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[Acute stress-induced cholecystitis]
C Kelm1, K H Muhrer, T Zimmermann
1Abteilung für Allgemeinchirurgie, Zentrums für Chirurgie, Justus Liebig-Universität Giessen.
Langenbecks Archiv Fur Chirurgie
|January 1, 1991
Summary
Acute cholecystitis, a severe complication after trauma or surgery, presents with abdominal pain and fever. Early diagnosis via sonography is crucial for timely intervention and improved patient outcomes.
Area of Science:
- Surgery
- Gastroenterology
- Critical Care Medicine
Context:
- Acute posttraumatic and postoperative cholecystitis is a life-threatening complication.
- High mortality rates (10-50%) underscore the severity of this condition.
- Multifactorial pathogenesis involves factors like blood transfusions, dehydration, shock, and PEEP.
Purpose:
- To review the clinical presentation, diagnosis, and management of acute cholecystitis in surgical patients.
- To highlight the importance of considering acute cholecystitis in patients with abdominal pain or fever post-trauma or surgery.
Summary:
- A retrospective review of 12 patients undergoing surgery for acute cholecystitis between 1980 and 1990.
- Six patients (50%) had acute acalculous cholecystitis, a subtype without gallstones.
- Two patients (16.7%) experienced postoperative mortality.
- Common symptoms include leukocytosis, fever, abdominal distension, and right upper quadrant pain.
- Sonography is an effective diagnostic tool, aiding in the decision for cholecystectomy.
Impact:
- Emphasizes the need for clinical vigilance regarding acute cholecystitis in surgical populations.
- Sonography plays a key role in diagnosis and surgical planning.
- Highlights the significant morbidity and mortality associated with this condition.