Die Eckdaten der akuten Cholezystitis sind vorgegeben: Pathogenetisch stehen steinbedingter Zystikusverschluβ, Hydrops und Wanddistension mit konsekutiver Mikrozirkulationsstörung im Vordergrund. Nur in 1-6% ist mit einer akuten steinfreien Cholezystitis zu rechnen. Die Komplikationen der sekundär bakteriellen Entzündung reichen vom Empyem (40%) bis zu Gangrän (2-6%) und Perforation (8-12%). Frauen sind dreimal häufiger betroffen als Manner, der Altersmedian aller Patienten befindet sich deutlich jenseits des 60. Lebensjahres. Als Diagnosekriterium der ersten Wahl hat sich die Sonographie mit einer Sensitivität und Spezifität von über 90% erwiesen. Die Therapie der Wahl ist unzweifelhaft die frühelektive Cholezystektomie innerhalb von 48 (-72) h nach Auftreten der Symptome.

Keywords:
Akute Cholezystitis, Pathogenese, Komplikationen, Diagnostik
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© 1992 S. Karger AG, Basel
1992
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