1/557. Perforation of the gallbladder: analysis of 19 cases.Perforation of the gallbladder occurred in 19 (3.8%) of 496 patients with acute cholecystitis treated at one hospital in an 8-year period. The average age of the 19 patients was 69 years and the female:male ratio was 3:2. Most had a history suggestive of gallbladder disease and most had coexisting cardiac, pulmonary, renal, nutritional or metabolic disease. The duration of the present illness was short, perforation occurring within 72 hours of the onset of symptoms in half the patients; the diagnosis was not suspected preoperatively in any. In the elderly patient with acute cholecystitis who has a long history of gallbladder disease, cholecystectomy should be performed early, before gangrene and perforation of the gallbladder can occur.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
2/557. A case of cryptic miliary tuberculosis mimicking cholecystitis with sepsis.Miliary tuberculosis is a rare form of tuberculosis in industrialized countries. We report on a 69-year-old woman presenting a sepsis syndrome caused by cryptic miliary tuberculosis clinically mimicking a case of cholecystitis with sepsis. The patient died of a multi-organ failure on day 6 of her hospital stay.- - - - - - - - - - ranking = 2.5keywords = cholecystitis (Clic here for more details about this article) |
3/557. Obstructive cholecystitis due to metastatic melanoma.A patient with isolated metastases from cutaneous melanoma to the gall-bladder is reported. The patient presented clinically with obstructive cholecystitis. The course of melanoma is unpredictable and the possibility that an apparently unassociated condition is due to metastases should always be considered. Isolated metastases may respond well to radical surgery and reward the surgeon's efforts.- - - - - - - - - - ranking = 2.5keywords = cholecystitis (Clic here for more details about this article) |
4/557. Acute acalculous cholecystitis in young patients without predisposing factors.We report the atypical presentation of acute acalculous cholecystitis in four young, otherwise healthy patients. These cases emphasize the fact that the traditional concept of this disease as being associated with trauma, major surgery, or other pathology may no longer be true, and an important number of cases may appear de novo in patients without any predisposing factors.- - - - - - - - - - ranking = 2.5keywords = cholecystitis (Clic here for more details about this article) |
5/557. Hepatobiliary dysfunction as the initial manifestation of disseminated cryptococcosis.A case of hepatobiliary dysfunction as the initial manifestation of disseminated cryptococcosis is described. The patient was admitted with symptoms of hepatitis with cholestatic jaundice. Antibody tests for hepatitis b and C and human immunodeficiency virus were negative. The patient continued to deteriorate clinically. Eventually, the patient succumbed to hepatic failure. autopsy disclosed systemic cryptococcosis that caused extensive necrosis of the liver. In review of the literature, only nine cases of cryptococcal infection presenting as hepatitis, cholangitis, and cholecystitis as initial manifestation were reported. Four of these patients had been subjected to exploratory laparotomy for clinical suspicion of acute abdomen. One patient developed cirrhosis as a result of cryptococcal hepatitis. Two patients succumbed to hepatic failure. cryptococcosis is known to occur commonly in immunocompromised patients, yet only two reported cases presenting as hepatitis were associated with immunocompromised status.- - - - - - - - - - ranking = 0.5keywords = cholecystitis (Clic here for more details about this article) |
6/557. Gas in the bile ducts (pneumobilia) in emphysematous cholecystitis.Gas in the biliary ducts (pneumobilia) was demonstrated in three cases of emphysematous cholecystitis. Pneumobilia is usually secondary to a spontaneous internal biliary fistula or incompetent sphincter of oddi, and is rarely considered a manifestation of emphysematous cholecystitis. The presence of gas in the biliary ducts in these cases suggests that the cystic duct is patent, allowing gas to escape from the gallbladder lumen. The pathophysiology of emphysematous cholecystitis is discussed and an ischemic etiology considered.- - - - - - - - - - ranking = 3.5keywords = cholecystitis (Clic here for more details about this article) |
7/557. 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 = 2.5keywords = cholecystitis (Clic here for more details about this article) |
8/557. Postoperative acalculous cholecystitis due to Torulopsis glabrata.Acute acalculous cholecystitis due to Torulopis glabrata, an opportunistic yeast, developed postoperatively in a 70-year-old man who had an extremely complicated course after resection of an abdominal aortic aneurysm. The infection first appeared as an acute surgical abdomen, three days after resumption of solid food intake subsequent to a prolonged ileus and after 31 days of parenteral hyperalimentation. The condition was successfully treated by cholecystostomy; at the time of writing, six months after cholecystostomy, there are no gastrointestinal symptoms.- - - - - - - - - - ranking = 2.5keywords = cholecystitis (Clic here for more details about this article) |
9/557. Peripheral clear cell cholangiocarcinoma: a rare histologic variant.We present the case of a 50-year-old diabetic male who underwent open cholecystectomy for acute gangrenous cholecystitis. At the time of exploration, a 1.5-cm mass was found peripherally in the right lobe of his liver, and an incisional biopsy was performed. Microscopic examination revealed a distinct overgrowth of clear cells in an acinar pattern, with tumor cells emerging directly from bile ducts. The tumor cells were periodic acid-Schiff reactive and diastase resistant, indicating the presence of mucin. No bile canaliculi were demonstrated by immunostaining with carcinoembryonic antigen. CT scans of the chest and abdomen were otherwise normal. Based on these microscopic, immunohistochemical, and clinical data, a diagnosis of clear cell cholangiocarcinoma was established. The patient later underwent reexploration and generous hepatic wedge resection. He did well postoperatively and is free of disease after 12 months.- - - - - - - - - - ranking = 0.5keywords = cholecystitis (Clic here for more details about this article) |
10/557. 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 = 3keywords = cholecystitis (Clic here for more details about this article) |
| | Next -> |