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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of amebic colitis that resulted in perforation of the colon, an ominous complication, are presented. The first was diagnosed preoperatively as acute ulcerative colitis with toxic megacolon, and the second as peritonitis complicating acute cholecystitis. In both instances the correct diagnosis was made after operation. The first patient recovered after colectomy and antiamebic therapy, but the second patient died in the early postoperative period, in septic shock. Amebic colitis occurs infrequently in the United States, and the diagnosis is rarely considered. In most cases an initial diagnosis of ulcerative or granulomatous colitis is made and the true diagnosis is recognized only after operation for colonic perforation or hepatic abscess. It is suggested that amebic colitis should be considered more frequently in cases of patients who have diarrhea. Stool examination for ova and parasites is often negative in amebic colitis. The IHA is usually positive in emebiasis, and should be performed early in casesof patients who have bloody diarrhea or other clinical symptons when amebiasis is suspected. Rectal biopsy is also a useful diagnostic approach, but failed to reveal amebae in one of our cases. Finally, it is suggested that operation be performed urgently when fulminating amebic colitis is not reversed by antiamebic therapy, when peritonitis occurs even with antiamebic treatment in progess, and for colonic perforation or toxic megacolon even when antiamebic therapy has not been indicated.
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PMID:Perforation of the colon in unsuspected amebic colitis: report of two cases. 19 Dec 33

100 patients with acute cholecystitis (AC) diagnosed by clinical, laboratory, and roentgenological examinations were randomly divided into 2 groups; early surgery (ES), operated within 7 days after the onset of acute symptoms, and delayed (DS), operated 2--3 months after the acute episode. Patients with elevated serum bilirubin and/or amylase were included in the trial. Two patients died during conservative treatment, and in 4 cases medical treatment was interrupted because of peritonitis, and in 3 cases because of increasing jaundice. Recurrence of AC was found in 24% of the patients in the DS group. There was no mortality in the ES group, but 2 patients died postoperatively in the DS group. Wound infection developed in 3 patients in the ES, and in 8 patients in the DS group. Retained stones remained in 3 cases of the DS and in 1 case of the ES group. The operative procedures were easier to perform in the ES group than in the DS, as estimated by the duration of operation. The operation time was 76.7 +/- 4.6 min (mean p S.E.) in the ES and 98.0 +/- 7.3 min in the DS group. There was a statistically significant difference between the 2 groups (p less than 0.01). The results suggest that early surgery in the treatment of acute cholecystitis is recommended. The complications of failed medical treatment can be avoided by early operation without added risk of mortality or complications.
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PMID:Acute cholecystitis treated by early and delayed surgery. A controlled clinical trial. 35 66

1. Cefmetazole was administered to 10 patients; 5 acute cholecystitis, 4 acute peritonitis and 1 periproctitis. 2. Cefmetazole was given by drip infusion at a daily dose of 2 to 4 g. 3. Clinical response was excellent in 3 patients, and good in other 7 patients. 4. No clinical adverse effect was recognized except the increase of GOT and GPT in 1 patient.
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PMID:[Clinical studies of cefmetazole (author's transl)]. 43 2

In the period from 1963 til 1978 the authors observed 1084 patients with cholecystitis. Operations were performed on 336 patients. Acute cholecystitis was diagnosed in 190 patients, chronic calculous cholecystitis--in 128 patients, chronic acalculous cholecystitis--in 18 cases. In acute cholecystitis the active-temporizing tactics was used. Urgent operations were performed on patients with peritonitis. In other variants the conservative treatment was prescribed. When the patient's condition was stated to improve, the surgical treatment was performed if indicated. Patients with chronic calculous cholecystitis were operated on diagnosing. Chronic acalculous cholecystitis was an indication for surgery in cases of frequent attacks of hepatic colic and inefficiency of the conservative therapy.
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PMID:[Diagnosis and treatment of cholecystitis]. 51 74

The authors present an analysis of the results of complex treatment in 4318 patients operated upon for acute peritonitis, caused by acute appendicitis, perforating gastric and duodenal ulcers, acute cholecystitis, ruptures and perforations of the intestine and other surgical and gynecological diseases. Patients with diffuse purulent peritonitis showed marked disorders in protein-aminoacid, nitrogen, and water electrolyte metabolism, acid-base balance, a reduced nonspecific immune responsiveness of the organism. Therpeutic tactics was delineated taking into account the revealed changes.
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PMID:[Some aspects of the complex treatment of acute suppurative perionitis]. 101 21

