1/28. False negative biliary scintigraphy in gangrenous cholecystitis.Gangrenous cholecystitis is a serious complication of acute cholecystitis and is associated with increased morbidity and mortality rates. We report a case in which the diagnosis was suggested by ultrasound, but cholecystectomy delayed due to atypical clinical presentation and a false negative radionuclide biliary scan.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
2/28. abdominal wall sinus due to impacting gallstone during laparoscopic cholecystectomy: an unusual complication.During laparoscopic cholecystectomy, perforation of the gallbladder can occurs in < or = 20% of cases, while gallstone spillage occurs in < or = 6% of cases. In most cases, there are no consequences. gallstones can be lost in the abdominal wall as well as the abdomen during extraction of the gallbladder. The fate of such lost gallstones, which can lead to the formation of an abscess, an abdominal wall mass, or a persistent sinus, has not been studied adequately. Herein we report the case of a persistent sinus of the abdominal wall after an emergent laparoscopic cholecystectomy in an 82-year-old woman with gangrenous cholecystitis and perforation of the friable wall in association with an empyema of the gallbladder. The culture of the obtained pus was positive for escherichia coli. After a small leak of dirty fluid from the wound of the epigastric port site of 4 months' duration, surgical exploration under local anesthesia revealed that the sinus was caused by spilled gallstones impacting into the abdominal wall between the posterior sheath and left rectus abdominalis muscle. The removal of the stones resulted in complete healing. Long-term complications after laparoscopic cholecystectomy involving the abdominal wall are rare but important possible consequences that could be avoided.- - - - - - - - - - ranking = 0.16666666666667keywords = cholecystitis (Clic here for more details about this article) |
3/28. Acalculous gangrenous cholecystitis in a young adult: a gastrointestinal manifestation of polyarteritis nodosa.The authors report a rare case of an acalculous gangrenous cholecystitis due to a form of vasculitis, polyarteritis nodosa (PAN). An 18-year-old man was admitted to the hospital with worsening symptoms of nausea, fever, intermittent abdominal pain, and high blood pressure that lasted for 4 days. After a sequential work-up, a diagnostic laparoscopy was performed and revealed a gangrenous cholecystitis with spontaneous perforation. Laparoscopic cholecystectomy was performed successfully. The patient had an uneventful recovery period and was discharged on the second postoperative day. The histopathologic examination showed gangrenous and perforated gallbladder, vasculitis, and clues of PAN. The purpose of this article is to describe a rare condition in a young patient that was diagnosed and treated with minimally invasive surgery.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
4/28. Acute acalculous cholecystitis after breast reconstruction.Postoperative acute acalculous cholecystitis (AAC) is a potentially lethal complication that presents with a high morbidity and mortality. Some elective plastic surgery patients are at risk to developing this complication, although it has not been previously reported in the plastic surgery population. patients at risk are those affected of ischaemic diseases, artheroschlerotic factors, smoking, diabetes, and patients requiring postoperative intensive care monitoring. The clinical presentation is non-specific and it is usually masked by postoperative pain and by the signs and symptoms of the primary disease. Significant delays in diagnosis result in a high incidence of gangrene, perforation, abscess, and death. Although difficult to prevent, a good preoperative planning, with correction of all physiologic abnormalities prior to surgery may help in minimising the incidence of AAC. Cessation of smoking is essential, and careful monitoring of patients during anaesthesia is crucial to avoid low cardiac output and ischaemic insults to the enteric circulation.- - - - - - - - - - ranking = 0.83333333333333keywords = cholecystitis (Clic here for more details about this article) |
5/28. The interrupted rim sign in acute cholecystitis: a method to identify the gangrenous form with MRI.We present the imaging findings on MR of a patient with acute gangrenous cholecystitis that demonstrated patchy enhancement of the gallbladder mucosa on gadolinium-enhanced fat-saturated T1-weighted gradient echo images. This interrupted rim of mucosal enhancement correlated with patchy areas of necrosis and inflammation of the gallbladder mucosa on the histopathological examination.- - - - - - - - - - ranking = 0.83333333333333keywords = cholecystitis (Clic here for more details about this article) |
