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

Traumatic acute cholecystitis is of secondary importance beside many other complications in the polytraumatised patient, since it is rarely diagnosed--possibly too rarely. Difficulties often arise because of a multitude of injuries, which are often life-threatening and which must be given top priority (3). Men are chiefly involved (4). In most cases, the condition is preceded by shock, but not necessarily by gallstones (10, 11). First pointers in literature were given by Mennenga (8). As early as 1939 he pointed out that blunt abdominal trauma may produce tears in the gallbladder and bile duct regions. Marre (7) described acute signs in the upper abdomen due to rupture of the bile duct. Genesis of post-traumatic acute cholecystitis is still unclarified. Apart from rupture or perforation of the gallbladder or bile ducts, it is mainly shock (4, 9, 12) which is considered to be an important causative factor.
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PMID:[Acute post-traumatic cholecystitis. Caused by or following polytrauma?]. 286 Jul 88

Age and clinical presentation as acute cholecystitis have widely been found to be predictors of outcome after cholecystectomy. Recently, male gender has been cited in several studies as a possible prognostic factor. A single Institution cholecystectomy registry (3.047 cases between 1959-1997) comprising 966 (31.7%) men and 2.81 (68.3%) women was retrospectively analysed. Men experienced significantly higher rate of major complications (5.3% vs 3.2%; p < 0.01) and mortality (1.55% vs 0.62%; p < 0.03). By logistic regression analysis, it was found that male gender, acute cholecystitis, respiratory and cardiovascular system disease were significantly related to postoperative morbidity. Age older than 65 years, male gender, respiratory and cardiovascular diseases were factors negatively affecting operative mortality.
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PMID:[Cholelithiasis in men. Observations on a case series of surgically treated 3,047 patients]. 1064 64

Acute cholecystitis is a complication in critical illnesses, including burns. The purpose of this report is to review one institution's experience with this complication during a 21-year time period. A computerized burn registry was used for data collection and analysis in this retrospective review. Twenty patients developed cholecystitis from a total burn admission population of 10,762 in this 21-year period (0.18%). Mean patient age was 43.5 years, and their mean burn size was 37.4% with a mean full-thickness burn size of 23% TBSA. Mean patient length of stay was 77.4 days. Sixteen of these patients were intubated and mechanically ventilated for a mean of 56 days. Total parental nutrition was required in 12 patients. The use of total parental nutrition steadily decreased over the length of the study, and early enteral tube feed use has become the norm. All but two patients were in the Burn Intensive Care Unit at the time of diagnosis. Men outnumbered women by three to one. Nine patients with positive sonograms were successfully managed without surgical intervention. Two of these patients also had positive hydroxy iminodiacetic acid scans. Surgically managed patients were treated with both open and laparoscopic cholecystectomy as well as cholecystostomy tube placement. Mortality was 25%. Acute cholecystitis remains a serious although relatively rare complication in burn patients. Patients often have an unreliable physical examination, several possible causes of fever, and abnormal laboratory results. A high index of suspicion and sound clinical judgment is required to manage this rare-but-challenging problem.
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PMID:Acute cholecystitis in burn patients. 1656 60