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KMID : 0371319680100060401
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Journal of the Korean Surgical Society
1968 Volume.10 No. 6 p.401 ~ p.413
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Acalculous Cholecystitis
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朴翰勝/Park, Han Sung
全烈慶/徐琪植/崔昌祿/Sibley, John R./李鐵/Chun, Yul Kyung/Suh, Ki Sik/Choi, Chang Rock/--/Lee, Chul
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Abstract
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Experience with 35 cases of acalculous cholecystitis from January 1931 to July 1937 is presented and the recent literature reviewed.
1) The incidence of acalculous cholecystitis was 35 (28.2%) of 118 patients who underwent cholecystectomy.
2) The sex ratio of male to female was 1.17 to 1
There was no significant difference in the incidence between the country and the city population. The age range was 14 to 64 years, the average age being 41 years.
3) Of 35 cases, 18 had acute cholecystitis; 2 subacute cholecystitis. 2 combined acute and chronic cholecystitis, and 13 had chronic cholecystitis.
4) In addition to abdominal pain which was present in all cases, also noted were fever, chills, nausea, vomiting, indigestion and weight loss. Physical findings were abdominal tenderness, rigidity, palpable mass in the right upper quardrant, hepatomegaly and jaundice.
5) The plain X-rayof abdomen was a diagnostic aid in 7 of 13 patients. The gall bladder was visualized in 8 of 11 cases with oral cholecystography.
6) Cholecystectomy was performed on 34 cases (97.14%), and cholecystostomy on 1 cases (2.85%). Of the 34 patients, who underwent cholecystectomy, 15 also had common duct exploration.
7) Of 15 cases who had common duct exploration, ascaris lumbricoides was found in 4 cases (11.43%). Ova of ascaris lumbricoides and ova or adult forms of liver fluke were found in the bile of the gall bladder or common duct in 3 additional cases (8.5%).
8) Of 21 cases in which the bile was cultured, 16 (76.9%) yield a positive result. E. Coli was the most common crganism found and salmonella typhosa the next most common.
9) A postoperative complication occured in 13 patients (37.14%), of which wound infection (9 cases) was the most common.
The operative mortality was 5.71% (2 cases).
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