1/26. Neurally mediated syncope in 2 patients with extracardiac disease.We describe the cases of 2 patients with repetitive episodes of syncope with profound bradycardia and hypotension. In both patients, the symptoms were initially thought to be neurally mediated and idiopathic but were ultimately determined to be triggered by serious underlying pathologic processes: a massive and locally invasive tumor of the hypopharynx in 1 patient and a gangrenous gallbladder in the other. Appropriate treatment resulted in a resolution of this syndrome in both patients. These cases emphasize the importance of an appropriate evaluation and broad differential diagnoses for patients with severe bradycardia and hypotension.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/26. Acute torsion of the gallbladder: review of the literature and report of a case.A case report is presented, and the literature reviewed, of acute torsion of the gallbladder. Originally described as a rare pathological entity, it is being witnessed more frequently as a probable concomitant of increasing life expectancy. Because it is a benign condition if diagnosed rapidly and treated surgically, it should be considered in differential diagnostic possibilities. When encountered intraoperatively, prompt recognition of the process should lead to detorsion of the organ and cholecystectomy as the procedure of choice.- - - - - - - - - - ranking = 5keywords = gallbladder (Clic here for more details about this article) |
3/26. gallbladder torsion: case report and review of the literature.Torsion of the gallbladder is a surgical emergency, occurring mainly in the elderly. female is predominant to male with ratio 3 to 1. Despite its unknown etiology, the anatomical variations in the attachment of gallbladder which occur on the mobile mesentery to the inferior margin of the liver are usually found. When the gallbladder twists around the cystic duct and artery, torsion takes place with ensuing occlusion of the flow of bile and blood. Preoperative diagnosis is difficult to make; however, patients who receive prompt surgical treatment with cholecystectomy always get excellent outcomes. mortality rate is low with 3% to 5%. Here, we report on elderly male patient with gallbladder torsion at our hospital and review the existing literature.- - - - - - - - - - ranking = 4keywords = gallbladder (Clic here for more details about this article) |
4/26. 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 = 3keywords = gallbladder (Clic here for more details about this article) |
5/26. 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 = gallbladder (Clic here for more details about this article) |
6/26. 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 = 2keywords = gallbladder (Clic here for more details about this article) |
7/26. 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 = 6keywords = gallbladder (Clic here for more details about this article) |
8/26. 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 = 1keywords = gallbladder (Clic here for more details about this article) |
9/26. 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 = 1keywords = gallbladder (Clic here for more details about this article) |
10/26. Laparoscopic management of gallstone presenting as obstructive gangrenous appendicitis.We present an unusual case of a 55-year-old man with symptoms of recurrent appendicitis. laparoscopy revealed a 1.5 cm gallstone impacted at the base of the appendix, leading to gangrenous appendicitis. This patient did not have any features of gallstone ileus. On imaging he had an inflammatory mass in the region of the right iliac fossa with a hyperintense shadow in the cecal area which was reported as an appendicolith. There was no demonstrable cholelithiasis or biliary-enteric fistula. There were dense omental adhesions in the pericholecystic area on laparoscopy. The case was successfully managed by laparoscopic appendectomy with retrieval of the gallstone. No surgery was undertaken for the gallbladder. diagnosis was confirmed by biochemical analysis of the stone, which contained calcium bilirubinate and cholesterol. A gallstone obstructing the appendicular lumen is a very rare etiology of gangrenous perforation of the appendix peritonitis. This case was successfully managed laparoscopically.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
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