RESUMO
Thirty-two patients with acute acalculous cholecystitis are presented. The age of the patients ranged from 1 to 80 years, with an average of 46.3 years. Acute acalculous cholecystitis occurred during the postoperative period in only four patients. Three patients were receiving total parenteral nutrition and 16 patients had one or more associated medical diseases. One patient had acute acalculous cholecystitis due to mechanical obstruction of the cystic duct caused by a diaphragmatic hernia. The most frequent signs and symptoms were right upper quadrant abdominal pain, nausea, vomiting, fever, abdominal mass, and jaundice. All patients were subjected to cholecystectomy. Nine (28.1%) gallbladder specimens had gangrene. Pericholecystic perforation was observed in four patients (12.5%) free perforation in one patient (3.1%), and empyema of the gallbladder in one patient (3.1%). Bacteria were cultured from 18 of 24 bile specimens. E. coli was the most common organism isolated. The overall postoperative mortality and complication rates were 15.6% and 40.6% respectively. The average hospital stay was 16.4 days.
Assuntos
Colecistite/epidemiologia , Doença Aguda , Brasil/epidemiologia , Colecistectomia , Colecistite/microbiologia , Colecistite/cirurgia , Infecções por Escherichia coli/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos RetrospectivosRESUMO
A case of gastroatrial fistula following resection of a carcinoma of the mid-esophagus and re-establishment of the alimentary tract with a cervical esophagogastrostomy is presented. Three episodes of moderate upper gastrointestinal hemorrhage secondary to chronic peptic ulcer of the stomach placed in the thorax occurred three years after the operation. At this time, the patient was also admitted to the hospital with diagnosis of pericarditis of unknown etiology. Three years later the patient had a massive and fatal episode of upper gastrointestinal bleeding.
Assuntos
Esôfago/cirurgia , Fístula/etiologia , Fístula Gástrica/etiologia , Cardiopatias/etiologia , Complicações Pós-Operatórias , Estômago/cirurgia , Adulto , Neoplasias Esofágicas/cirurgia , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Úlcera Péptica/etiologiaRESUMO
In this study, a series of 705 patients with chronic cholecystitis and 203 with acute cholecystitis were surgically treated. The age distribution for the two groups was similar. Operative cholangiography was performed upon 661 patients (94.0 per cent) with chronic cholecystitis and upon 182 patients (90 per cent) with acute cholecystitis. The common bile duct was explored in 146 patients (20.7 per cent) with chronic cholecystitis and in 41 patients (20.1 per cent) with acute cholecystitis, and bile duct calculi were found in 106 patients (15 per cent) with chronic cholecystitis and in 29 patients (14.2 per cent) with acute inflammation of the gallbladder. The total number of postoperative complications and the operative mortality were similar for the two groups. It is concluded that the incidence of common bile duct stones in patients with acute cholecystitis is the same as for those with chronic cholecystitis.