1/5. Usefulness of cholescintigraphy with lipid meal loading for diagnosis and determination of cholecystectomy in a patient with gallbladder dysfunction.A 47-year-old woman was admitted to our hospital because of upper abdominal and back pain. Abdominal ultrasonogram, computed tomogram, endoscopic retrograde cholangiopancreatography and arteriography examination did not reveal any abnormalities. As cholescintigraphy after lipid meal loading detected dysfunction of the gallbladder, we diagnosed dyskinesia of the gallbladder. And the output ratio of the gallbladder from scintigraphy was less than 1%. cholecystectomy completely relived her from symptoms. Histological examination disclosed chronic cholecystitis and arteritis causing dysfunction of the gallbladder. This case suggested the usefulness of cholescintigraphy with lipid meal loading for gallbladder dysfunction in determining whether or not to do cholecystectomy.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/5. Prolonged urinary incontinence and biliary dyskinesia following abdominal contact with jellyfish tentacles.A 16-year-old girl was seriously stung on her abdomen by a jellyfish as she jumped on her small surfboard. She and her mother identified the animal from photographs as Chrysaora fuscescens. Within several minutes the girl developed a massive abdominal cutaneous eruption composed of hundreds of punctuate erythematous papules and macules, which persisted for 5 to 7 days. Persistent urinary incontinence and biliary dyskinesia appeared over the following night. It is theorized that a systemic uptake of venom occurred percutaneously after contact of the jellyfish tentacles with her abdominal skin. The result was an injury to the urinary and biliary bladders. This is the first case report of such sequellae after topical contact with a marine animal. The causal relationship of these abnormalities with the sting is suggested by their temporal association. The gallbladder disorder required surgical intervention, but spontaneous resolution of the urinary bladder dysfunction occurred within 20 months.- - - - - - - - - - ranking = 0.11111111111111keywords = gallbladder (Clic here for more details about this article) |
3/5. Asymmetric gallbladder contraction following cholecystokinin hepatobiliary imaging.Three patients are presented with abnormal hepatobiliary images. A slow infusion of the terminal octapeptide of cholecystokinin caused asymmetric contraction in all three. Two of the patients displayed a bilobate appearance of the gallbladder. In one of the patients, there were typical changes associated with adenomyomatosis by other imaging modalities. The third patient showed good contraction of the fundus of the gallbladder but not of the proximal segment. In two of the patients, the global ejection fraction was considered to be normal. The asymmetrical contraction under the stimulus of cholecystokinin may be an important indicator of biliary dysfunction despite a normal ejection fraction.- - - - - - - - - - ranking = 0.66666666666667keywords = gallbladder (Clic here for more details about this article) |
4/5. The dilated common duct sign. A potential indicator of a sphincter of oddi dyskinesia.The cholescintigraphic findings of a sphincter of oddi dyskinesia (SOD) in a 45-year-old woman with persistent right upper quadrant pain and biliary colic are reported. After an overnight fast, the patient was injected with 5 mCi of Tc-99 disofenin and .02 micrograms/kg of cholecystokinin (CCK) post maximal gallbladder filling. Pre and postcholescintiscans were obtained and gallbladder ejection fractions determined. The hepatobiliary scan was normal, except for a delay in biliary-bowel transit. The gallbladder responded normally to CCK, however, the sphincter of oddi responded abnormally, as there was a paradoxical response to CCK manifested by a marked dilatation of the common bile duct. We postulate that this dilatation (the dilated common duct sign) was due to an inappropriate response of the smooth muscle of the sphincter of oddi (contraction vs relaxation) to CCK and was the cause of this patient's biliary colic. The dilated common duct sign should alert the physician to the possibility of a Sphincter of Oddi dyskinesia.- - - - - - - - - - ranking = 0.33333333333333keywords = gallbladder (Clic here for more details about this article) |
5/5. gallbladder hypokinesia: an unusual cause of duodenal obstruction.gallbladder hypokinesis is an uncommon condition and a potential etiologic factor in the formation of gallstones and the development of cholecystitis. It is associated with a number of different conditions, but gallbladder hypokinesia as a cause of small bowel obstruction is unreported. In the case presented below, we saw a postoperative partial upper small bowel obstruction due to hypokinesia of the gallbladder. The investigations, management, and subsequent recovery are described. A review of the literature failed to reveal any similar occurrence.- - - - - - - - - - ranking = 0.22222222222222keywords = gallbladder (Clic here for more details about this article) |