6/28. False-negative morphine-augmented cholescintigraphy in a patient with gangrenous cholecystitis.Intravenous morphine sulfate is commonly used to shorten study time and has been reported not to lower the specificity of hepatobiliary imaging. Although the false-negative rate is low, caution has to be taken in interpreting morphine-enhanced cholescintigraphy. The report presents a false-negative study in a patient with acute gangrenous cholecystitis.- - - - - - - - - - ranking = 0.83333333333333keywords = cholecystitis (Clic here for more details about this article) |
7/28. Volvulus of the gallbladder: laparoscopic detorsion and removal.A 73-year-old woman who presented with symptoms of acute cholecystitis was found to have a gangrenous gallbladder wrapped in three complete rotations around its pedicle. Detorsion and removal of the gallbladder were accomplished laparoscopically. Our review of the literature found no other case in which this degree of torsion was successfully treated laparoscopically.- - - - - - - - - - ranking = 0.16666666666667keywords = cholecystitis (Clic here for more details about this article) |
8/28. Gangrenous cholecystitis as a complication of hepatic artery embolization: case report.Ischemic injury to the gallbladder has been described after hepatic artery embolization but has not been considered a clinically significant complication of this procedure. We present three cases in which therapeutic embolization resulted in symptomatic gangrenous cholecystitis requiring urgent surgical intervention. Clinical parameters that distinguish this infrequent ischemic septic process from the more common postembolization syndrome are discussed and recommendations concerning the diagnosis and management of these complicated patients are outlined.- - - - - - - - - - ranking = 0.83333333333333keywords = cholecystitis (Clic here for more details about this article) |
9/28. Gangrenous cholecystitis: five patients with intestinal obstruction.Gangrenous cholecystitis, a disease more common in older patients and diabetics, may be complicated by perforation, pericholecystic abscess, and fistula. intestinal obstruction has rarely been reported as a complication and only in cases involving perforation or acute, nongangrenous cholecystitis. A retrospective review of hospital records between 1961 and 1989 identified 126 patients with gangrenous cholecystitis, five of whom came to the hospital with intestinal obstruction. Three were cases of paralytic ileus and two of simple mechanical obstruction without perforation. The latter group may represent the first such cases reported. gallbladder perforation occurred in two patients and cholelithiasis was found in three. The mean age of the total patient cohort was 70.6 years; patients were predominantly male and black. hypertension and diabetes were common concomitant diseases. patients commonly came to the hospital with nausea and vomiting, increasing abdominal girth, and obstipation. A leukocytosis on admission was more common than fever or hyperbilirubinemia. The clinical presentation of intestinal obstruction and the lack of objective data specific for gangrenous cholecystitis made a preoperative diagnosis impossible. Thus, a high index of suspicion should increase diagnostic accuracy. The incidence of intestinal obstruction (at presentation) in cases of gangrenous gallbladders was 4 per cent. morbidity and mortality are reduced with early operation.- - - - - - - - - - ranking = 1.3333333333333keywords = cholecystitis (Clic here for more details about this article) |
10/28. Scintigraphic gallbladder visualization with gangrenous acalculous cholecystitis.Hepatobiliary scintigraphy evaluates the biliary clearance of Tc-99m-labeled iminodiacetic acid agents (Tc-99m IDA) and has a high sensitivity and specificity for the diagnosis of acute cholecystitis. False-negative studies are extremely rare. We describe an apparently normal nonmorphine-augmented hepatobiliary study in gangrenous acalculous cholecystitis. Based on clinical findings, computed tomography, and ultrasound demonstration of a dilated gallbladder, a cholecystectomy was performed. Pathologic examination of the gallbladder revealed acute gangrenous cholecystitis with culture positive for klebsiella pneumoniae.- - - - - - - - - - ranking = 1.1666666666667keywords = cholecystitis (Clic here for more details about this article) |
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