Characteristic Manifestations And Clinical Analysis Of 41 Cases Of Acute Abdomen With Gallbladder Perforation

Objective:To discuss the clinical manifestations and misdiagnosis of gallbladder perforation,and to get better understanding of the disease.Methods:The first hospital of Shanxi Medical University was collected from May 2013 to December 2018.The diagnosis of clear gallbladder perforation was performed in 41 patients.The patients with acute abdominal pain within 72 hours were in the emergency group,while the others were in the non-emergency group.The characteristics of pathology,combined basic diseases,clinical symptoms and signs,laboratory tests were compared;retrospective analysis of 41 clinical features of gallbladder perforation.Result:1.More than 60 years old is the high incidence age of gallbladder perforation,and male patients are more than female,subacute gallbladder perforation has the highest proportion,chronic gallbladder perforation has the lowest proportion;2.Emergency group compared with non-emergency group,two groups There was no statistical difference in sex ratio,age at onset,combined underlying disease,elevated white blood cell count,elevated PCT,elevated CRP,elevated ALT,elevated AST,elevated AKP,and decreased platelet count.Acute group with acute gallbladder The biliary peritonitis caused by perforation was clinically characterized;3.37 cases of bile culture,28 cases of biliary culture were positive,9 patients with cholestasis;4.The misdiagnosis rate of emergency group(27.8%),the rate of misdiagnosis of non-emergency group(47.8%),the total diagnosis rate was 61.0%(25/41);5.All 41 patients with gallbladder perforation except 1 patient with acute pancreatitis type I(acute gallbladder perforation),the intra-abdominal infection was transferred to the hospital for further treatment,the rest 40 cases were cured.Conclusion:1.Acute gallbladder perforation is common in acute abdomen caused by gallbladder perforation,and diffuse biliary peritonitis is its clinical characteristic manifestation.Compared with the other two types of gallbladder perforation,the diagnosis of gallbladder perforation relies on imaging,clinical symptoms and abdominal puncture;2.Gallbladder perforation must be cured by surgery,laparotomy is necessary for patients with large amount of peritoneal effusion,and laparoscopic surgery for subacute and chronic gallbladder perforation can achieve better results.