1/163. Duplicate gallbladder cholecystitis after open cholecystectomy.A 42-year-old man presented with acute right upper quadrant abdominal pain 2 years after open cholecystectomy. Evaluation revealed cholecystitis in a second gallbladder and a second cholecystectomy was performed. Acute right upper quadrant abdominal pain after cholecystectomy presents a wide differential diagnosis, including the often idiopathic and difficult to manage postcholecystectomy syndrome. Emergency physicians should be aware of the most common causes of pain in these patients. Previously unrecognized congenital abnormalities of the biliary system should be considered when the diagnosis is not clear, as highlighted by this case report.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/163. Percutaneous drainage of emphysematous cholecystitis associated with pneumoperitoneum.emphysematous cholecystitis, a relatively rare variant of acute cholecystitis, is associated with high morbidity and mortality rates. In the presence of a concomitant pneumoperitoneum, these rates may be considered even higher, approaching those of perforation of the gallbladder. The first choice of treatment in cases presenting with pneumoperitoneum is emergency laparotomy. We performed a staged procedure as a second best alternative. In a 65 year-old female patient, initial percutaneous cholecystostomy with a strict intravenous antibiotics regimen, and subsequent cholecystectomy 6 months, later was carried out with successful outcome. A review of the literature revealed 13 other cases of this combination. Treatment modalities and outcome of these patients are discussed.- - - - - - - - - - ranking = 0.2keywords = gallbladder (Clic here for more details about this article) |
3/163. Mucosa-associated lymphoid tissue type lymphoma of the gallbladder associated with acute myeloid leukemia.We describe a patient with mucosa-associated lymphoid tissue (MALT) type lymphoma of the gallbladder who developed concurrent acute myeloid leukemia (M2). She was admitted because of progressive jaundice and underwent cholecystectomy. Histologic examination of the gallbladder showed diffuse proliferation of atypical lymphoid cells and a formed lymphoepithelial lesion. Because of progressive thrombocytopenia, a bone marrow tap was performed 25 days after the operation. bone marrow contained 65.5% blasts, and was positive for peroxidase, CD33 and HLA-DR, and negative for lymphoid markers. We discuss the rare association of these disorders.- - - - - - - - - - ranking = 1.2keywords = gallbladder (Clic here for more details about this article) |
4/163. Acute acalculous cholecystitis complicated by penetration into the liver after coronary artery bypass grafting.BACKGROUND: Perforation or penetration due to acute acalculous cholecystitis is a rare complication after open-heart surgery. The mortality rate of this disease is high. methods: A 71-year-old woman complained of a sudden onset of right upper abdominal pain with development of peritoneal signs at 21 days after coronary artery bypass grafting. Abdominal ultrasonography and laboratory examination performed at 1 day earlier had revealed no abnormalities. Neither anticoagulants nor antiplatelet agents were administered following the bypass operation. An exploratory laparotomy was performed to locate a presumed embolization to the superior mesenteric artery. RESULTS: laparotomy revealed acute acalculous cholecystitis complicated by penetration into the liver, causing a subserosal hematoma. The hematoma had ruptured into the abdominal cavity. A cholecystectomy was performed. The gallbladder wall which was in contact with the liver was necrotic. Most of the gallbladder mucosa was necrotic. Microscopical examination revealed atherosclerosis of the cystic artery which was partially obstructed by thrombus. CONCLUSIONS: Given the atherosclerotic condition of the cystic artery, hypotension during the bypass in combination with postoperative total parenteral nutrition and hypovolemia may have induced the cystic artery thrombosis. Surgeons who manage patients with cardiovascular disease should be aware of this potentially lethal development.- - - - - - - - - - ranking = 0.4keywords = gallbladder (Clic here for more details about this article) |
