Document Detail


The urgency of diagnosis and surgical treatment of acute suppurative cholangitis.
MedLine Citation:
PMID:  1275137     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Twenty patients with suppurative cholangitis were seen at the Massachusetts General Hospital over a nine year period. Fifteen patients had acute obstructive suppurative cholangitis due to complete obstruction of the common duct, many with coma, hypotension, and positive blood cultures. Sixty per cent of patients were older than seventy years, and most had a history of biliary tract disease. Although most had jaundice, abdominal pain, and fever, clinical symptoms were variable. The diagnosis of cholangitis was made in only 30 per cent of patients before autopsy or surgery. Eighteen patients had calculi in the common duct, and two had primary fibrosis of the ampulla. Patients explored less than 24 hours after admission or deterioration died less often than those operated on after some delay. Most patients underwent common duct exploration and four had a concomitant sphincterotomy. In one instance, cholecystostomy only was performed and this patient died because of ongoing sepsis. The overall mortality was 40 per cent; of those subjected to operation, 25 per cent died in the hospital. Recovery was dramatic among most survivors, and calculous disease did not recur, except for two patients with retained stones. Prophylactic cholecystectomy is recommended to prevent the occurrence of this subtle and highly dangerous syndrome.
Authors:
J P Welch; G A Donaldson
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  131     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1976 May 
Date Detail:
Created Date:  1976-08-02     Completed Date:  1976-08-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  527-32     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Anti-Bacterial Agents / therapeutic use
Cholangitis / diagnosis,  mortality,  surgery*
Cholecystectomy
Cholestasis / surgery
Common Bile Duct / surgery
Female
Gallstones / surgery
Humans
Hyperbilirubinemia / therapy
Male
Middle Aged
Postoperative Complications / mortality
Retrospective Studies
Suppuration
Time Factors
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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