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

Seven burned patients developed acute cholecystitis within 10-37 days of injury, associated with jaundice in 5. There were 6 males and 1 female, with 5 patients aged 28-40 years, the others being 56 and 69 years. Cholecystectomy was performed in all patients with 1 death. It is suggested that the cause of post-burn cholecystitis is traumatic and septic shock with consequent biliary stasis.
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PMID:Acute non-calculous cholecystitis in burns. 63 46

Ultrasonography is a helpful, non-invasive, and relatively inexpensive adjuvant to oral cholecystography for evaluating the gallbladder and its diseases. This method can be highly accurate in detecting gallstones and is specially useful when there is non-visualisation in radiographic contrast studies. Various ultrasound patterns of gallstones are described. All these patterns should demonstrate a sonic shadow in association with an intraluminal defect. Sonography is particularly useful in demonstrating cholelithiasis and organ dilatation in suspected acute cholecystitis. In addition to gallbladder disease, this technique simultaneously offers pertinent anatomical information about the porta hepatis. This information would otherwise require additional diagnostic investigation. Because, in many instances, sonography is non-specific, or blind to certain gallbladder non-calculous filling defects, and because of present lack of uniform standard quality control methods for performing this procedure, it should be considered only as a complementary, imaging procedure to oral cholecystography.
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PMID:Ultrasonic examination of the gallbladder: a review. 63 55

On the basis of 15 resp. 25 years of experience with surgical treatment of acute cholecystitis the authors evaluate their results of urgent and acute operations in 1.080 patients in whom the intensive conservative treatment of acute attacks did not sufficiently influence the symptoms of acute cholecystitis. From this group of 1.080 patients operated on urgently or acutely 21 died, the operative mortality being thus 1.9%. The mortality rate was highest after urgent operations where from 58 patients 10 died, the mortality being 17.2%. From the group of 889 acute cases operated on during 12, 24 or 48 hours following hospital admission, only 5 patients died, the mortality rate being 0.6%.
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PMID:[Surgical treatment of acute cholecystitis (authors' transl)]. 64 65

During a 10-year period, 555 cholecystectomies were performed without drainage of the gallbladder bed or subhepatic space. Six per cent of the patients had acute cholecystitis or hydrops of the gallbaldder and 11% had common duct exploration. Only in those patients with frank infection, spillage of obviously infected bile or in whom satisfactory closure of the gallbladder bed could not be accomplished was a drain used. Meticulous closure of the gallbladder bed was performed to minimize leakage of bile. The series was critically studied to evaluate complications, morbidity, mortality and hospital stay. It was concluded that drainage following cholecystectomy or choledochotomy can safely be omitted except for the indications mentioned.
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PMID:Review of 555 cholecystectomies without drainage. 64 33

Consecutive patients undergoing emergency appendectomy (283) or urgent cholecystectomy (51) were prospectively studied for the development of post-operative incisional or peritoneal sepsis. Severity of the original peritoneal infection was carefully recorded, while use of a Penrose dam to drain the peritoneum was randomized according to pre-assigned hospital number. Both aerobic and anaerobic cultures were taken from the abdomen at the time of operation as well as from all postoperative infectious foci. Results demonstrated no essential differences in incidence of wound and peritoneal infection following appendectomy for simple or suppurative appendicitis (187) or following cholecystectomy for acute cholecystitis (51). However, with gangrenous or perforative appendicitis (94), incisional and intra-abdominal infection rates were 43% and 45%, respectively, when a drain was used; yet only 29 and 13%, respectively, without a drain. These latter differences were significant (p < 0.001). In addition, intra-abdominal abscesses were three times as likely to drain through the incision than along any tract provided by the rubber conduit. Cultures revealed that hospital pathogens accounted for a greater proportion of wound and peritoneal sepsis after cholecystectomy and appendectomy for simple or suppurative appendicitis if a drain had been inserted than if managed otherwise. By contrast, a mixed bacterial flora was responsible for most infections following appendectomy for gangrenous or perforated appendicitis, irrespective as to use of a drain.
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PMID:Abdominal drainage following appendectomy and cholecystectomy. 64 99

