1/64. Gallstone pancreatitis with normal biliary radiology.Three patients with relapsing gallstone pancreatitis and normal routine biliary radiology are reported and discussed. It is emphasized that when dealing with recurrent pancreatitis for which no cause is evident, normal conventional biliary radiology (oral cholecystogram and intravenous cholangiogram) should not necessarily be accepted as conclusive. The use of endoscopic cholangiography in such a situation is encouraging.- - - - - - - - - - ranking = 1keywords = pancreatitis (Clic here for more details about this article) |
2/64. Laparoscopic cholecystectomy for the adult with unrepaired tetralogy of fallot: a case report.A 24-year-old woman with a history of unrepaired tetralogy of fallot was scheduled to undergo laparoscopic cholecystectomy. Her significant history included tetralogy of fallot with pulmonary atresia, hypoplastic left pulmonary artery, pulmonary vascular obstructive disease, a functioning right subclavian artery to right pulmonary artery shunt (modified Blalock-Taussig palliative procedure) with a similar shunt on the left side that is occluded. The patient underwent general endotracheal anesthesia for laparoscopic cholecystectomy for cholelithiasis and pancreatitis. Anesthetic induction, intraoperative course, and the postoperative period proceeded uneventfully, and the patient quickly progressed to the preoperative level of functioning. The careful application of pharmacological and physiological principles guided the anesthetic plan and produced a successful outcome. Principles for the anesthetic management of the patient with cyanotic congenital heart disease undergoing noncardiac surgery are reviewed.- - - - - - - - - - ranking = 0.16666666666667keywords = pancreatitis (Clic here for more details about this article) |
3/64. pancreatitis following intestinal bypass for obesity.Three out of 24 patients undergoing intestinal bypass in the treatment of morbid obesity have developed acute pancreatitis in the postoperative period. All three had undergone end-to-end jejunoileal bypass. This serious postoperative complication has been infrequently recorded. Its significance and possible aetiological factors are discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = pancreatitis (Clic here for more details about this article) |
4/64. Massive intraperitoneal hemorrhage from a pancreatic pseudocyst.Massive bleeding from a pancreatic pseudocyst is a rare condition that poses a diagnostic and therapeutic challenge. A 36-yr-old woman presented with acute pancreatitis due to gallstones. Twenty-two days later, she developed severe abdominal pain and hypotension. CT scan revealed hemorrhage into a pancreatic pseudocyst and a large amount of free blood in the peritoneal cavity. At laparotomy, 8 L of blood was evacuated from the peritoneal cavity and 14 units of blood were transfused. The gastroduodenal artery was found to be the cause of the bleeding and was undersewn. A pancreatic necrosectomy was performed and the cavity was packed. The packs were removed the following day. Postoperatively, pancreatic collections were aspirated under ultrasound guidance on three occasions. She was discharged 50 days after admission and had an open cholecystectomy 1 month later. She remains well 1 yr after surgery.- - - - - - - - - - ranking = 0.16666666666667keywords = pancreatitis (Clic here for more details about this article) |
5/64. Bouveret's syndrome complicated by acute pancreatitis.BACKGROUND/AIM: This study evaluated a case of Bouveret's syndrome due to a cholecystoduodenal fistula and gallstone obstruction of the duodenum, complicated by acute pancreatitis and cholecystitis. methods: The presenting features, special investigations, radiological findings, operative and endoscopic procedures were reviewed. RESULTS: Symptoms persisted after laparotomy and removal of a gallstone in the duodenum. Intra-operative endoscopy identified a second previously undetected stone impacted in the distal duodenum. CONCLUSION: The importance of excluding more than one stone causing Bouveret's syndrome is emphasized.- - - - - - - - - - ranking = 0.83333333333333keywords = pancreatitis (Clic here for more details about this article) |
6/64. Aortic pseudoaneurysm secondary to pancreatitis.A patient with a pseudoaneurysm of the distal abdominal aorta, which developed as the result of complicated gallstone pancreatitis, is reported. The aorta was bypassed with an axillofemoral-femorofemoral graft; the pseudoaneurysm was resected, and the infrarenal aorta was oversewn. The patient survived a complicated postoperative course and was discharged with well-perfused lower extremities. No previous description of a pseudoaneurysm of the aorta as a complication of pancreatitis was found on review of the literature.- - - - - - - - - - ranking = 1keywords = pancreatitis (Clic here for more details about this article) |
