Arrosive bleeding from the cystic artery to the abdomen in elderly woman with acute gangrenous perforated calculous cholecystitis

Abstract The 82 years old patient was admitted to the general surgery clinic with complaints of severe abdominal pain, dry mouth, weakness. 3 hours before sharp pain had appeared in the epigastric region and spread to the right side of the abdomen. Pulse was100 BPM. Abdomen was greatly increased,...

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Main Authors: A.V. Kapshitar, A.A. Kapshitar, V.Yu. Erokhin
Format: Article
Language:English
Published: Zaporizhzhia State Medical and Pharmaceutical University 2013-08-01
Series:Patologìâ
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Online Access:http://pat.zsmu.edu.ua/article/view/141415/140065
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author A.V. Kapshitar
A.A. Kapshitar
V.Yu. Erokhin
author_facet A.V. Kapshitar
A.A. Kapshitar
V.Yu. Erokhin
author_sort A.V. Kapshitar
collection DOAJ
description Abstract The 82 years old patient was admitted to the general surgery clinic with complaints of severe abdominal pain, dry mouth, weakness. 3 hours before sharp pain had appeared in the epigastric region and spread to the right side of the abdomen. Pulse was100 BPM. Abdomen was greatly increased, painful in all regions, sharply and with tension in the epigastric region and right half. Shchetkin symptom was positive. Dullness on percussion. Intestinal peristalsis was absent. Survey radiography of the abdomen was normal. Hb – 137 g/l, Er – 4,45×1012/l, L – 14, 6x109/l, stabneutrophils – 23%. Diagnosis: «Perforated duodenal ulcer. Acute calculous cholecystitis? Diffuse peritonitis». Ultrasonography – gallbladder 11×5,3 сm, moderately swollen wall, filled with calculi. Diameter of common bile duct was 0,6 сm. In 2 hours after preparation the upper midline laparotomy was performed. Acute gangrenous ruptured calculous cholecystitis, bleeding into the abdominal cavity from the anterior branch of the cystic artery, grade 2 haemoperitoneum, stage 3 of shock, cirrhosis of the liver were diagnosed. Cholecystectomy from the neck, sanitation and drainage of the abdominal cavity were performed. The postoperative course was uneventful. The case shows the difficulties of clinical, laboratory and radiation diagnostics in establishing therare complication before the operation.
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spelling doaj-art-3fc95e5f735a42f094cd282de72d25792025-08-20T02:16:28ZengZaporizhzhia State Medical and Pharmaceutical UniversityPatologìâ2306-80272310-12372013-08-012128135Arrosive bleeding from the cystic artery to the abdomen in elderly woman with acute gangrenous perforated calculous cholecystitisA.V. KapshitarA.A. KapshitarV.Yu. ErokhinAbstract The 82 years old patient was admitted to the general surgery clinic with complaints of severe abdominal pain, dry mouth, weakness. 3 hours before sharp pain had appeared in the epigastric region and spread to the right side of the abdomen. Pulse was100 BPM. Abdomen was greatly increased, painful in all regions, sharply and with tension in the epigastric region and right half. Shchetkin symptom was positive. Dullness on percussion. Intestinal peristalsis was absent. Survey radiography of the abdomen was normal. Hb – 137 g/l, Er – 4,45×1012/l, L – 14, 6x109/l, stabneutrophils – 23%. Diagnosis: «Perforated duodenal ulcer. Acute calculous cholecystitis? Diffuse peritonitis». Ultrasonography – gallbladder 11×5,3 сm, moderately swollen wall, filled with calculi. Diameter of common bile duct was 0,6 сm. In 2 hours after preparation the upper midline laparotomy was performed. Acute gangrenous ruptured calculous cholecystitis, bleeding into the abdominal cavity from the anterior branch of the cystic artery, grade 2 haemoperitoneum, stage 3 of shock, cirrhosis of the liver were diagnosed. Cholecystectomy from the neck, sanitation and drainage of the abdominal cavity were performed. The postoperative course was uneventful. The case shows the difficulties of clinical, laboratory and radiation diagnostics in establishing therare complication before the operation.http://pat.zsmu.edu.ua/article/view/141415/140065old ageacute gangrenous ruptured calculous cholecystitisarrosive bleeding from the cystic artery
spellingShingle A.V. Kapshitar
A.A. Kapshitar
V.Yu. Erokhin
Arrosive bleeding from the cystic artery to the abdomen in elderly woman with acute gangrenous perforated calculous cholecystitis
Patologìâ
old age
acute gangrenous ruptured calculous cholecystitis
arrosive bleeding from the cystic artery
title Arrosive bleeding from the cystic artery to the abdomen in elderly woman with acute gangrenous perforated calculous cholecystitis
title_full Arrosive bleeding from the cystic artery to the abdomen in elderly woman with acute gangrenous perforated calculous cholecystitis
title_fullStr Arrosive bleeding from the cystic artery to the abdomen in elderly woman with acute gangrenous perforated calculous cholecystitis
title_full_unstemmed Arrosive bleeding from the cystic artery to the abdomen in elderly woman with acute gangrenous perforated calculous cholecystitis
title_short Arrosive bleeding from the cystic artery to the abdomen in elderly woman with acute gangrenous perforated calculous cholecystitis
title_sort arrosive bleeding from the cystic artery to the abdomen in elderly woman with acute gangrenous perforated calculous cholecystitis
topic old age
acute gangrenous ruptured calculous cholecystitis
arrosive bleeding from the cystic artery
url http://pat.zsmu.edu.ua/article/view/141415/140065
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