TITLE

Clinicopathological Analysis of Idiopathic Perforation of the Gallbladder

AUTHOR(S)
Tsutomu Namikawa; Michiya Kobayashi; Takehiro Okabayashi; Ken Okamoto; Toyokazu Akimori; Takeki Sugimoto; Kazuhiro Hanazaki
PUB. DATE
August 2007
SOURCE
Surgery Today;Aug2007, Vol. 37 Issue 8, p633
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract  Idiopathic perforation of the gallbladder (IPGB) is a rare event, and the underlying mechanisms are unknown. We investigated the clinicopathological characteristics of this disorder. We reported a case of IPGB, and reviewed 30 other cases reported up to the end of 2005 in a Medline and Japan Centra Revuo Medicina search of the medical literature. We analyzed the clinical findings, laboratory data, and histopathological features. The mean age of the patients was 70.2 � 12.8 years, and there were 19 men and 12 women. Underlying diseases such as hypertension, cerebral infarction or hemorrhage, renal failure, respiratory failure, and malignancy were reported in 35.5% of the patients. Perforation was found more often in the fundus (53.3%) than in the body (43.3%) or neck (3.3%) of the gallbladder. Thrombus was found in the intramural vessels of the gallbladder wall in 13 patients (50%), whereas 13 (50%) were free of thrombus. Serum amylase was significantly higher in the intramural vessels in the thrombus-negative group than in the thrombus-positive group. The overall operative mortality was 3.3%. Univariate and multivariate analyses indicated that a delay of more than 24 h from the manifestation of symptoms to operation and a perforation size greater than 2 cm required significantly longer hospitalization. Thrombosis in the intramural vessels seems to be related to the events leading to IPGB; however, it is difficult to consider it the only cause. Early operation and the size of the perforation are important determinants of the outcome of treatment for IPGB.
ACCESSION #
26015855

 

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics