Clinicopathological analysis of idiopathic perforation of the gallbladder.

Clinicopathological analysis of idiopathic perforation of the gallbladder. Research Abstract Details 

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Clinicopathological analysis of idiopathic perforation of the gallbladder. Abstract Text:

Tsutomu Namikawa,Michiya Kobayashi,Takehiro Okabayashi,Ken Okamoto,Toyokazu Akimori,Takeki Sugimoto,Kazuhiro Hanazaki,Tsutomu Namikawa,Michiya Kobayashi,Takehiro Okabayashi,Ken Okamoto,Toyokazu Akimori,Takeki Sugimoto,Kazuhiro Hanazaki,

Idiopathic perforation of the gallbladder (IPGB) is a rare event, and the underlying mechanisms are unknown. We investigated the clinicopathological characteristics of this disorder. We reported a case of IPGB, and reviewed 30 other cases reported up to the end of 2005 in a Medline and Japan Centra Revuo Medicina search of the medical literature. We analyzed the clinical findings, laboratory data, and histopathological features. The mean age of the patients was 70.2 +/- 12.8 years, and there were 19 men and 12 women. Underlying diseases such as hypertension, cerebral infarction or hemorrhage, renal failure, respiratory failure, and malignancy were reported in 35.5% of the patients. Perforation was found more often in the fundus (53.3%) than in the body (43.3%) or neck (3.3%) of the gallbladder. Thrombus was found in the intramural vessels of the gallbladder wall in 13 patients (50%), whereas 13 (50%) were free of thrombus. Serum amylase was significantly higher in the intramural vessels in the thrombus-negative group than in the thrombus-positive group. The overall operative mortality was 3.3%. Univariate and multivariate analyses indicated that a delay of more than 24 h from the manifestation of symptoms to operation and a perforation size greater than 2 cm required significantly longer hospitalization. Thrombosis in the intramural vessels seems to be related to the events leading to IPGB; however, it is difficult to consider it the only cause. Early operation and the size of the perforation are important determinants of the outcome of treatment for IPGB.

Clinicopathological analysis of idiopathic perforation of the gallbladder. Publishing Authors By Initials

T Namikawa,M Kobayashi,T Okabayashi,K Okamoto,T Akimori,T Sugimoto,K Hanazaki,T Namikawa,M Kobayashi,T Okabayashi,K Okamoto,T Akimori,T Sugimoto,K Hanazaki,

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Clinicopathological analysis of idiopathic perforation of the gallbladder. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Surgery today

VOLUME: 37

Page Numbers: 633-7

Journal Abbreviation: Surg. Today

ISSN: 0941-1291

DAY: 26

MONTH: 07

YEAR: 2007

Clinicopathological analysis of idiopathic perforation of the gallbladder. Information

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LANGUAGE: eng

NlmUniqueID: 9204360

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Grant and Affiliation Information for Clinicopathological analysis of idiopathic perforation of the gallbladder.

AFFILIATION: Department of Tumor Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku 783-8505, Japan.

Country: Japan

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MEDLINETA: Surg Today

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