Based on the analysis of the immediate results of 231 operations on extrahepatic bile ducts, 174 primary interventions and 57 reoperations, it is concluded that the operation at the height of the attack of acute cholecystitis or in total obturation of bile passages yields considerable mortality (1/3 and 1/5 of observations, accordingly). The best results of surgery were obtained in attenuation of acute inflammatory phenomena in the gallbladder under conditions of liquidation of obturation of extrahepatic bile ducts (1/7 of observations). However, bile peritonitis and progression of destructive acute cholecystitis would necessitate an urgent operation. According to the authors' data well-grounded indications to surgery, a selection of optimum terms and extent of its accomplishment could contribute to favourable immediate results of surgical therapy for diseases of extrahepatic ducts.
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PMID:[Ways of mortality reduction after operations on the extrahepatic bile ducts]. 110 33

15 cases of free gallbladder-perforation among 3,950 cholezystectomies during the last 15 years are discussed. There was no difference in the sex-distribution. The average age was 67 years. This factor together with delay of the operation because of atypical symptoms and perhaps a toxic agens in the gall are responsible for the high mortality of 26-70 p.c. Nearly always are gallstones and inflammation present. Therefore 2 consequences are made: 1) Acute cholecystitis with signs of diffuse peritonitis: Operation at once, otherwise during the first 3-5 days after preparation. 2) Widened indication for cholecystectomy by gallstone-illness is recommended.
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PMID:[The free gallbladder perforation]. 116 Aug

In a series of 20 patients with bile peritonitis seen during a 15-year period, 15 were men and 5 women, with an average of 72 years. They represented 1.8% of 1123 patients with acute cholecystitis admitted during the same period. Three patients were not operated upon and all died, while 5 of 17 operated patients died. The high mortality rate is due to a delay in diagnosis and treatment. Early operative treatment of acute cholecystitis should be resorted to whenever possible.
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PMID:Bile peritonitis in acute cholecystitis. 121 38

Addition of (intramuscular+intravenous) leukinferon (LF) to the schemes for the treatment of acute peritonitis promoted a more rapid positive development of the time course of clinical signs and decreasing of leukocytosis in the presence of a pronounced tendency to normalization of the main immunological indices i. e. the counts of differential T-lymphocytes and T-helper cells. There was also activation of neutrophil phagocytic function. A rapid decrease in objective signs of endotoxicosis was recorded: the intoxication leukocytic index and the level of medium-mass molecules. In parallel with the decrease in the intoxication leukocytic index, there was a decrease in cytosis of the peritoneal exudate. The use of LF in the treatment of elderly patients with acute cholecystitis eliminated the clinical signs and normalized the main laboratory indices without surgical interventions which allowed one to make a planned operation with the minimum risk.
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PMID:[Leukinferon in immunological correction of acute inflammatory diseases of the abdominal organs]. 151 54

In analysis of a group of 48 patients, the authors describe an entity they call acute cholangio-cholecystitis (or acute cholecystitis of choledochal origin) and define it by 4 obligatory criteria: 1. vesicular lesion of acute cholecystitis type; 2. the obstruction of the main bile duct in the direction of its junction with the cystic duct; 3. free duct communication between the gallbladder and the main bile ducts; 4. fluid content (purulent gallbladder) found identical over the whole biliary territory (the gallbladder the main bile ducts the intrahepatic bile ducts). This entity represents 7.6% of the total of acute cholecystitis and was met in 2.8% of the total of the interventions for the main bile ducts obstruction. The deficient biological background of the patients (60% over 60 years old), and other seriousness factors--vesicular destructive lesions associated with biliary peritonitis (7/48), the existence of the duct obstruction, usually calculous (42/48), but also hydatic (3/48) or tumoural (3/48), the multitude and seriousness of the associated lesions are emphasized. The surgery, performed in over 80% emergent cases, was directed to the decomprimation of the main biliary axis to which the increase of the gangrenous cholecyst, treatment of the duct obstructive factor, repair of the internal biliary fistulas, treatment of the consequent peritonitis were added. The results, very often good (71%), were shadowed by a series of complications (29%) which ended in deaths (14.5%). The paper pleads for the early surgery of the lithiasic biliary disease, before the appearance of the inevitable complications.
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PMID:[Acute cholangiocholecystitis]. 168 26


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