5/163. Acute cholecystitis and pancreatitis in a patient with biliary sludge associated with the use of ceftriaxone: a rare but potentially severe complication.ceftriaxone may precipitate in the bile leading to the formation of biliary sludge. Biliary complications, even serious ones, have rarely been described in patients treated with this antibiotic. A 71-year-old woman presented to the emergency room with biliary sludge complicated by acute cholecystitis and pancreatitis after 10 days of treatment with ceftriaxone (2 g, 40 mg/kg per day). There had been no evidence of sludge or gallstones on a transabdominal ultrasonography performed 6 months earlier. The patient underwent open cholecystectomy and recovered fully. ceftriaxone should be kept in mind as a potential cause of biliary sludge. In most cases, resolution of sludge occurs after interruption of ceftriaxone. Young subjects, patients receiving a prolonged course and a daily dose > or = 40 mg/kg, and subjects with impaired gallbladder emptying have a greater risk of ceftriaxone-associated sludge. Cholecystectomy is the definitive therapy for severe complications.- - - - - - - - - - ranking = 0.2keywords = gallbladder (Clic here for more details about this article) |
6/163. Obstetric triage: management of acute nonobstetric abdominal pain in pregnancy.Acute, nonobstetric abdominal pain is a common complaint during pregnancy. Both anatomic and physiologic variations in pregnancy cloud the clinical picture when attempts at clinical decision-making and triage are made. Abdominal disorders such as appendicitis, gallbladder disease, pancreatitis, bowel obstruction, liver disease, pyelonephritis, and inflammatory bowel disease are explored from an obstetric triage perspective. Key triage points are noted to augment clinical assessment by the practitioner.- - - - - - - - - - ranking = 0.2keywords = gallbladder (Clic here for more details about this article) |
7/163. Ultrasound of gallbladder wall thickening and its relation to cholecystitis.A prospective ultrasound study of gallbladder wall thickness in patients with suspected gallbladder disease was performed over a 9 month period. Gallbladder walls thicker than 3 mm in fasting patients whose gallbladders were wider than 2 cm were considered abnormal. gallstones were documented by ultrasound in 62 patients, a thickened gallbladder wall was demonstrated in 12 of these. Five patients without cholelithiasis had thick-walled gallbladders and were diagnosed as acalculous cholecystitis.- - - - - - - - - - ranking = 1.8keywords = gallbladder (Clic here for more details about this article) |
8/163. Heterotopic pancreas--an unusual cause of cholecystitis.A 47-year-old woman presented with signs and symptoms of acute cholecystitis. A routine cholecystectomy was performed. No gallstones were present. On histological examination of the gallbladder, a nodule impinging on the lumen was present in the region of the cystic duct. This nodule was composed of mature, uninflamed exocrine and endocrine pancreatic tissue. In the absence of gallstones, the heterotopic pancreas was the cause of obstruction, with subsequent cholecystitis.- - - - - - - - - - ranking = 0.2keywords = gallbladder (Clic here for more details about this article) |
9/163. Primary posttransplant lymphoproliferative disorder of the gallbladder in a lung transplant patient presenting with acute cholecystitis.BACKGROUND: Acute cholecystitis in an immunocompromised host is potentially devastating. Posttransplant lymphoproliferative disorder (PTLD) is a well described complication of immunosuppressive therapy used after solid organ transplantation; however, isolated involvement of the gallbladder has not been described. methods: Case report format is used. RESULTS: We report a case of PTLD isolated to the gallbladder, as well as histological evidence of acute cholecystitis, in a patient who presented with signs and symptoms of acute cholecystitis 1 year after single lung transplant. CONCLUSIONS: PTLD can occur in the setting of acute cholecystitis and may be missed if careful pathological examination is not undertaken.- - - - - - - - - - ranking = 1.2keywords = gallbladder (Clic here for more details about this article) |
10/163. Acute on chronic phenomenon in hepatic IVC obstruction: a case report.Hepatic IVC obstruction though common is usually misdiagnosed because of lack of appreciation of the disease. Patient with chronic disease may develop acute exacerbation, which may be precipitated by surgery or endoscopic procedures. It is a report of a case of chronic IVC disease with acute development of ascites following gallbladder surgery.- - - - - - - - - - ranking = 0.2keywords = gallbladder (Clic here for more details about this article) |
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