1/33. Hepatic periportal tracking associated with severe acute pyelonephritis.The computed tomographic appearance of hepatic perivascular halos has been described in a variety of disorders. We observed three cases with sepsis due to acute pyelonephritis who presented with anasarca and had identical computed tomographic features of periportal edema associated with ascites, pleural effusion, a thickened gallbladder wall, and a dilated inferior vena cava. None of the three patients had an underlying disease process that was previously described as an etiology for an altered hepatic lymphatic dynamics. Acute severe pyelonephritis should be included in the differential diagnosis of extrahepatic diseases that cause hepatic perivascular lucencies.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/33. diarrhea and gallbladder hydrops in an immunocompetent child with Cryptosporidium infection.We report a case of an immunocompetent child who developed gallbladder hydrops during a concurrent diarrheal illness caused by cryptosporidium parvum. Hepatobiliary disease and chronic cryptosporidial diarrhea is an accepted association in adults with hiv infection but has only once previously been reported in a child, also with hiv.- - - - - - - - - - ranking = 5keywords = gallbladder (Clic here for more details about this article) |
3/33. Acute hydrops of the gallbladder in childhood.Acute hydrops of the gallbladder (AHGB) is a rare paediatric disease being diagnosed with increased frequency due to its association with other illnesses and the availability of ultrasonography. The symptoms and signs of AHGB include abdominal pain, vomiting, abdominal mass and/or tenderness. As these clinical features mimic the more common surgical conditions such as acute appendicitis, intussusception and volvulus, some cases are still diagnosed only at laparotomy. diagnosis is established by ultrasonography of the abdomen demonstrating normal biliary ducts and a distended gallbladder without calculi or congenital malformation. The aetiology of acute hydrops of the gallbladder is unknown but may be multifactorial. Treatment varies from non-operative management to surgical intervention.- - - - - - - - - - ranking = 7keywords = gallbladder (Clic here for more details about this article) |
4/33. drainage of gallbladder fossa fluid collections with endoprosthesis placement under endoscopic ultrasound guidance: a preliminary report of two cases.collections of fluid in the gallbladder fossa can be detected by ultrasound in as many as 29% of patients following cholecystectomy. Traditionally, persistent collections are treated by percutaneous drainage and bile duct decompression. We present two cases of persistent gallbladder fossa fluid collections which were refractory to bile duct decompression but which were successfully drained by endoscopic ultrasound-guided endoprosthesis placement. Under endoscopic ultrasound (EUS) control, a 19-gauge needle was inserted through the duodenal wall into the gallbladder fossa fluid collection. A guide wire was coiled within the collection, and an endoprosthesis was placed over the wire. Endoprosthesis insertion was successful in both cases, resulting in rapid symptomatic and radiographic improvement. EUS-guided drainage offers a minimally invasive alternative to percutaneous treatment of persistent gallbladder fossa fluid collections following cholecystectomy.- - - - - - - - - - ranking = 8keywords = gallbladder (Clic here for more details about this article) |
5/33. Autoimmune pancreatitis presenting as simultaneous masses in the pancreatic head and gallbladder.CONTEXT: Autoimmune pancreatitis is a rare variant of chronic pancreatitis characterized by pancreatic ductal narrowing and pancreatic parenchymal edema on computed tomography and rarely with intermittent attacks of abdominal pain. Recently, it has been found to be a systemic disease with lymphoplasmacytic infiltration that has been associated with several autoimmune diseases and described in multiple organs including the extrahepatic bile duct, liver and gallbladder. CASE REPORT: We describe the clinical, radiographic and histopathologic aspects of a patient who presented with synchronous masses in the pancreatic head and gallbladder. Postoperatively, the patient's jaundice subsided and IgG4 levels, which were drawn one week postoperatively, were all within normal limits. Nonetheless, immunohistochemical staining for IgG4 was positive. CONCLUSION: Autoimmune pancreatitis is the most common benign entity identified in patients that underwent pancreaticoduodenectomy for presumed pancreatic adenocarcinoma. Our patient with autoimmune pancreatitis presented with simultaneous inflammatory masses in the gallbladder and pancreatic head, an association not previously reported. Preoperative evaluation of IgG4 or autoantibody levels may have obviated the need for an operation. Therefore, we have begun screening for elevated serum IgG4 concentrations to identify patients with possible autoimmune pancreatitis who present without definitive pathological or radiographic evidence for malignancy. If pre-operative diagnosis is not made, immunohistochemical staining of pathology specimens can confirm the diagnosis.