胆囊穿孔伴出血致网膜囊巨大血性脓肿1例报告

郭贤德; 王奥; 张雅男; 李宁

doi:10.12449/JCH260622

胆囊穿孔伴出血致网膜囊巨大血性脓肿1例报告

DOI: 10.12449/JCH260622

天津医科大学附属南开医院肝胆胰外科，天津 300100

基金项目:

天津市医学重点学科建设资助 (TJYXZDXK-3-028C)

伦理学声明：本例报告已获得患者及其家属知情同意。

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：郭贤德负责检索文献，拟定论文思路，撰写论文；王奥、张雅男参与收集数据，修改论文；李宁负责指导、修改论文并最终定稿。

详细信息

通信作者:
李宁， ningli851023@sina.com （ORCID： 0000-0001-9433-1350）

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出版历程
- 收稿日期: 2025-08-29
- 录用日期: 2025-12-02
- 出版日期: 2026-06-25

Massive hemorrhagic abscess in the omental bursa caused by gallbladder perforation with bleeding： A case report

Department of Hepatopancreatobiliary Surgery，Tianjin Nankai Hospital，Tianjin Medical University，Tianjin 300100，China

Research funding:

Tianjin Key Medical Discipline Construction Project （General Surgery） (TJYXZDXK-3-028C)

More Information

Corresponding author: LI Ning， ningli851023@sina.com （ORCID： 0000-0001-9433-1350）

摘要

摘要: 亚急性胆囊炎并发胆囊穿孔通常表现为胆囊周围炎性病变，引发网膜囊大量积血并继发感染，形成巨大血性脓肿的情况极为罕见。本文报告了1例68岁女性患者，因胆囊颈部嵌顿结石引发局部穿孔伴出血，继而形成网膜囊巨大血性脓肿。该患者有30年胆囊结石病史，此次因腹痛加剧、寒战和发热，经三级转诊至天津医科大学附属南开医院。经过多学科团队的综合评估，患者接受紧急腹腔镜胆囊切除术和网膜囊血性脓肿清除术。术后患者恢复良好，10天后顺利出院，随访期间身体状况良好。
- 自发性穿孔 /
- 胆石 /
- 腹膜腔 /
- 脓肿
Abstract: Subacute cholecystitis complicated by gallbladder perforation often manifests as inflammatory lesions around the gallbladder， and it is extremely rare for this condition to cause massive hemorrhage into the omental bursa with secondary infection and result in massive hemorrhagic abscess. This article reports a case of a female patient， aged 68 years， who experienced massive hemorrhagic abscess in the omental bursa due to localized perforation and bleeding caused by a stone impacted in the gallbladder neck. The patient had a history of gallstones for 30 years and was admitted to Tianjin Nankai Hospital， Tianjin Medical University， after tertiary referral due to aggravated abdominal pain， chills， and fever. After comprehensive assessment by a multidisciplinary team， the patient underwent emergency laparoscopic cholecystectomy and clearance of the hemorrhagic abscess in the omental bursa. The patient recovered well and was discharged on day 10 after surgery， with good conditions during follow-up.
- Spontaneous Perforation /
- Gallstones /
- Peritoneal Cavity /
- Abscess

HTML全文

注： a，腹部CT平扫轴位示：胆囊多发结石伴颈部穿孔（黄色箭头所示），网膜囊下隐窝感染性液体（红色箭头所示）；b，腹部CT平扫冠状重建示：网膜囊下隐窝大量感染性液体（红色箭头所示）；c，腹部CT平扫轴位示：网膜囊上隐窝感染性液体积聚（绿色箭头所示），脾隐窝感染性液体（红色箭头所示）；d，腹部CT平扫矢状重建示：网膜囊上隐窝感染性液体积聚（绿色箭头所示），下隐窝胰腺前方感染性液体（红色箭头所示）。CT，计算机体层成像。

图 1 腹部CT影像

Figure 1. Abdominal CT imaging

下载: 全尺寸图片幻灯片

注：白色箭头所示为胆囊颈部穿孔。

图 2 腹腔镜术中图片

Figure 2. Laparoscopic intraoperative images

下载: 全尺寸图片幻灯片

图 3 胆囊切除后病理图片（苏木精-伊红染色，×100）

Figure 3. Pathological image of the gallbladder after resection （HE staining，×100）

下载: 全尺寸图片幻灯片

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