7/64. Vaterian diverticula as a cause of acute pancreatitis.The association of duodenal diverticula and pancreatitis is rare. Various types of such diverticula are reviewed, especially intra- and extraluminal Vaterian diverticula in which common and pancreatic duct terminate. The pathogenesis of the pancreatitis in case of interposed Vaterian diverticula is thought to be mechanical by means of the creation of a closed Vaterian pouch in which higher pressures produce reflux of bile and pancreatic enzymes. Two patients with this particular type of duodenal diverticula are presented.- - - - - - - - - - ranking = 1keywords = pancreatitis (Clic here for more details about this article) |
8/64. cytodiagnosis of bile microspheroliths: a case report.We recently observed numerous microspheroliths consisting of microscopic organized crystalline structures of varying shapes, sizes, and colors in a bile specimen from a 65-yr-old woman obtained directly from the gallbladder during a surgical procedure for cholecystectomy. Detection of microspheroliths could be very useful in the diagnostic approach to patients with recurrent pain in the biliary region or with acute pancreatitis of unknown origin. To date, we are unaware of any cytologic reports describing microspheroliths in bile.- - - - - - - - - - ranking = 0.16666666666667keywords = pancreatitis (Clic here for more details about this article) |
9/64. common bile duct obstruction secondary to a balloon separated from a Fogarty vascular embolectomy catheter during laparoscopic cholecystectomy.Laparoscopic instrumentation of the common bile duct (CBD) via the transcystic route or through direct choledochotomy seems to be safe, but in rare cases, complications such as pancreatitis, bile duct damage, and hemorrhage from cystic artery may occur. We report an unusual complication with this approach. A 62-year-old man with gallbladder stones presented with obstructive jaundice, mild pancreatitis, and a dilated CBD. He underwent laparoscopic cholecystectomy with an intraoperative cholangiogram through the cystic duct. A small stone seen in the CBD was removed using a 6-Fr vascular Fogarty catheter. Two days later, he became jaundiced again with a rising bilirubin. An endoscopic retrograde cholangiogram showed a 1.5-cm round filling defect floating in a dilated CBD. A sphincterotomy was performed, and a balloon catheter was inflated proximally and pulled down. To our surprise, the filling defect was a crystal clear object, which we finally realized was a fully inflated Fogarty catheter balloon. The balloon spontaneously deflated while being caught with a basket. Surgeons should be aware of this possible complication, and every effort should be made to verify that the balloon still is in place after removal of the embolectomy catheter. Whether vascular embolectomy catheter balloons are appropriate for stone removal or more rigid balloons should be used needs further evaluation.- - - - - - - - - - ranking = 0.33333333333333keywords = pancreatitis (Clic here for more details about this article) |
10/64. Laparoscopic cholecystectomy and the Peter Pan syndrome.We report the case of a patient who experienced hemobilia a few weeks after undergoing laparoscopic cholecystectomy (LC). This condition was due to the rupture of a pseudo-aneurysm of the right hepatic artery in the common bile duct, probably caused by a clip erroneously fired during LC on the lateral right wall of the vessel. It also caused the formation of multiple liver abscesses and the onset of sepsis. This life-threatening complication led to melena, fever, epigastric pain, pancreatitis, liver dysfunction, and severe anemia, requiring urgent hospitalization and operation. In the operating theater, the fistula was closed, the liver abscesses drained, and a Kehr tube inserted. Thereafter, the patient's general condition improved, and she is now well. LC is often considered to be the gold standard for the management of symptomatic cholelithiasis. However, recent data have undermined that opinion. The apparent advantages offered by LC in the short term (less pain, speedier recovery, shorter hospital stay, and lower costs) have been overwhelmed by the complications that occur during long-term follow-up. When the late downward trend in the bile duct and the vascular injury rate are taken into consideration, the learning curve is prolonged. Therefore, LC should be regarded as the surgical equivalent of a modern Peter Pan-i.e., it is like a young adult who should make definitive steps toward becoming an adult but does not succeed in doing so. We report the case of a patient who experienced hemobilia a few weeks after undergoing laparoscopic cholecystectomy. Based on the facts in this case, we argue that the endoscopic procedure still needs to be perfected and cannot yet be considered the gold standard for selected cases of gallstone disease.- - - - - - - - - - ranking = 0.16666666666667keywords = pancreatitis (Clic here for more details about this article) |
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