J.Jpn. Surg. Soc.. 86(10): 1426-1433, 1985
Original article
THE CLINICAL AND PATHOLOGIC CORRELATIONS IN ACUTE CHOLANGITIS
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*) The First Department of Surgery, Fukui Medical School, Fukui, Japan Hiroshi Shimada*), Shuichi Niimoto*), Akira Matsuda*), Kohoichi Miwa*), Gizo Nakagawara*), Mamoru Kobayashi**), Shuji Tsuchiya**) |
Patients with acute cholangitis were divided into mild cholangitis (1st group, n=18) and severe cholangitis (2nd, 3rd and 4th groups) accompanied by hypotension.
The 2nd group consisted of 6 surviving patients who underwent liver biopsy during hypotension. The 3rd group consisted of 3 non-surviving patients with biopsy during hypotension. The 4th group consisted of 7 patients with biopsy during autopsy.
The frequency of endotoxemia, gram negative bacteremia, disseminated intravascular coagulopathy and hepatic failure were significantly higher in severe cholangitis than in mild cholangitis.
The incidence of neutrophilic infiltration in the sinusoid and microabscess in lobule were significantly higher in severe cholangitis than in mild one.
The incidence of portal thrombosis and massive necrosis of hepatic cells were also significantly higher in severe cholangitis, especially in the 3rd and 4th groups. It was suggested that the neutrophilic infiltration in the sinusoid and microabscess in lobules which proved the existence of endotoxemia or bacteremia were characteristic findings in severe cholangitis.
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