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Query: UMLS:C0149520 (acute cholecystitis)
 2,784 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Amebic abscess of the liver has protean manifestations that often resemble causes of an acute surgical abdomen. Patients presenting at University of California, Los Angeles Hospital with acute abdominal injuries who underwent exploratory laparotomy and subsequently were found to have an amebic hepatic abscess were studied. There are various clinical symptoms of amebic hepatic abscess as well as problems of differentiating this pathologic entity from an acute surgical abdomen. Most patients with amebic hepatic abscess that mimics an acute abdomen present as acute cholecystitis or acute appendicitis. All patients recovered uneventfully once the diagnosis was made and appropriate therapy instituted. The salient features of the history, physical examination and laboratory data that can identify the amebic abscess were analyzed. The key to correct diagnosis is cognizance of the condition.
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PMID:The symptoms of an amebic abscess of the liver simulating an acute surgical abdomen. 43 69

Gallstone formation around metallic foreign bodies is an unusual cause of acute cholecystitis. Two cases of penetrating abdominal trauma are described in which metallic fragments served as the nidus for calculus formation and later precipitated an acute abdominal problem.
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PMID:Acute cholecystitis secondary to unusual gallstones. 43 3

Cholecystostomy was performed on 22 patients with acute cholecystitis after partial (13) or complete (9) removal of gallbladder stones. One patient had complementary common-duct drainage. Early mortality occurred in two patients. Three patients with associated cholangitis but intraoperative reflux of cysticduct bile were all treated by cholecystostomy alone and survived. For the poor-risk patient with cholecystitis, cholecystostomy is effective. When there is associated cholangitis and documented cystic-duct patency, cholecystostomy is also sufficient. When accompanying cholangitis is associated with cystic-duct occlusion, choledochotomy and T tube drainage should be added.
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PMID:Reassessment of simple cholecystostomy. 43 66

A patient with giant cell (temporal) arteritis developed acute cholecystitis related to vasculitis. Histopathologically, the vasculitic lesions in the gallbladder resembled polyarteritis nodosa. In addition to demonstrating the rare occurrence of vasculitis of the gallbladder in a patient with giant cell arteritis, this case points out the inadequacies of currently used criteria to separate the various forms of arteritis.
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PMID:Vasculitis of the gallbladder in a 70-year-old man with giant cell (temporal) arteritis. 43 15

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

On the grounds of 98 own clinico-pathomorphologic studies and analysis of 112 records the authors have come to the conclusion that at the root of the pathogenesis of acute cholecystitis in elderly and senile patients is the disorder of the gall-bladder wall blood supply, resulting from thrombosis of atherosclerotic vessels against the back-ground of increased coagulation. The authors believe, that the treatment of cholecystitis in these patients with drugs, decreasing the coagulation of the blood and improving hemocirculation, has pathogenetic grounds.
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PMID:[Characteristics of the pathogenesis and treatment of acute cholecystitis in the middle-aged and elderly]. 45 1

Acute cholecystitis is a rare complication of systemic brucellosis. This report details the occurrence of acute noncalculous cholecystitis in which Brucella suis was cultured from both the blood and the gallbladder. A discussion of the various diagnostic tests and the recommended therapy for brucellosis is included.
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PMID:Brucella-induced cholecystitis. 45 41

An experience with 68 patients with hemorrhagic pancreatitis identified at operation or autopsy is reported. Sixteen of the patients were subjected to operation, and 6 survived after celiotomy and peritoneal irrigation. There were no survivors in the unoperated group. Death when the pancreas is hemorrhagic and due to pancreatitis occurs an average of 10 days after the onset of symptoms or within 7 days of hospitalization. In eight patients who presented in coma, the diagnosis was not established before death. Early recognition of patients with hemorrhagic pancreatitis can be facilitated by the routine use of amylase and methemalbumin determinations and peritoneal lavage. Translocation of large volumes of albumin-rich fluid from the intravascular compartment to the retroperitoneum and pleural and abdominal cavities is in part responsible for many of the signs, symptoms, and complications of hemorrhagic pancreatitis. These include hemoconcentration, hypotension, tachycardia, tachypnea, ascites, abdominal distress, respiratory insufficiency, and renal failure. Adequate initial resuscitation and intensive follow-up are probably the most important elements in the management of patients with hemorrhagic pancreatitis. Careful monitoring of fluid and electrolytes and blood gases is required to avoid shock and renal and pulmonary failure. The need for careful monitoring is emphasized by the number of our patients in whom inadequacies of fluid replacement and ventilation were often not appreciated until the patient was in extremis from shock or respiratory or renal failure. Antibiotics are indicated in patients with biliary tract disease and penetrating ulcer in whom the risk of secondary infection is considerable. Associated diseases that initiated pancreatitis and that in themselves may be life-threatening, such as acute cholecystitis or cholangitis, should be promptly treated by operation. Diagnostic and therapeutic lavage are justified in the treatment of hemorrhagic pancreatitis. Resection of the necrotic pancreas should be considered when the patient fails to improve after lavage and nonoperative resuscitation.
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PMID:Hemorrhagic pancreatitis. 45 56

Torsion of the gallbladder is an uncommon process that is usually found at the time of exploration for an acute surgical abdomen. It results from two congenital anomalies and may be complete or partial. It should be considered in the etiology of what appears to be acute cholecystitis in the elderly, thereby prompting early surgical management. Two cases are presented to help define the true incidence of this process.
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PMID:Acute torsion of the gallbladder. 45 75

Three case histories of patients who were treated for gonococcal perihepatitis (Fitz-Hugh-Curtis syndrome) are reviewed. The incidence rate of this disease process is believed to be increasing, and a surgical consultation is often asked for in the evaluation of these individuals. The diagnosis of FHCS requires a high index of suspicion. However, if a patient has signs and symptoms of acute cholecystitis plus the recent onset of a purulent genitourinary infection, the diagnosis of FHCS is suggested. Confirmation of this diagnosis is obtained with the culturing of N. gonorrheae from urethral or cervical secretions. The clinical presentation may vary from a moderately symptomatic to an acutely ill individual. Most commonly there is an abrupt onset of sharp right upper quadrant pain. The finding of any degree of lower abdominal or pelvic tenderness in addition to the upper abdominal pain, should make one highly suspicious of pelvic inflammatory disease and concommitant FHCS. Although no deaths have been reported from this syndrome, it is important to make a prompt clinical diagnosis and commence appropriate antibiotic therapy. The currently recommended therapeutic regimen is procaine penicillin, 1,200,000 U, twice a day for 10 days.
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PMID:Gonococcal perihepatitis (the Fitz-Hugh-Curtis syndrome): a diagnostic dilemma. 45 27


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