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Related Experiment Videos

Acute cholecystitis in burn patients.

Brett D Arnoldo1, John L Hunt, Gary F Purdue

  • 1Department of Surgery, UT Southwestern Medical Center, Dallas, Texas 75390-9158, USA.

Journal of Burn Care & Research : Official Publication of the American Burn Association
|March 29, 2006
PubMed
Summary

Acute cholecystitis is a rare but serious complication in burn patients. Early diagnosis and clinical judgment are crucial for managing this challenging condition, with a 25% mortality rate observed.

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Area of Science:

  • Critical Care Medicine
  • Surgical Gastroenterology
  • Burn Management

Background:

  • Acute cholecystitis is a recognized complication in critically ill patients, particularly those with severe burns.
  • Burn patients present unique challenges for diagnosing cholecystitis due to unreliable physical exams and multiple potential causes of fever.
  • The incidence of acute cholecystitis in burn patients is low but associated with significant morbidity and mortality.

Purpose of the Study:

  • To review a single institution's 21-year experience with acute cholecystitis in burn patients.
  • To identify the incidence, patient demographics, clinical characteristics, management strategies, and outcomes of this complication.
  • To highlight the diagnostic and management challenges in this specific patient population.

Main Methods:

Related Experiment Videos

  • Retrospective review of a computerized burn registry spanning 21 years.
  • Data collection included patient demographics, burn characteristics (size, depth), length of stay, ventilation status, nutritional support, diagnostic findings, and treatment modalities.
  • Analysis of 20 patients diagnosed with acute cholecystitis out of 10,762 total burn admissions.

Main Results:

  • The incidence of acute cholecystitis was 0.18% (20 patients).
  • Mean patient age was 43.5 years, mean burn size 37.4% TBSA (23% full-thickness). Mean length of stay was 77.4 days; 16 patients required mechanical ventilation.
  • Nine patients were managed non-surgically; mortality rate was 25%. Total parenteral nutrition use decreased, with early enteral feeding becoming standard.

Conclusions:

  • Acute cholecystitis is a rare but severe complication in burn patients requiring a high index of suspicion for diagnosis.
  • Management strategies vary, including non-surgical approaches for some patients.
  • Despite advances, acute cholecystitis in burn patients remains a challenging problem with a significant mortality rate.