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

Within a three-year period six female patients with gonococcal perihepatitis were encountered. In the acute stage they had clinical symptoms indistinguishable from acute cholecystitis. In all six patients the diagnosis was established by positive growth of Neisseria gonorrhoeae from cervix specimens. Evidence of previous gonococcal pelvic infection was disclosed in three of the patients. In two patients the gonococcal aetiology of the disease was suggested by papular skin lesion and arthritis. Of the annual mean number of patients admitted to the emergency ward with suspicion of acute cholecystitis within the same three year period, 2.6% presented with gonococcal perihepatitis. As the incidence of gonorrhoea is increasing, complications such as perihepatitis are seen more frequently among young female patients admitted to surgical emergency wards because of acute abdominal pains.
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PMID:Gonococcal perihepatitis in a surgical ward. 45 81

In a 12-month period 100 patients with clinical evidence of acute disease of the gallbladder were studied in hospital by grey-scale ultrasonography. During the same hospital admission it was possible to correlate results of ultrasonography with operative findings in 66 patients. In 52 patients the ultrasonographic diagnosis of gallstones was proved to be correct. There were no false-positive results. In seven patients the ultrasonographic report of a normal gallbladder without stones was also confirmed. In two patients, the report of a normal gallbladder without stones was erroneous. In two more patients the scan was indeterminate and stones were found at operation. In the remaining three patients echogenic material was reported and at operation minute stones and "sludge" were found. No complications resulted from the ultrasonography. The study showed that grey-scale ultrasonography is a reliable, rapid and safe technique for detecting gallstones in patients with a clinical diagnosis of acute cholecystitis.
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PMID:Diagnostic ultrasonography in acute cholecystitis. 45 69

During a 12-month period from September 1976 to September 1977, 114 patients in a community hospital had ultrasonography as part of their diagnostic work-up for suspected gallbladder disease. While 65 per cent had an additional study, such as an oral cholecystogram or intravenous cholangiogram, 35 per cent had ultrasonography as the only study to make the diagnosis. All patients in this group had laparotomy and cholecystectomy to confirm or disprove the diagnosis of calculous gallbladder disease. The overall accuracy rate of ultrasonography for calculous gallbladder disease was 90 per cent, which compares favorably with the standard oral cholecystogram. Ultrasonography has some distinct advantages in certain clinical situations such as acute cholecystitis, jaundice, pancreatitis and pregnancy. A review of our clinical experience in the everyday use of ultrasonography for calculous biliary disease has been discussed, and guidelines for the use of ultrasonography as part of the diagnostic armamentarium for gallbladder disease are presented.
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PMID:The use of ultrasonography in the diagnosis of calculous gallbladder disease. 46 91

A retrospective review of the records of 1,507 patients with a diagnosis of cholecystitis was conducted for the five-year period, 1972 to 1977. Of this group of patients, a histopathologic diagnosis of acute cholecystitis was established in 154 patients (10.2%). Common duct calculi were detected in 17 of these 154 patients, an incidence of 11%. Preoperative evaluation by means of serum bilirubin and alkaline phosphatase levels and intravenous cholangiography was unsatisfactory for consistent demonstration of choledocholithiasis in the presence of acute cholecystitis. Intraoperative cholangiography was found to be the most reliable method for detection of common duct calculi and was successfully employed in 14 of 17 patients with choledocholithiasis. The remaining three patients had palpable stones.
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PMID:Choledocholithiasis associated with acute cholecystitis. 46 4

Computed tomography (CT) has the ability to detect small variations in tissue density. Meglumine diatrizoate was given intravenously to four patients with clinical acute cholecystitis as part of the CT scanning procedure. The enhancement of the thick gallbladder wall, together with an enlarged gallbladder and the presence of stones, confirmed the diagnosis of acute cholecystitis. Our present experience indicates that, after contrast medium administration, CT has a distinct place in the assessment of acute inflammation of the gallbladder.
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PMID:Contrast computed tomography in the diagnosis of acute cholecystitis. 47 8

104 patients with acute cholecystitis were divided into four groups according to the kind of pre-operative treatment received: immediate; early; late; and interval operation. Total duration of hospital stay depended on the duration of pre-operative treatment. It was shortest (24.9 days) in those operated on within the first week, longest (71.1 days) in those operated on during the interval. Evidence of severe gallbladder wall changes (macroscopic and microscopic) was obtained in two thirds of patients, even after weeks of conservative treatment. Six patients (5.7%) died postoperatively, three of them after early operation. Overall mortality was only in part due to severe complications of the gallbladder disease.
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PMID:[Early operation in acute cholecystitis]. 48 67

In some patients, gallstones are asymptomatic, lying dormant in the gallbladder or wedged in the cystic duct. In others, stones cause specific symptoms of gallbladder disease, such as biliary colic, acute cholecystitis, or cholangitis. Symptoms of flatulent dyspepsia are not markers of gallstone disease, since they occur equally in those with and without gallstones. Complications of gallstone disease include pancreatitis, biliary-enteric fistulas, hydrops, limy bile, porcelain gallsbladder, and carcinoma of the gallbladder. Cholecystectomy is indicated for symptomatic gallstones; for suspected stones in diabetics, who are at high risk should complications of gallstone disease occur; and in a few other limited situations. Prophylactic cholecystectomy for asymptomatic gallstones remains controversial.
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PMID:Manifestations of gallstone disease. 48 73

Sixty-three patients with the clinical suspicion of acute cholecystitis were examined with infusion tomography of the gallbladder. Ultrasonography was performed in 51 of these cases. The technique and diagnostic principles of both methods when used in combination is stressed. Thus in a case of gangrenous cholecystitis when opacification of the gallbladder wall may not appear at infusion tomography, ultrasonography may demonstrate signs of gallbladder disease. Infusion tomography, on the other hand, may be of great value if ultrasonography is not informative.
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PMID:Infusion tomography and ultrasonography of the gallbladder in the diagnosis of acute cholecystitis. 48 19

The authors studied 333 acute cholecystitis out of 2,200 operated on for lithiasis of the gall-bladder, 186 bacteriological tests were carried out on the vesicular liquid and wall. They insist on the main anatomo-pathological characteristic: early, partial or total destruction of the mucous together with acute inflammatory lesions of the wall and even sometimes necrosis. This irreversible lesion is due to the acute obstruction of the gall-bladder by blockage of a calculus. Acute cholecystitis are practically always aseptic at the beginning. Sepsis is a secondary complication. These anatomo-pathological and bacteriological elements have two therapeutic corollaries: 1. The patient has to be operated very early at the aseptic stage. 2. Preliminary antibiotherapy becomes useless. Under these conditions there is practically no death before the age of 65. Mortality concern old people, operated late and suffering from other disease.
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PMID:[Acute calculous cholecystitis (author's transl)]. 48 81

The usual ultrasound findings in acute cholecystitis include diffuse hyperreflective wall thickening, hazy wall delineation and gallbladder distension. In 11 patients with acute cholecystitis, an additional sign was seen consisting of a hyporeflective or sonolucent layer, continuous or interrupted, within the hyperreflective, thickened gallbladder wall. Anatomic-pathologic correlation, comparative CT scans and clinical follow-up studies showed subserosal edema and necrosis to be the most probable cause of this finding.
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PMID:Gallbladder wall sonolucency in acute cholecystitis. 49 31


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