[Acute cholecystitis in a traumatologic patient sample]

Among the patients of the Accident Hospital of the Co-operative Trade Association Tübingen, there were 11 cases of acute cholecystitis between 1985 and 1991. Acute cholecystitis occurred after polytrauma (n = 5), multiple fractures (n = 2), head injury (n = 1), fracture of femoral neck (n = 1) or elective hip surgery (arthrodesis, total hip replacement) (n = 2). The mean age was 57 (16-89) years, acute cholecystitis was confirmed 27 (6-54) days after trauma of surgery. 7 cases presented as acute acalculous cholecystitis, whereas in 4 cases of acute cholecystitis cholecystolithiasis was present. 9 patients were treated via cholecystectomy; one juvenile paraplegic recovered after conservative treatment, one 82-year old female was in too bad condition for surgery so that percutaneous cholecystostomy had to be performed prior to cholecystectomy. 10 patients recovered without complication, one 89-year old multi-morbid male died after cholecystectomy. Analysis of the clinical course prior to the occurrence of acute cholecystitis showed a high incidence of shock, frequent blood transfusion, long-time respiratory therapy and parenteral nutrition as well severe trauma, and high cumulation of opiate therapy in this group of patients. Diagnosis was confirmed by ultrasound in all patients, clinical symptoms and laboratory data being mostly unspecific.