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Posttraumatic and postoperative acute cholecystitis.

T C Fabian, W L Hickerson, E C Mangiante

    The American Surgeon
    |April 1, 1986
    PubMed
    Summary
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    Diagnosing acute cholecystitis in hospitalized patients is challenging. Early diagnosis relies on recognizing clinical signs and symptoms, not just lab values, to reduce mortality.

    Area of Science:

    • Gastroenterology and Hepatobiliary Surgery
    • Critical Care Medicine

    Background:

    • Acute cholecystitis in hospitalized patients, particularly those with comorbidities, presents diagnostic challenges.
    • Delayed diagnosis can lead to severe complications and increased mortality.
    • Distinguishing between acalculous and calculous cholecystitis is crucial for management.

    Purpose of the Study:

    • To determine the clinical presentation of acute cholecystitis in hospitalized patients.
    • To identify predisposing factors and outcomes in posttraumatic and postoperative cases.
    • To emphasize early diagnostic strategies for acute cholecystitis in this vulnerable population.

    Main Methods:

    • Retrospective analysis of 18 patients with posttraumatic or postoperative acute cholecystitis over a 10-year period.

    Related Experiment Videos

  • Review of clinical findings, laboratory values, and surgical outcomes.
  • Comparison of characteristics between acalculous and calculous cholecystitis groups.

    • Main Results:

    • Fever, right upper quadrant pain, and tenderness were common presenting symptoms.
    • Leukocytosis, hyperbilirubinemia, and elevated alkaline phosphatase were frequently observed.
    • Gangrenous cholecystitis was prevalent, indicating delayed diagnosis; mortality was 17%.

    Conclusions:

    • Awareness of predisposing factors, especially in acalculous disease, can reduce morbidity.
    • Clinical signs and symptoms are more critical than laboratory values for early diagnosis.
    • Prompt diagnosis and treatment are essential for improving outcomes in hospitalized patients with acute cholecystitis.