K S Wiboltt1, R B Jeffrey. 1. Department of Surgery, Stanford University Hospital, CA 94305, USA.
Abstract
OBJECTIVE: To evaluate factors associated with acalculous cholecystitis in patients undergoing bone marrow transplantation and the role of repeat ultrasound examinations. DESIGN: Retrospective study. SETTING: University hospital, United States. SUBJECTS: 381 Patients who underwent bone marrow transplantation between 1987 and 1992. INTERVENTIONS: Abdominal ultrasound examination (n = 134), repeat ultrasound in those considered to have acalculous cholecystitis (n = 8), and acute cholecystectomy (n = 5). RESULTS: 14 Patients (4%) with acalculous cholecystitis were identified. The 8 who had had liver tissue examined also had veno-occlusive disease of the liver. It was possible to follow progressing or resolving acalculous cholecystitis by repeat ultrasound examinations. 4 Of the 5 patients treated surgically survived, compared with 3 of the 9 not operated on. CONCLUSIONS: Acalculous cholecystitis was associated with veno-occlusive disease of the liver. Repeat ultrasound examinations were valuable in showing progressing or resolving acalculous cholecystitis and may guide treatment. Cholecystectomy seems to be a safe procedure for acalculous cholecystitis in patients undergoing bone marrow transplantation.
OBJECTIVE: To evaluate factors associated with acalculous cholecystitis in patients undergoing bone marrow transplantation and the role of repeat ultrasound examinations. DESIGN: Retrospective study. SETTING: University hospital, United States. SUBJECTS: 381 Patients who underwent bone marrow transplantation between 1987 and 1992. INTERVENTIONS: Abdominal ultrasound examination (n = 134), repeat ultrasound in those considered to have acalculous cholecystitis (n = 8), and acute cholecystectomy (n = 5). RESULTS: 14 Patients (4%) with acalculous cholecystitis were identified. The 8 who had had liver tissue examined also had veno-occlusive disease of the liver. It was possible to follow progressing or resolving acalculous cholecystitis by repeat ultrasound examinations. 4 Of the 5 patients treated surgically survived, compared with 3 of the 9 not operated on. CONCLUSIONS:Acalculous cholecystitis was associated with veno-occlusive disease of the liver. Repeat ultrasound examinations were valuable in showing progressing or resolving acalculous cholecystitis and may guide treatment. Cholecystectomy seems to be a safe procedure for acalculous cholecystitis in patients undergoing bone marrow transplantation.