Subacute haemorrhagic acalculous cholecystitis after blunt trauma in a patient on anticoagulant therapy
0
Citation
10
Reference
10
Related Paper
Abstract:
Haemorrhagic cholecystitis is an uncommon cause of abdominal pain that can lead to significant morbidity and mortality if not promptly identified and treated. Known risk factors include trauma, anticoagulation use and cholelithiasis. In a patient with right upper quadrant pain after blunt trauma on anticoagulation without cholelithiasis, haemorrhagic acalculous cholecystitis should be considered in the differential diagnosis, as appeared to be the case in the patient we present here. Fortunately, she recovered after temporisation with a cholecystostomy tube until she underwent more elective interval laparoscopic cholecystectomy.Keywords:
Cholecystostomy
Blunt trauma
The Authors propose ultrasonographic percutaneous cholecystostomy in the treatment of acute cholecystitis.During the period between July 1991-December 1993, 26 patients with acute cholecystitis (18 calculous and 8 acalculous) were observed. The cholecystostomy was performed in principle on patients aged over 70 years and in those with acalculous acute cholecystitis. To rationalize the indication for cholecystostomy in patients aged under 70 years with calculous acute cholecystitis, the Authors elaborated a Risk Score.The cholecystostomy was performed in 23 patients, 15 with calculous and 8 with acalculous acute cholecystitis, and was successful in 22 patients (95.7%). In the group with acalculous acute cholecystitis, the cholecystostomy was the resolutive treatment, while in that with calculous acute cholecystitis was associated, when indicated, to the surgery.The cholecystostomy interrupted the natural history of the disease and has a low morbidity and mortality. It is an effective and rationale contribution to the treatment of the acute cholecystitis.
Cholecystostomy
Cholecystography
Cite
Citations (13)
Ureteric injury is uncommon and mostly follows penetrating trauma or surgical injury. Ureteric rupture following blunt abdominal trauma is rare, there being only a few reported cases. The case described here, in which blunt abdominal trauma resulted in delayed intraperitoneal rupture, appears to be the first report of this type of injury in blunt trauma.
Blunt trauma
Penetrating Trauma
Cite
Citations (5)
Key Clinical Message Blunt abdominal trauma is a rare case of intestinal obstruction, and only few cases have been reported in the world literature. Stenotic intestinal obstruction following blunt abdominal trauma is a very rare complication . This case highlights the need for clinical suspicion serial clinical assessment and radiological evaluation and the need for early surgery in patients presenting with abdominal symptoms following blunt abdominal trauma .
Blunt trauma
Cite
Citations (5)
Objective: To investigate the early clinical features and the diagnosis effect of contrast enhanced ultrasound for blunt abdominal trauma. Method: All the ninety blunt abdominal trauma patients were analyzed. They were divided into three groups by their abdominal CT scanning results. Results: The vital signs of the blunt abdominal patients changed slightly in their early stage. Only the heart rate and hemoglobin level changed when liver or spleen ruptured accompanying abdominal bleeding. The diagnosis accurate rate was very high by using contrast enhanced ultrasound,which was more than 97.78%. Conclusion: Blunt abdominal trauma patients often accompanying solid organs rupture,and their vital signs changed slightly in the early stage. Using contrast enhanced ultrasound can enhance the diagnosis accurate rate.
Abdominal ultrasound
Vital signs
Cite
Citations (0)
Objective B ultrasonic examination in the diagnosis of blunt abdominal trauma in the application.Methods Retrospective analysis of our hospital in January 2008 and 2010 were treated in 110 patients with blunt abdominal trauma,B ultrasonic diagnosis and clinical diagnosis of the situation.Results Bultrasond diagnosis of blunt abdominal trauma in the accuracy rate was 90%.Conclusion B-ultrasound diagnosis of rupture of the abdominal organs and the clinical classification of high value.
Abdominal ultrasound
Clinical Diagnosis
Blunt trauma
Cite
Citations (0)
The isolated duodenal injury following blunt abdominal trauma is extremely rare.Because, duodenal injury is usually presented with other intra-abdominal organs injuries such as hepatic injury, pancreatic injury due to the anatomical position.So, We report a case of isolated duodenal injury following blunt abdominal trauma, and the discuss about the related article.[
Pancreatic injury
Blunt trauma
Cite
Citations (1)
We sought to determine the safety, efficacy, and outcome of percutaneous cholecystostomy (PC) in all patients undergoing the procedure at our institutions. We reviewed 53 consecutive cases of acute cholecystitis seen at our hospitals over 5.5 years in which PC was performed at the initial treatment. Follow-up was obtained by chart review and telephone questionnaire. Acute cholecystitis was the primary admitting diagnosis in 18 cases. In the remaining 35, cholecystitis developed during hospitalization. All patients were considered high surgical risks on the basis of the presence of comorbid conditions. The gallbladder was successfully catheterized under radiologic guidance in all patients and with no immediate procedure-related morbidity. Acute cholecystitis resolved in 44 of 53 patients (83%), whereas nine patients (17%) did not improve clinically after PC and died during the same hospitalization. A total of 33 (62%) eventually survived hospitalization. Elective cholecystectomy was done in 25 patients with no mortality. After cholecystectomy, three of these patients subsequently died of other causes, whereas 22 are alive. Eight patients did not undergo cholecystectomy because of underlying medical conditions or because they had acalculous cholecystitis. These patients remained free of biliary problems after removal of their cholecystostomy tube, but two have subsequently died of nonbiliary conditions. Percutaneous cholecystostomy is a safe, effective treatment for high-risk patients with acute cholecystitis. Cholecystostomy can be followed by elective cholecystectomy at a later time if the patient's condition permits or by expectant conservative management in patients who have had acalculous cholecystitis or have a very high mortality risk with surgery.
Cholecystostomy
Cite
Citations (98)
Objective To improve the diagno stic and operational skills in blunt abdominal trauma due to traffic accidents. Methods Eighty nine cases of blunt abdominal trauma in our hos pital for the past 12 years were analyzed,and the data indicated that injuries h append more frequently on abdominal organs,such as spleen,liver and intestines. Results There were 81 survivals and 8 deaths.The mortality was 9%.Conclusion For patients with blunt abdominal trauma,early di agnosis is the key to a success rescue.The application of peritoneoscopy will im prove the diagnostic and therapeutic skills in blunt abdominal trauma.
Blunt trauma
Cite
Citations (0)