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Journal of Trauma and Injury 2012;25(4):203-208.
Acalculous Cholecystitis Following Multiple Trauma with Fractures
Ki Hoon Kim, Kyu Hyouk Kyung, Jin Su Kim, Kwan U Kim, Woon Won Kim, Ji Wan Kim
1Department of Surgery, University of Inje College of Medicine, Haeundae Paik Hospital, Busan, Korea.
2Department of Orthopaedic Surgery, University of Inje College of Medicine, Haeundae Paik Hospital, Busan, Korea. bakpaker@hanmail.net
골절을 동반한 다발성 외상 환자에서 발생한 비결석성 담낭염
인제대학교 의과대학 해운대백병원 외과학교실, 1정형외과학교실
Received: 10 July 2012   • Revised: 16 July 2012   • Accepted: 25 October 2012
The purpose of this study is to investigate the incidence of acalculous cholecystitis after multiple trauma with fractures and to analyze the characteristics of cholecystitis.
We performed a retrospective study of multiple trauma patients with fractures between April 2010 and April 2012. Sixty-nine patients were identified, and the average age was 46.8(range: 15-74) years. Data were collected regarding associated injury, injury severity score (ISS), the diagnosis time after trauma, diagnostic tool, and management.
There were three cases(4.3%) of cholecystitis among the 69 cases, and cholecystitis was diagnosed an average of 20.7(range: 8-33) days after injury. Two patients complained of abdominal pain at diagnosis, but the other patient who had undergone surgery for small bowel perforation at the time of the injury had no abdominal pain. All three patients had abnormal liver function tests (LFTs) at diagnosis. The cholecystitis was confirmed with ultrasonography or computed tomography, and all cases were acalculous cholecystitis. At first, percutaneous transhepatic gallbladder drainage was performed; then, laparoscopic cholecystectomy (LC) was tried an average of 12(range: 11-13) days later. An laparoscopic cholecystectomy was successfully done in only one case, the other cases being converted to an open cholecystectomy due to severe inflammation.
The incidence of acaculous cholecystitis was 4.3% after multiple trauma with fractures. We should consider cholecystitis in patients with abdominal pain, fever and elevated LFTs after multiple trauma.
Key Words: Trauma; Gallbladder; Fracture; Acalculous cholecystitis
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