Clinical study of empyema of gall bladder in Assam medical college and hospital, India

Abstract

Background: A Gallbladder disease represents a major health problem worldwide and has been known since the time of the Egyptian dynasty. The empyema of gall bladder may be associated with calculus cholecystitis, acalculus cholecystitis or carcinoma of the gallbladder. More commonly it is associated with acute cholecystitis and occurs in the setting of infected bile and an obstructed cystic duct. In the bacterially contaminated gall bladder, stagnation and marked inflammation ultimately leads to suppuration, tightly filling the gall bladder lumen with exudative material primarily comprising of frank pus. Patients with gallbladder empyema require urgent cholecystectomy or percutaneous cholecystostomy tube placement, depending on the severity of illness at the time of presentation. Methods: This prospective clinical study covers 80 cases of empyema of the gall bladder, which were admitted in the General Surgery department of Assam Medical College and Hospital, India during the period from January 2013 to December 2015. Results: In this series, age of the patients range from 25 years to 71 years. Maximum incidence was found in between the age group of 40-60 yrs. The average age for female was 44.78 years and for male was 49.5 years. In this study there is much higher incidence of disease in females with a male: female ratio of 1:2.33. Conclusions: In the present study we found that Empyema of gall bladder is one of the common complications of acute cholecystitis and the patients were mostly younger females. The clinical history of a patient with empyema of gall bladder is most of the time similar to that of a patient with acute cholecystitis. An aggressive policy of early introduction of broad-spectrum antibiotics and cholecystectomy is the criterion standard of treatment.