本月医学影像:穿孔性坏疽性胆囊炎

Lauren Blackley, M. Chopra, Tammer El-Aini
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摘要

没有可用的摘要。文章在150字后被截断。临床场景:一名47岁的女性,既往有高血压病史、沙雷托DVT和甲基苯丙胺使用史,有3天进行性右上象限疼痛史。体格检查显示有明显的右上腹触诊触痛和明显的反跳触痛。未经静脉造影的腹部和骨盆CT显示,其结果与急性结石性胆囊炎一致,有穿孔和胆囊周围脓肿的证据。患者被紧急送往手术室,在那里她接受了开放性胆囊切除术,结果显示穿孔的坏疽性胆囊炎伴胆囊窝大脓肿。术后,她因感染性休克住进了重症监护室,在液体复苏和抗生素给药方面表现良好。讨论:急性胆囊炎是胆结石最常见的急性并发症,占急性腹痛住院人数的3-9%。8%至95%的急性胆囊炎是由…
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Medical Image of the Month: Perforated Gangrenous Cholecystitis
No abstract available. Article truncated after 150 words. Clinical Scenario: A 47-year-old lady with a past medical history of hypertension, DVT on Xarelto, and methamphetamine use presented with a 3-day history of progressive right upper quadrant pain. Physical examination demonstrated marked right upper quadrant tenderness with palpation and significant rebound tenderness. A CT of the abdomen and pelvis without intravenous contrast demonstrated findings consistent with acute calculus cholecystitis with evidence of perforation and a pericholecystic abscess. The patient was taken emergently to the operating room where she underwent an open cholecystectomy which demonstrated perforated gangrenous cholecystitis with a large abscess in the gallbladder fossa. She was admitted to the ICU post-operatively due septic shock and did well with fluid resuscitation and antibiotic administration. Discussion: Acute cholecystitis is the most common acute complication of cholelithiasis and accounts for 3-9% of hospital admissions for acute abdominal pain. Eight to 95% of cases of acute cholecystitis are the result of a …
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