NMS. Casos Clínicos

182

Part II ♦ Specific Disorders

A

Abdominal wall

In this case, the bacteria are gas-forming organisms. Patients commonly demonstrate jaun- dice and require urgent decompression of the bile duct. Quick stabilization with IV fluids and antibiotics is essential. Many surgeons do not perform cholangiography in this situation because it may worsen the patient’s sepsis and potentially cause injury to the common duct due to poor visualiza- tion of the common duct due to inflammation. In cases of suppurative cholangitis, B Figure 7-7: Percutaneous cholecystostomy. A. An ultrasound image demonstrating needle placement into the distended gallbladder (arrowhead) during ultrasound-guided cholecystostomy tube placement. (From Irwin RS, Lilly CM, Mayo PH, Rippe JM. Irwin & Rippe’s Intensive Care Medicine , 8th ed. Wolters Kluwer Health; 2017, Fig. 24-1B.) B. Percutaneous cholecystostomy for temporary drainage of an infected gallbladder. SAMPLE