1/16. 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 = 1keywords = aneurysm (Clic here for more details about this article) |
2/16. True giant common hepatic artery aneurysm associated with obstructive jaundice: a case report.The appropriate treatment for extrahepatic hepatic artery aneurysms remains controversial, with arguments for and against embolization. We describe a case of a giant true aneurysm of the common hepatic artery associated with obstructive jaundice of nonhemobilia origin. The patient, a 49-year-old previously healthy man, presented with upper midepigastric pain, jaundice, and low-grade fever. The diagnosis of the aneurysm was mainly based on computed tomography scan findings. The aneurysm was successfully embolized using wire coils, and the patient was operated on for acute abdomen. Necrotizing acalculus cholecystitis was found, and cholecystectomy followed by aneurysmectomy without hepatic artery reconstruction was performed. The jaundice subsided spontaneously, and the patient was discharged in good condition. Giant common hepatic artery aneurysms can be managed by either surgery or embolization. In the absence of liver ischemia there is no need for common hepatic artery reconstruction unless a bilioenteric bypass has to be performed to resolve the issue of jaundice. If the latter is required, reconstruction of the hepatic artery might be justifiable to maximize the blood supply to the bile duct.- - - - - - - - - - ranking = 10keywords = aneurysm (Clic here for more details about this article) |
3/16. Right hepatic artery pseudoaneurysm and cystic duct leak after laparoscopic cholecystectomy.Laparoscopic cholecystectomy (LC) seems to be associated with an increased risk of biliary or vascular injuries. hepatic artery pseudoaneurysms (HAP) are rare complications of LC. HAP can occur in the early or late postoperative period. patients with HAP present with abdominal pain, hemobilia, and liver function test (LFT) alterations. We report the case of a patient who was affected with a cystic duct stump leak associated with a right HAP and was treated by endoscopic biliary drainage and angiographic coil embolization.- - - - - - - - - - ranking = 288.76139198559keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
4/16. hepatic artery pseudoaneurysm associated with cholecystitis that ruptured into the gallbladder.Pseudoaneurysm of the hepatic artery due to cholecystitis may be very rare, and in our survey of the literature, the present case report is the first case of such a pseudoaneurysm. A 64-year-old woman presented with upper gastrointestinal bleeding and severe epigastric pain. upper gastrointestinal tract endoscopy revealed blood coming out of the papilla of Vater. color-Doppler ultrasound imaging showed a pulsatile wave pattern in an echogenic lesion inside the gallbladder. Contrast-enhanced computed tomography demonstrated a 3-cm pseudoaneurysm in the distended gallbladder. angiography disclosed extravasation originating from the right hepatic artery. Emergency selective transcatheter arterial embolization was performed, with intravascular stainless steel microcoils, and complete occlusion of the pseudoaneurysm was achieved. The patient underwent cholecystectomy with resection of the extrahepatic bile duct and biliary reconstruction in a Roux-en-Y fashion. Macroscopically, the resected gallbladder contained clotted blood and multiple cholesterol stones. Microscopically, the mucosa of the gallbladder showed extensive necrosis and many inflammatory cells. The final diagnosis was pseudoaneurysm of the hepatic artery associated with calculous gangrenous cholecystitis. Although the mechanism of the pseudoaneurysm remains speculative, severe inflammatory reaction in the gallbladder may have infiltrated the liver parenchyma and may have eroded the wall of the hepatic artery, thus forming a pseudoaneurysm. hemobilia is one of the important differential diagnoses when unexplained gastrointestinal bleeding is observed, especially in patients with hepatobiliary diseases.- - - - - - - - - - ranking = 578.52278397119keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
5/16. cholangitis after coil embolization of an iatrogenic hepatic artery pseudoaneurysm: an unusual case report.Pseudoaneurysm involving the hepatic arterial system is a recognized complication of biliary surgery. The standard nonsurgical treatment is coil embolization. We present a case of a patient who underwent coil embolization of a pseudoaneurysm and subsequently presented with ascending cholangitis due to migration of coils into the common bile duct.- - - - - - - - - - ranking = 289.76139198559keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