We reviewed our experience with intravenous cholangiography in the evaluation of 70 patients with suspected acute cholecystitis. Twenty-one of these patients had visualization of the biliary ducts without opacification of the gallbladder, a roentgenographic finding that was considered diagnostic of acute cholecystitis. Twenty of the 21 patients were noted to have acute cholecystitis during exploratory laparotomy. The remaining patient had a normal gallbladder, but was found to have a liver abscess. Opacification of the gallbladder with evidence of gallstones was found in eight patients; all had acute cholecystitis. Visualization of the gallbladder without gallstones was found in 22 patients, revealing no acute cholecystitis in this group. Many of these patients were admitted to the hospital with a primary diagnosis of acute cholecystitis and were spared an unnecessary surgical exploration. Nineteen patients had nonvisualization of the gallbladder and biliary ducts. This roentgenographic finding may be caused by acute intra-abdominal conditions other than cholecystitis and caution is warranted in its interpretation. This test has been found to be a reliable adjunct in the work-up of patients with suspected acute cholecystitis.
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PMID:Intravenous cholangiography in the diagnosis of acute cholecystitis. 64 14

The accuracy and possible clinical value of grey scale ultrasonography in the detection of gallstones has been prospectively studied in 100 unselected patients presenting with recurrent biliary colic, acute cholecystitis or acute pancreatitis. Adequate visualization of the gallbladder was obtained in 79 cases, with 3 false positive and no false negative reports. Oral cholecystography remains the initial investigation of choice in patients presenting with recurrent biliary colic, but grey scale ultrasound has been shown in this study to be a reliable means of detecting gallstones in the 'acute' situation, when conventional contrast radiology is of limited value.
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PMID:A prospective study of the clinical value and accuracy of grey scale ultrasound in detecting gallstones. 64 99

On the grounds of the analysis of 1300 case records and own observations with the use of angioscopy and angiography the authors have come to the conclusion that acute cholecystitis in elderly individuals results from the blood supply disorder in the gallbladder wall, caused by the thrombosis of the vascular branches of the cystic artery. They have suggested the classification of acute cholecystitis, mirroring the stage character of the disease and the nature of pathological changes in the gallbladder.
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PMID:[Characteristics of the classification of acute cholecystitis in the elderly]. 65 10

Accumulation of lysophosphatidylcholine in gall-bladder bile is involved in the pathogenesis of acute cholecystitis. [1-14C]oleoyl- or [1-14C]palmitoyl-lysophosphatidylcholine was thus instilled in the in situ guinea pig gall-bladder and the absorption and metabolism of the lipid were determined. We found that, after 6 h instillation, 53% of the oleoyl derivative was adsorbed by the gall-bladder, whereasee only 37% of the palmitoyl derivative was absorbed. Although some differences in the metabolism of these two lipids were observed, a major portion of the absorbed radioactivity was found in the gall-bladder wall as phosphatidylcholine. To determine the mechanism of phosphatidylcholine formation from lysophosphatidylcholine by the gall-bladder mucosa, we used lysophosphatidylcholine which was labelled in the fatty acid moiety with 14C and in the choline moiety with 3H. Our data suggest that the mechanism of phosphatidylcholine formation from lysophosphatidylcholine involved acylation with an acyl donor other than a second molecule of lysophosphatidylcholine. We hypothesize that this mechanism as well as others described serve to prevent accumulation of lysophosphatidylcholine within the gall-bladder lumen and thus prevent damage to the gall-bladder mucosa.
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PMID:Lipid metabolism by the gall-bladder. I. The in situ uptake and metabolism of lysophosphatidylcholine. 66 91

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 for acute cholecystitis (author's transl)]. 66 25


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