ABSTRACT
The increase of acute acalculous cholecystitis (AAC) in out-patients produces the review of clinic files of 810 cases of cholecystectomy because of acute cholecystitis; 27 were acalculous (3.3%). AAC was predominant in female sex (20/27) in which the mean age was 37 years. In twelve patients (44%) the cholecystitis was associated with diabetes and hypertension. The clinical manifestations were similar to patients with cholelithiasis and preoperative diagnosis was made in only 33% by ultrasonography. The surgical findings were: Edematous gallbladder without stones, wall thickness and necrosis, as well as perivesicular adherences. In all patients the treatment was immediate cholecystectomy, with morbidity of 14.4% and no mortality. AAC is not only present in critically ill patients, but also is present in patients not hospitalized, and immediate cholecystectomy is the treatment of choice.
Subject(s)
Cholecystitis/epidemiology , Acute Disease , Adult , Cholecystitis/diagnosis , Cholecystitis/surgery , Female , Humans , Incidence , MaleABSTRACT
Free perforation of the small bowel in Crohn's disease is a rare event. The reported incidence is between 1 to 2 per cent, and only in 25 per cent of the cases it appears as the first manifestation of the disease. A case is reported, which we consider is unique, due to the fact that within one year there had been three independent episodes of perforation as her first manifestation of the disease.
