Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A prospective bacteriologic investigation was made in 43 consecutive patients (mean age 63 years) operated on for acute cholecystitis. Gallbladder bile and wall were cultured, using four methods and with special attention to optimal anaerobic technique. Cultures were positive in 72% of the patients, yielding a wide variety of species (21 species among 48 isolates). Anaerobes constituted 23% of the isolates. Cultures from gallbladder bile and from gallbladder wall gave almost identical results, as did sampling at the beginning and at the end of cholecystectomy. Bactibilia was found in all patients operated on within 48 hours after the onset of symptoms. Bactibilia and postoperative septic complications showed statistically significant correlation with high patient age. Bactibilia and gallbladder gangrene were significantly correlated with preoperative temperature greater than 38.5 degrees C. There was coincidence of strains isolated from local wound sepsis and from peroperatively sampled gallbladder bile. Adequate preoperative or peroperative antibiotic therapy according to susceptibility testing was associated with significantly reduced rate of postoperative septic complications. The study indicates that bacteria are present early in the course of acute cholecystitis and that they are causally important for postoperative morbidity and mortality.
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PMID:Biliary microflora in acute cholecystitis and the clinical implications. 638 Jan 77

Image-guided percutaneous transhepatic cholecystostomy (PTC) was suspected Acute Acalculous Cholecystitis (AAC). Seven of them developed AAC at home while eight patients developed the disease while hospitalized by critical illness. We performed PTC with Seldinger technique, guided: 13 by US CT. In every cases the catheter was placed successfully AAC was confirmed in 14/15 patients. No severe complications were related to the procedure. All but 3 improved following PTC: 2 required cholecystectomy because of diffuse gallbladder gangrene and one died by sepsis 48 hs after PTC. Light complications were: 1 homobilia and fever by 36 hs. In this series mobility was 35% and mortality 21%. Thus 9 patients with AAC were cured with PTC and are alive and symptom-free without surgery. PTC failed in 3/14 patients and other 2 died by causes unrelated to biliary disease. We conclude that PTC is a safe and effective temporary method for definitive treatment of AAC. Surgery is limited to that cases with generalized peritonitis and those when PTC has fallen.
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PMID:[Current therapeutic approach to acute acalculous cholecystitis]. 913 51