[Post-stress nonlithiasic acute cholecystitis. Contribution of ultrasonics to the diagnosis and treatment in 50 cases].
Fifty cases of post-stress acute acalculous cholecystitis were observed during the past 9 years, mainly after major surgery or trauma. The apparently increasing incidence over the last 4 years (42 cases) could probably be explained by a better diagnostic approach of this condition by routine use of ultrasonography. No specific etiological factor could be found; however total parenteral nutrition and/or sepsis and/or use of narcotics could possibly play a role in the appearance of this complication. Although diagnosis can occasionally be suspected in the basis of abdominal and infectious signs, diagnosis was made primarily on the following ultrasonographic signs: enlarged gallbladder with thickened wall, sludge, and occasionally a double-wall aspect and a pericholecystic collection. In this series, most of the patients were treated by cholecystectomy, but a new therapeutic approach was used in 10 cases: percutaneous transhepatic drainage under sonographic control. Outcome is still poor, with a 50 p. 100 mortality rate.
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002763:Cholecystectomy; D002764:Cholecystitis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013312:Stress, Physiological / Q000150:complications; D014463:Ultrasonography; D014947:Wounds and Injuries / Q000150:complications
Les cholécystites aiguës non lithiasiques post-agressives. Apport de l'échographie au diagnostic et au traitement dans 50 cas.