Akut taşsız kolesistit
Loading...
Date
1984
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Akut kolesistit olgularının % 85-95'inde safra taşı, hastalığa eşlik eder ve kolesistit etyolojisinde safra taşlarının majör rol oynadığına inanılır. Akut kolesistitli tüm olguların içinde taşsız safra kesesi nadir olarak görülmekle birlikte operasyonlardan, travmalardan sonra ve çocuklarda gelişen akut kolesistit durumlarında yüksek bir oranda karşımıza çıkarr - 4 . Semptom ve bulgularıyla akut taşlı kolesistit olgularından ayrılamaz. Sağ üst kadranda ağrı ve defans, kusma, abdominal distansiyon, barsak seslerinde azalma sarılık, ateş yaygın semptomlardır. Ameliyat ve travma sonrası ortaya çıkan akut taşsız kolesistit tanı güçlüklerine yol açmaktadır. Kliniğimizde 1 Ocak 1983-31 Ekim 1984 tarihleri arasında 6 adet akut taşsız kolesistit olgusu ameliyat edilmiş, bunlardan 4 'üne preoperatif tanı konulmuş, 2 'si acil laparotomide tesbit edilmiştir. Hastaların tümüne kolesistektomi uygulanmış, safra kesesi gangrene ve perfore olan bir olgu kaybedilmiştir. Özellikle operasyon ve travma sonrası abdominal bulguları ortaya çıkan olgularda, akut taşsız kolesistit ayırıcı tanıda dikkate alınmalıdır. Ciddi komplikasyonları nedeniyle acil operasyona alınması gereği vurgulanmıştır.
Acute cholecystitis is accompanied by cholelithiasis in 85 to 95 percent to cases, and gallbladder stones are believed to play a major role in the etiology of cholecystitis. Although acalculous gallbladders are found infrequently among all patients with acute cholecystitis, they occur in a high percentage of patients with acute cholecystitis occuring after operation and after trauma and in children 1 The sign and symptoms did not differ markedly from those found when acute cholecystitis is associated with cholelithiasis. Pain and tenderness in the right upper abdominal quadrant, vomiting, abdominal distention, decreased bowel sound. Jaundice and fever were common 1 . The diagnosis was not confirmed easy, when it occurs after trauma or operation. In our clinic, six patients were operated in ten months period between January 1st, 1983 and October 31st, 1984 because of acute acalculous cholecystitis. Four of them were diagnosed preoperatively and two of them were diagnosed during laparotomy. Cholecystectomy was performed in all patients. One of the patients had a gangrenous perforated gallbladder. He died after the operation. In the differential diagnosis of the patients having abdominal signs after on operation or trauma, the possibility of acute acalculous cholecystitis must be especilly concidered. After our study we conclude that a patient having abdominal signs of acute acalculous cholecystitis after a trauma on operation, because of its serious complications, must be operated emergently.
Acute cholecystitis is accompanied by cholelithiasis in 85 to 95 percent to cases, and gallbladder stones are believed to play a major role in the etiology of cholecystitis. Although acalculous gallbladders are found infrequently among all patients with acute cholecystitis, they occur in a high percentage of patients with acute cholecystitis occuring after operation and after trauma and in children 1 The sign and symptoms did not differ markedly from those found when acute cholecystitis is associated with cholelithiasis. Pain and tenderness in the right upper abdominal quadrant, vomiting, abdominal distention, decreased bowel sound. Jaundice and fever were common 1 . The diagnosis was not confirmed easy, when it occurs after trauma or operation. In our clinic, six patients were operated in ten months period between January 1st, 1983 and October 31st, 1984 because of acute acalculous cholecystitis. Four of them were diagnosed preoperatively and two of them were diagnosed during laparotomy. Cholecystectomy was performed in all patients. One of the patients had a gangrenous perforated gallbladder. He died after the operation. In the differential diagnosis of the patients having abdominal signs after on operation or trauma, the possibility of acute acalculous cholecystitis must be especilly concidered. After our study we conclude that a patient having abdominal signs of acute acalculous cholecystitis after a trauma on operation, because of its serious complications, must be operated emergently.
Description
Bu çalışma, 1-4 Mayıs 1985 tarihlerinde İstanbul[Türkiye]'da düzenlenen Ulusal Cerrahi Kongresi'nde bildiri olarak sunulmuştur.
Keywords
Akut, Kolesistit, Acute, Cholecystitis
Citation
Bozgül, M. vd. (1984). ''Akut taşsız kolesistit ''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 11(2-3), 285-290.