Author/Editor		Šustić, Alan; Miletić, Damir; Cicvarić, Tedi
Title		Ultrasonography of gallbladder in surgical patients with a prolonged stay (>14 days) in the intensive care unit
Translated title		Ultrazvočna preiskava žolčnika pri bolnikih s podaljšanim bivanjem (< 14 dni) v enoti intenzivnega zdravljenja
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 39, št. 4
Publication year		2005
Volume		str. 243-7
Language		eng
Abstract		Background. The aim of this stady was to establish the incidence of abnormal ultrasonographic (US) findings of gallbladder (GB) in surgical patients with the prolonged stay in the intensive care unit (ICU) and to correlate these findings with the severity of illness. Methods. In the prospective study fifty-seven (57) adult surgical patients (male 66%; age 49±18 y/r.) with the prolonged stay in ICU (>14 days) were analyzed. In all patients the US examination was performed on the 15th day of their stay in ICU. The presence of the following US findings was analyzed: GB wall thickening (?4 mm), biliary sludge, GB hydrops, striated GB wall and pericholecystitic fluid. The severity of illness was also evaluated on the 15th day of the stay in ICU using Simplified Acute Physiology Score (SAPS II). Results. At least one abnormal US finding was found in 36 (63%), patients with GB wall thickening in 32 (56%), biliary sludge in 23 (40%), pericholecystitic fluid in 9 (16%), hydrops of GB in 7 (12%), and striated GB wall in 4 (7%) cases, respectively. Two to five US findings were found in 20 (35%) patients, three to five in 12 (21%), four to five in 10 (18%), while all five US findings were present in 4 (7%) cases. The patients with one and more US findings had significantly higher SAPS ll than the patients who presented regular US findings of the GB (36+-9 vs. 28+-7; p < 0.01). The patients with two and more US findings had higher SAPS ll than those with one or none US criteria (40+-8 vs. 29+--6; p < 0.001), while the patients with three and more had higher SAPS ll than those with two, one or none (41+-8 vs. 31+-9; p < 0.001). The patients with four or five US findings had higher SAPS II than those with three or less (42+-11 vs. 31+-6; p < 0.001) while the patients with all five had higher SAPS II than all others (45+-10 vs. 32+-9; p < 0.001). Conclusions. (Abstract truncated at 2000 characters)
Summary		Izhodišča. Namen pričujoče raziskave je bil ugotoviti pogostnost nenormalnega ultrazvočnega (UZ) izvida žolčnika pri kirurških bolnikih, ki so bivali v enoti intenzivnega zdravljenja več kot 14 dni. Prav tako smo želeli primerjati te UZ izvide z resnostjo obolenja. Metode. V prospektivno raziskavo smo zajeli 57 odraslih kirurških bolnikov (66% moških; starost 49±18 let) s podaljšanim bivanjem v enoti intenzivnega zdravljenja. Pri vseh bolnikih smo UZ preiskavo naredili 15. dan bivanja v intenzivni enoti. Ultrazvočno smo ugotavljali: debelino stene žolčnika (>4 mm), vsebino žolčnika, brazgotinjenje žolčnikove stene in periholecistitično tekočino. Isti dan smo ocenjevali tudi resnost obolenja po SAPS II lestvici. Rezultati. Vsaj en UZ znak obolenja žolčnika je imelo 36 (63%) bolnikov, med njimi zadebeljeno steno žolčnika 32 (56%), žolčno usedlino 23 (40%), periholecistitično tekočino 9 (16%), hidropičen žolčnik 7 (12%) in zabrazgotinjeno steno žolčnika 4 (7%) bolniki. Od naštetih 5 UZ znakov obolenja žolčnika smo dva in več ugotovili pri 20 (35%) bolnikih, tri in več pri 12 (21%), štiri in več pri 70 (18%) in vseh pet pri 4 (7%) bolnikih. Bolniki z enim ali več UZ znakom obolenja žolčnika so imeli statistično značilno resnejše obolenje po SAPS II lestvici glede na bolnike z normalnim UZ izvidom (36+-9 vs. 287; p<0,01). Statistično značilno resnejša obolenja po SAPS II lestvici smo tudi ugotovili, ko smo primerjali bolnike z dvema UZ znakoma obolenja žolčnika in bolnike z nobenim ali enim (40+-8 vs. 29+-6; p<0,001), bolnike s tremi znaki in bolniki z dvema ali manj znakoma (41+-8 vs. 31+-9; p<0,001), bolnike s štirimi in bolnike s tremi ali manj znaki (42+-11 vs. 31+-6; p<0,001) ter bolnike s petimi zanki in bolnike z manj UZ znaki obolenja žolčnika (45+-7 0 vs. 32+-9; p<0,001). (Izvleček prekinjen pri 2000 znakih)
Descriptors		POSTOPERATIVE COMPLICATIONS INTENSIVE CARE UNITS GALLBLADDER DISEASES