- - - - - - - - - - ranking = 7keywords = gallbladder (Clic here for more details about this article) |
6/33. Prolonged postprandial abdominal pain following Kawasaki syndrome with acute gallbladder hydrops: association with impaired gallbladder emptying.Acute hydrops of the gallbladder is a well-recognized complication of Kawasaki syndrome. We report a case of a child with this syndrome whose gallbladder hydrops slowly resolved after intravenous gamma-globulin therapy. However, he continued to experience postprandial right upper quadrant abdominal pain. Hepatobiliary scintigraphy revealed normal filling of the gallbladder but marked impairment of meal-stimulated gallbladder emptying. endoscopy with biopsy of the esophagus, stomach, and duodenum was normal, ruling out peptic complications of his aspirin therapy. This child's discomfort improved slowly over several months, finally ending approximately 6 months after the onset of his illness. A repeat gallbladder emptying study done ultrasonographically at that time revealed near-normal meal-stimulated gallbladder emptying. We conclude that poor emptying of the gallbladder may be associated with prolonged abdominal pain in Kawasaki syndrome. Meal-stimulated gallbladder emptying can be assessed by a simple ultrasonographic technique and should be considered in any patient with Kawasaki syndrome and abdominal pain.- - - - - - - - - - ranking = 16keywords = gallbladder (Clic here for more details about this article) |
7/33. Hydrops of gallbladder as a presenting symptom of Kawasaki disease.Hydrops of the gallbladder is a rare symptom in young children and might appear in Kawasaki disease (KD) patients. We report this unusual manifestation as a presenting symptom in a 15 month old boy with KD.- - - - - - - - - - ranking = 5keywords = gallbladder (Clic here for more details about this article) |
8/33. Surgical presentation of Kawasaki disease (mucocutaneous lymph node syndrome).Five patients with Kawasaki disease (mucocutaneous lymph node syndrome) are reported whose varied presentations included acute abdominal pain, peripheral arterial aneurysms, digital gangrene and sterile pyuria and whose presenting pathology ranged from hydrops of the gallbladder to enteric pseudo-obstruction. As the complications of the disease can usually be managed without resort to surgery, which is associated with a mortality rate of up to 25 per cent, the recognition of Kawasaki disease will prevent hazardous and unnecessary laparotomy.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
9/33. Obstructive jaundice in Kawasaki's disease.We describe a case of Kawasaki's disease in a 10-year-old child who had obstructive jaundice, intrahepatic biliary duct dilatation and gallbladder hydrops. The diagnosis was defined by echography, CT-scan and cholangiography. Immediate relief from symptoms and progressive resolution of jaundice was achieved by percutaneous transhepatic biliary drainage (PTBD). laparotomy was avoided.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
10/33. Gallbladder hydrops in mucocutaneous lymph node syndrome.A 36-month-old boy had acute gallbladder hydrops in association with mucocutaneous lymph node syndrome. A review of 46 other cases of this association has shown that patients having MLNS with gallbladder hydrops are older than those without gallbladder hydrops. The diagnosis is suggested by abdominal symptoms and abnormal results of liver function tests. The diagnosis is confirmed by ultrasonography, which shows the gallbladder to be twice the normal size. Cardiac complications may be increased. Treatment is largely supportive, but cholecystostomy is the procedure of choice in cases requiring operative intervention.- - - - - - - - - - ranking = 4keywords = gallbladder (Clic here for more details about this article) |
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