 85.2 per cent of the cases.
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PMID:[Our experience with the diagnosis and treatment of acute noncalculous cholecystitis]. 228 76

A case of xantomatogranulomatous cholecystitis found in a review of 615 surgical gallbladders is reported, an incidence of 0.16%. Symptoms were those of acute cholecystitis. There was xantogranulomatous infiltration of the neighboring tissues. Both macroscopic and imaging features were those of a carcinomatous lesion. The definitive diagnosis was made by peroperative frozen sections.
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PMID:[Xantogranulomatous cholecystitis. A clinicopathologic study of a case]. 234 87

In Frederiksberg Hospital in Denmark the therapeutic procedure for acute cholecystitis requiring operation was altered in 1983. Since then, acute cholecystitis has constituted 15% of all cholecystectomies which corresponds to 15 per 100,000 of the population per annum. 12% of these cases were without stones in the gallbladder. Cases of a calculous cholecystitis do not differ from calculous cases as regards age, sex, clinical history in the month preceding operation and the histological findings.
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PMID:[Acute cholecystitis with and without gallstones. The frequency of surgical interventions in Frederiksberg during the period 1978-1988]. 236 19


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