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

The analysis of operative interventions performed for acute cholecystitis in 3324 patients was carried out. Local peritonitis was revealed in 149 (52.3%) patients, the diffuse one--in 136 (47.7%). Depending on the character of contents of the abdominal cavity, the authors distinguish purulent, biliary and mixed peritonitis. The general principles of tactics for surgical treatment and its different variants depending on a type of peritonitis are substantiated.
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PMID:[Surgical treatment of acute cholecystitis complicated by peritonitis]. 176 69

The authors studied the data concerning 101 patients who had undergone erroneous laparotomy for suspected acute surgical disease; these accounted for 0.4% of all the patients who were operated on for emergency indications in the same period. Eleven patients died. The operation was undertaken for an erroneous diagnosis of acute appendicitis (32 patients), acute cholecystitis (18), perforating gastric ulcer (15), peritonitis of unknown etiology (14), acute intestinal obstruction (5), strangulated hernia (3), destructive pancreatitis (3), tumor of the large intestine complicated by obstruction (3), abdominal abscess (2), thrombosis of the mesenteric vessels (1), ovarian apoplexy (1), closed abdominal trauma with injury to the viscera (4 patients). Diseases simulating the clinical picture of "acute abdomen" but not requiring an emergency operation were as follows: female reproductive (20 patients), pancreatic (11), renal diseases (11), hepatitis, cirrhosis of the liver (10), cardiovascular (9), pulmonary diseases (5), mesoadenitis (5), Crohn's disease (3), chronic colitis (3), carcinomatosis of the peritoneum (3), herpes zoster (3), and other diseases and injuries (20 patients). The main causes of the diagnostic and tactical errors were objective difficulties in the differential diagnosis due to similar symptomatology, as well as errors in the examination of the patient and haste in making a decision to make an operation.
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PMID:[Erroneous laparotomy in emergency surgery]. 177 33

Analysis of the features of calculous cholecystitis in 522 females and 106 males showed that acute cholecystitis takes a course which is more severe and acute in males than in females. Its gangrenous forms were encountered more often in males, which was an indication for more frequent emergency operations. In males the process was complicated by obstructive jaundice more frequently. In females acute cholecystitis was attended more frequently by peritonitis and was often combined with pancreatitis. Chronic cholecystitis also had some distinguishing features. Chronic indurative pancreatitis and hydrops of the gallbladder were encountered more often in females. The mortality in the abnormality was higher among males.
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PMID:[Characteristics of manifestations of calculous cholecystitis in men]. 177 47

Operations were conducted on 253 patients with acute cholecystitis, which was gangrenous in 84 (33.2%) and perforative in 7 patients. No relation was found between the frequency of these forms and the patients' age and duration of the disease. Quite frequently the clinical picture did not correspond to the morphological changes in the gallbladder wall. On 17 (20.23%) patients the operation was performed in the first 24 hours after hospitalization and circumscribed or generalized peritonitis was often found; 57 patients (67.85%) underwent operation on day 2-3 and infiltration was found in 24 and circumscribed peritonitis in 8 patients; in 10 cases the operation was conducted after day 3, the clinical manifestations of the disease were scarce. All were treated by cholecystectomy, postoperative complications developed in 5 (5.95%), 2 (2.38%) patients died. The authors recommend more active surgical tactics and claim that cholecystectomy in the most substantiated operation which can be practically carried out in all cases.
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PMID:[Surgical tactics in gangrenous and perforative cholecystitis]. 180 87

The authors performed 20 laparoscopies in patients previously submitted to abdominal surgery, in whom after clinical evaluation by the medical staff, the existence of intra-abdominal affection was still questioned. In this study group 14 patients exhibited more than 19 days old former abdominal incisions while in six patients they were recent ones. The incisions were median and para-median, McBurney incisions and Pfannenstiel incisions; one patient had been previously submitted to laparoscopy. The laparoscopic findings were hemoperitoneum, encapsulating peritonitis, ascites, subphrenic abscess, acute adnexitis, acute traumatic pancreatitis, genital tuberculosis, acute cholecystitis and one case of peritonitis due to a hollow viscus perforation by a fish bone. In one patient presenting encapsulating peritonitis the laparoscopic examination was complicated by a hollow viscus perforation.
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PMID:Emergency laparoscopy in patients submitted previously to abdominal surgery: a study of 20 cases. 184 26

The article analyses 610 patients with acute cholecystitis complicated by circumscribed peritonitis which determines the results of surgical treatment in many patients. The clinical manifestations of circumscribed peritonitis complicating destructive cholecystitis are discussed. It is shown that laparoscopy plays a role in the early diagnosis of atypical or asymptomatic course of this complication, particularly in elderly and old-aged patients. Data on the surgical treatment of acute cholecystitis complicated by localized circumscribed and ++non-circumscribed peritonitis are presented. The authors show the possibility of choosing the optimal operation--laparoscopic drainage of the gallbladder and abdominal cavity--in the first stage of treatment of patients with phlegmonous cholecystitis and localized ++non-circumscribed peritonitis in the presence of serious concomitant diseases.
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PMID:[Diagnosis and treatment of acute cholecystitis complicated by local peritonitis]. 214 98

The authors treated 462 patients with acute cholecystitis. Operated on were 220 patients. Of them, 53.6%--at the first 24 hours after admission. In 26.3% of the patients, peritonitis was an indication for the operation. The postoperative lethality was 4.1%.
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PMID:[The treatment of acute cholecystitis]. 227 69

A review of all patients treated for acute cholecystitis (n = 5848) during an 18-year period (1969-1986) at two hospitals (one practising early surgery in patients with acute cholecystitis and the other not) disclosed that 104 (1.8%) had bile within the abdominal cavity at surgery; 71 with a visible perforation of the gallbladder and 33 without. The bile was infected in 82% of performed cultures (most commonly with Escherichia coli). Mortality was 7.7% (8/104 patients), being 20% (4/20) in the hospital practising delayed surgery and 5% (4/84) in the hospital practising early surgery (p less than 0.10). Infectious complications were responsible for the deaths by leading to multiple organ failure with pulmonary or renal insufficiency or gastro-intestinal bleeding. The timing of surgery was the only factor that had prognostic significance, i.e. the longer the hospital delay before surgery the higher the mortality, although elderly patients or patients with perforation tended to have a worse prognosis. In conclusion, the results of this study indicated that early surgery is important in patients with acute cholecystitis as a means of lowering mortality in bile peritonitis in this condition.
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PMID:Bile peritonitis in acute cholecystitis. 228 32

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 case of severe rhabdomyolysis with extensive myocardial involvement in a 32 year old alcoholic man is reported. He referred effort dyspnea for the last eight months which worsened thirteen days before his death. Admitted at the institute he was obnubilated and dyspneic. Massive pulmonary thromboembolism was suspected and heparin was given. He was then transferred to our intensive care unit in circulatory collapse. A chest Rx showed cardiomegaly. A Swan-Ganz catheter was introduced and abnormal parameters corrected. Evolution was complicated with acute cholecystitis, nosocomial bronchopneumonia and hypoxic brain damage. A net reduction of cardiac size as judged by a chest roentgenogram was noted in the final days. Necropsy showed skeletal and cardiac rhabdomyolysis, early alcoholic cirrhosis, diffuse peritonitis and bronchopneumonia. To our knowledge, this case is the first in the literature to provide anatomical evidence of cardiac rhabdomyolysis, a fact which was suspected on clinical grounds but had not been proven.
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PMID:[Alcoholic rhabdomyolysis with myocardial involvement]. 229 13


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