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[The forme-fruste clinical symptoms of peritonitis in acute destructive cholecystitis]
Abstract:
Among 894 patients with acute destructive cholecystitis complicated by peritonitis there were 478 patients with slight clinical symptoms of peritonitis. In 125 of these patients (26.1%) the clinical symptoms of peritonitis were completely absent, extremely slight manifestations being observed in 353 patients (73.9%). The percentage of patients with acute destructive cholecystitis having slight clinical symptoms of peritonitis was considerably higher in elderly and senile patients (72.3%) than in the group of young patients (27.7%). The slight clinical symptoms of this complication was observed more often in patients with a local peritonitis.
Insights
In patients with acute destructive cholecystitis and peritonitis, mild or absent symptoms were common, especially in older adults. This highlights the challenge of diagnosing peritonitis in certain patient groups.
Area of Science:
- Gastroenterology
- Surgical Pathology
Context:
- Acute destructive cholecystitis is a severe gallbladder inflammation.
- Peritonitis is inflammation of the abdominal lining.
- This study examines the clinical presentation of peritonitis in patients with acute destructive cholecystitis.
Purpose:
- To analyze the prevalence and characteristics of mild or absent clinical symptoms of peritonitis in patients with acute destructive cholecystitis.
- To identify patient demographics and conditions associated with subtle peritonitis presentation.
Summary:
- Out of 894 patients with acute destructive cholecystitis and peritonitis, 478 (53.5%) had mild clinical symptoms.
- Among these, 125 (26.1%) had no symptoms, and 353 (73.9%) had extremely slight manifestations.
- Mild peritonitis symptoms were significantly more frequent in elderly (72.3%) versus young patients (27.7%) and in cases of local peritonitis.
Impact:
- Findings suggest that clinical presentation can be misleading in diagnosing peritonitis, particularly in elderly patients with acute destructive cholecystitis.
- Highlights the need for careful evaluation beyond overt symptoms to ensure timely diagnosis and treatment of peritonitis.