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文献考察１）：気腫性胆嚢炎20例，死亡率は25％．
Hepatogastroenterology. 1999 Jul-Aug;46(28):2144-8.
Acute emphysematous cholecystitis. Report of twenty cases.
Garcia-Sancho Tellez L, Rodriguez-Montes JA, Fernandez de Lis S, Garcia-Sancho Martin L.
BACKGROUND/AIMS: Our aim is to present our experience with acute emphysematous cholecystitis (AEC), a severe variety of acute cholecystitis characterized by early gangrene and perforation of the gallbladder. METHODOLOGY: We reviewed the clinical records of 20 patients with AEC, analyzing age, sex, past medical history, symptoms, laboratory tests, X-rays, ultrasounds, operative and microbiological findings, morbidity and mortality. RESULTS: Our study included 13 men and 7 women (mean age 59 years). Associated factors were diabetes mellitus (11 cases) and gallstones (6 cases, 3 of them with common bile duct stones). Clinical symptom presentation included: right hypochondrial pain and fever in all cases, vomiting in 9, septic shock in 3, jaundice in 7, and peritonitis in 8. Hyperbilirubinemia was present in 7 cases. Plain abdominal X-rays or ultrasounds led to diagnosis in 95% of the cases. Surgical findings were AEC in all cases, pericholecystic abscess in 8, gallbladder necrosis in 7 and bile peritonitis in 3. C perfringens, E coli and B fragilis were the most frequent pathogens. Mortality rate was 25%, and morbidity 50%. CONCLUSIONS: AEC predominantly affects elderly diabetic men. Abdominal X-rays or ultrasounds are good diagnostic techniques, and emergency surgery is needed due to the high incidence of gangrene and perforation Despite all the efforts made, morbidity and mortality are still high.PMID: 10521957
文献考察２）：気腫性胆嚢炎，本邦集計170例（表）．
PTGBDにて症状軽快後胆嚢摘出術を行った急性気腫性胆嚢炎の1例 170例の文献的考察を含めて
Author：曽我美純子(奈良県立医科大学 救急医), 村尾佳則, 中村達也, 小延俊文, 植田史朗, 今西正巳, 宮本誠司, 打田日出夫, 中野博重, 小西登
Source：外科治療(0433-2644)81巻5号 Page641-647(1999.11)
Abstract：1)62歳男.PTGBDは,high risk患者の多い急性気腫性胆嚢炎で待機手術を安全かつ確実に施行するための有力な補助手段である. 2)病理組織の結果からも,炎症反応が陰性化しても,組織は壊死像を示していたことより,摘出術は必要である．
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