6/16. Hepatobiliary complications of polyarteritis nodosa.Although polyarteritis nodosa (PAN) may result in thrombosis or aneurysm formation in any organ in the body, hepatobiliary complications are unusual. We reviewed seven cases that demonstrated the diagnostic difficulties and therapeutic options available in the management of hepatobiliary PAN. No consistent sign that indicated the severity of hepatobiliary PAN could be identified. In cases of thrombotic PAN, acalculus cholecystitis usually could be diagnosed preoperatively. Early tissue diagnosis and aggressive intervention are required for appropriate patient treatment. If the diagnosis is unclear, a preoperative muscle or skin biopsy specimen is often helpful in establishing a tissue diagnosis of PAN, even if no obvious pathologic condition is evident. patients who undergo celiotomy for acalculus cholecystitis or peritoneal signs of an unclear origin should have tissue specimens (gallbladder wall, liver, or omentum) submitted for pathologic study. angiography may be diagnostic preoperatively or when results of biopsies are equivocal. In addition, early angiography can define the extent of visceral involvement and permit control by embolization of hemorrhage secondary to aneurysm rupture. awareness of the possibilities of thrombotic, ischemic, or bleeding complications from PAN allows more aggressive and rapid management of abdominal complaints, especially in patients who are receiving immunosuppressant therapy.- - - - - - - - - - ranking = 2keywords = aneurysm (Clic here for more details about this article) |
7/16. Pseudoaneurysm of the cystic artery with upper gastrointestinal hemorrhage. Case report.A rare case of pseudoaneurysm of the cystic artery caused by acute cholecystitis is reported. During the severe inflammatory process the common bile duct, duodenum and transverse colon were eroded, in addition to the cystic artery. Findings at computed tomography prompted celiac angiography, which confirmed the preoperative diagnosis. Surgery was successful.- - - - - - - - - - ranking = 61.752278397119keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
8/16. Acute acalculous cholecystitis complicating aortic aneurysm repair.In a series of 374 consecutive abdominal aortic aneurysmal repairs, the incidence of acute acalculous cholecystitis was 1.1 per cent. This complication occurred in only one of 352 patients (0.3 per cent) after elective aneurysmorraphy, as compared with three of 22 (13.6 per cent) after emergency repair of a ruptured aneurysm. This difference proved highly significant (p = 0.0001). All of the patients who had postoperative acute cholecystitis after aortic aneurysmal repair had acalculous disease. A mortality rate of 50 per cent was noted for this complication. technetium cholescintigraphy proved the most valuable diagnostic study when acute cholecystitis was suspected.- - - - - - - - - - ranking = 8keywords = aneurysm (Clic here for more details about this article) |
9/16. candidiasis of the extrahepatic biliary tract.A case of isolated candidal cholecystitis and cholangitis involving the extrahepatic biliary tract is described. A 72-year-old man developed fever and unexplained jaundice following repair of a descending thoracic aortic aneurysm. candidemia was noted, and therapy with amphotericin b was instituted. The patient died of a cerebral infarct, and at autopsy the gallbladder was noted to be partly necrotic and contained blastospores and pseudohyphae of candida albicans. The common bile duct was markedly stenosed and chronically inflamed. candidiasis of the extrahepatic biliary tract with or without systemic involvement is rare; to our knowledge, only nine cases have been reported. Although this condition represents a diagnostic challenge, the treatment is highly effective with most patients who were described having recovered.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
10/16. Pancreaticoduodenal arterial aneurysms.Experience with four aneurysms of the pancreaticoduodenal artery is reviewed and compared to the reported experience of 19 other cases. In view of the common presentation of such lesions as intra-abdominal hemorrhage preceded by non-specific abdominal pain and other digestive symptoms, it is suggested that angiography perfomed preoperatively or intraoperatively allows definitive diagnosis and leads to specific therapy.- - - - - - - - - - ranking = 5keywords = aneurysm (Clic here for more details about this article) |
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