1/23. "Abdominal crunch"-induced rhabdomyolysis presenting as right upper quadrant pain.A young, active duty sailor presented with right upper quadrant abdominal pain. history, physical, and laboratory findings initially suggested cholecystitis or related disease. Further evaluation found myoglobinuria and a recently increased exercise program, leading to the diagnosis of exercise-induced right upper abdominal wall rhabdomyolysis. Although not a common cause of abdominal pain, this diagnosis should be considered in the patient with abdominal pain and a recently increased exercise program, particularly exercises of the abdominal wall such as "abdominal crunches."- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
2/23. anesthesia in a patient with undiagnosed salicylate poisoning presenting as intraabdominal sepsis.An 81-year-old woman with unintentional salicylate intoxication presented with features of sepsis, abdominal pain, and tenderness. laparotomy was performed to rule out acute cholecystitis. anesthesia was complicated by severe hypercarbia despite hyperventilation, and progressive cardiovascular and neurologic deterioration postoperatively. The adverse neurologic, respiratory, and hepatic effects of abdominal surgery and general anesthesia probably potentiated salicylate toxicity and increased patient morbidity. Anesthesiologists should be aware of the protean manifestations of salicylate poisoning and consider it as a cause of "medical abdomen."- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
3/23. Endoscopic ultrasound for chronic abdominal pain and gallbladder disease.Endoscopic ultrasound (EUS) is a major advance in gastrointestinal endoscopy. EUS, which is invaluable in the diagnosis and staging of gastrointestinal cancer, is now being used in the diagnosis of chronic upper abdominal pain. EUS combined with stimulated biliary drainage (EUS/SBD) aids in the diagnosis of choledocholithiasis, cholecystitis, microlithiasis, and various conditions of the upper gastrointestinal tract. This article describes the EUS/SBD procedure and nursing care. Two case histories illustrating potential benefits to patients are presented.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
4/23. The value of laparoscopy in the diagnosis and therapy of violin-string like perihepatic nonpostoperative adhesions.We report three cases of Fitrz-Hugh Curtis syndrome (FHCs) that were diagnosed laparoscopically and showed microbiological or serological evidence of chlamydial infection. The case histories underscore the part played by abdominal right quadrant symptoms. In all three cases, right quadrant pain and tenderness constituted the presenting features. The patients were thought to have acute cholecystitis or acute appendicitis, but investigations proved negative. laparoscopy was the key to the diagnosis, revealing the violin-string-like perihepatic adhesions typical of this syndrome. Lysis of the adhesions resolved the patients' symptoms of persistent severe abdominal pain. In the first case, the pain lessened dramatically only after the third operation, when the perihepatic adhesions were lysed. In the two other cases, the lysis was performed laparoscopically by fulguration and cutting. We consider this procedure to be an excellent therapeutic modality for the pain associated with FHCs.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
5/23. Hepatobiliary and pancreatic complications of ascariasis in children: a study of seven cases.OBJECTIVES: This study presents seven cases of severe hepatobiliary and pancreatic complications of ascariasis in children. The authors describe the clinical, laboratory, and imaging findings, as well as the patients' clinical evolution. methods: These cases were studied within a period of approximately 1 year and included children younger than 11 years (mean age, 4.4 years). The authors reviewed their medical history and evaluated the results of their main diagnostic examinations. RESULTS: All of the patients had vomiting, abdominal pain, pallor, and abdominal distension at presentation. Passage of ascaris lumbricoides in stool occurred in five cases, emesis with worms in three, fever in three, and hepatomegaly in two. Five patients had pancreatitis, of which two were necrohemorrhagic and one had pseudocyst of the pancreas. In three patients, A. lumbricoides was present in the pancreatic duct. Two patients had hepatic abscess (28.6%), and one of them also had cholangitis. One of the patients with pancreatitis also had signs of cholecystitis at presentation. CONCLUSIONS: ultrasonography was the imaging diagnostic method of choice and demonstrated the presence of A. lumbricoides in the biliary and the pancreatic ducts, as well as signs of pancreatitis, cholecystitis, and hepatic abscess. Endoscopic retrograde cholangiopancreatography, used to confirm the diagnosis, was a fundamental procedure in the treatment, allowing the removal of worms from the biliary duct in four of seven patients.- - - - - - - - - - ranking = 2keywords = cholecystitis (Clic here for more details about this article) |
6/23. acalculous cholecystitis in a patient with visceral leishmaniasis.Acute acalculous cholecystitis (ACC) is unusual. We present a case of cholecystitis associated with visceral leishmaniasis (VL) in a man in venezuela who presented high fever, anorexia and abdominal pain. Histopathological study of the gallbladder showed Leishmania spp. ACC in VL must be kept in mind in tropical countries.- - - - - - - - - - ranking = 6keywords = cholecystitis (Clic here for more details about this article) |
7/23. abdominal pain in children: a case of acalculous cholecystitis.acalculous cholecystitis is a rare disease in children. Most cases are associated with systemic infections or with autoimmune pathologies, but it may also occur without predisposing factors. A case observed in an otherwise healthy child is reported.- - - - - - - - - - ranking = 5keywords = cholecystitis (Clic here for more details about this article) |
8/23. Remote complications of spilled gallstones during laparoscopic cholecystectomy: causes, prevention, and management.In the last 11 years (November 1989-December 2000), 5526 laparoscopic cholecystectomies were performed in a community residency training program. Two cases (0.04%) of remote complications secondary to spilled gallstones were identified. A 75-year-old woman presented with a sterile abscess in the abdominal wall containing gallstones 4 years and 4 months after an elective laparoscopic cholecystectomy. The second patient, a 43-year-old woman, presented with a subdiaphragmatic/subhepatic abscess containing gallstones. The abscess grew the same bacteria that were present 2 years and 3 months previously during a laparoscopic cholecystectomy for acute gangrenous cholecystitis. In both cases, pigmented gallstones were identified. Causes of gallstone spillage, means of prevention, and ways of managing this complication are discussed.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
9/23. Septic lithiasis of the pelvis.Laparoscopic cholecystectomy has become a standard technique for the treatment of symptomatic cholelithiasis. Despite a significant reduction in the complication rate with increasing experience, bile duct injury and gallstone spillage still occur more frequently with this approach than with the open procedure. Unretrieved gallstones, in particular, have been associated with late infection and the formation of abscesses in virtually every area of the abdominal cavity. We present a rare case of an isolated pelvic abscess that developed in a postmenopausal woman 5 months after laparoscopic cholecystectomy for recurrent cholecystitis. The preoperative differential diagnosis of this case is also discussed.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
10/23. Falciform ligament abscess: report of a case.Falciform ligament abscess is rare. We report a case of a 65-year-old man who presented with right upper quadrant abdominal pain, postprandial fullness, and fever. Computed tomography disclosed a cylindrical mass in the anterior abdomen that aroused suspicion of a hepatic abscess. At laparoscopic surgery, an abscess of the falciform ligament was found and drained. Two months later, the patient developed recurrence of the abscess secondary to acute calculous cholecystitis. abscess drainage and cholecystectomy were performed. The presence of right uppper quadrant abdominal pain, epigastric tenderness, fever, leukocytosis, and a mass in the anterior abdomen should arouse suspicion of falciform ligament abscess. Its treatment consists of abscess drainage.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
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