1/33. Perforation of the gallbladder: analysis of 19 cases.Perforation of the gallbladder occurred in 19 (3.8%) of 496 patients with acute cholecystitis treated at one hospital in an 8-year period. The average age of the 19 patients was 69 years and the female:male ratio was 3:2. Most had a history suggestive of gallbladder disease and most had coexisting cardiac, pulmonary, renal, nutritional or metabolic disease. The duration of the present illness was short, perforation occurring within 72 hours of the onset of symptoms in half the patients; the diagnosis was not suspected preoperatively in any. In the elderly patient with acute cholecystitis who has a long history of gallbladder disease, cholecystectomy should be performed early, before gangrene and perforation of the gallbladder can occur.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
2/33. Ultrasonographic evaluation of pericholecystic abscesses.Pericholecystic abscess formation is a serious complication of cholecystitis that develops after gallbladder perforation and is usually associated with acute inflammatory signs and symptoms. Ultrasonographic findings in three surgically proven cases of pericholecystic abscess are reported. The findings ranged from a well defined band of low-level echoes around the gallbladder to multiple, poorly defined hypoechoic masses surrounding an irregular, indistinct gallbladder outline. The former situation correlated with a well encapsulated pericholecystic inflammatory process, while the latter was associated with extensive abscess formation resulting from gallbladder rupture. cholelithiasis was identified in two of the three cases. Ultrasound for preoperative detection of pericholecystic abscess is discussed.- - - - - - - - - - ranking = 0.5keywords = cholecystitis (Clic here for more details about this article) |
3/33. Spontaneous spleen rupture during typhoid fever.Typhoid fever currently is an uncommon disease in western countries, and cases usually are imported from endemic areas.1 The most common complications are intestinal bleeding or perforation and necrotizing cholecystitis, although hepatitis, myocarditis, nephritis, and meningitis may occur. Spontaneous spleen rupture during typhoid fever is a known but rare complication. This report describes a new case and reviews the literature.- - - - - - - - - - ranking = 0.5keywords = cholecystitis (Clic here for more details about this article) |
4/33. An unusual paratyphoid fever.salmonella typhi is known to produce acalculous cholecystitis and related gall bladder perforation. Following is a documentation of a patient of sub-phrenic abscess and gall bladder perforation which was possibly a result of salmonella paratyphi a.- - - - - - - - - - ranking = 0.5keywords = cholecystitis (Clic here for more details about this article) |
5/33. Successful major surgical recovery of a patient following haploidentical stem cell transplantation for chronic myeloid leukemia in blast crisis and aspergillosis.A 44-year-old woman who underwent haploidentical stem cell transplantation (haplo SCT) for chronic myeloid leukemia in blast crisis and aspergillosis was admitted to the emergency room 7 months later because of severe right upper quadrant abdominal pain, fever, leukocytosis and peritoneal signs. Computer tomography disclosed cholecystitis and gallbladder perforation. Within hours, she underwent urgent open laparatomy and cholecystectomy. The postoperative period was uneventful and she was discharged 10 days later without any complications. Currently, she is 2(1/2) years posttransplantation in full hematological, cytogenetic and molecular remission with 100% karnofsky performance status. Most notably, normal and fast recovery was observed following major surgery 7 months post-haplo SCT which is usually considered to result in long-lasting immunosuppression and malfunction of the immune system.- - - - - - - - - - ranking = 0.5keywords = cholecystitis (Clic here for more details about this article) |
6/33. Spontaneous cystic duct perforation associated with acalculous cholecystitis.Spontaneous perforation of the extrahepatic biliary tree is rare in adults. Although perforation of the hepatic, common hepatic, common bile, and cystic ducts has been reported, review of the English literature reveals only four cases of cystic duct perforation, each attributed to calculi. We herein report the first known case of spontaneous perforation of the cystic duct in the absence of biliary calculi.- - - - - - - - - - ranking = 2keywords = cholecystitis (Clic here for more details about this article) |
7/33. MRI of perforated gall bladder.Gall bladder perforation is a dreaded complication of acute cholecystitis that, if not diagnosed early in the course, might have a poor prognosis. Both CT and ultrasonography have been used until now extensively for the diagnosis of acute cholecystitis, but diagnosis of perforation is always difficult. Magnetic resonance, by its superior soft tissue resolution and multiplanar capability, is a better modality and should fare better than ultrasonography and CT, as demonstrated in our case. magnetic resonance imaging demonstrates the wall of the gall bladder and defects to a much better advantage and more convincingly. In addition, MR colangiopancreatography images demonstrate the biliary tree better than other modalities. We suggest that in the case of acute cholecystitis, if perforation is suspected and CT and ultrasonography are not conclusive, MR should be the modality of choice. It can be used as a first line of investigation; however, it might not be cost-effective.- - - - - - - - - - ranking = 1.5keywords = cholecystitis (Clic here for more details about this article) |
8/33. Diagnosis of gallbladder perforation in acute acalculous cholecystitis in critically ill patients.In the presence of ascites ultrasound is not appropriate to distinguish between gallbladder perforation and acute acalculous cholecystitis. However, the correct and early diagnosis of gallbladder perforation is important for the treatment and prognosis. We report 4 critically ill patients with ascites. All patients had evidence of gallbladder perforation by ultrasound and underwent cholecystectomy: 2 patients had gallbladder perforation, but 2 had acalculous cholecystitis without perforation. Markedly elevated serum alkaline phosphatase was the only discriminating finding indicating gallbladder perforation.- - - - - - - - - - ranking = 3keywords = cholecystitis (Clic here for more details about this article) |
9/33. Gastroduodenal artery pseudo-aneurysm after cholecystectomy.We report the case of a 69-year-old man presenting with rupture of a pseudo-aneurysm of the gastroduodenal artery into the duodenum eight days after open cholecystectomy for acute cholecystitis. The surgical approach to a ruptured visceral artery pseudo-aneurysm is technically difficult and hazardous. The operative mortality rate reaches 16 to 50%, mainly dependent on the anatomic location of the visceral artery pseudo-aneurysm. This report describes a case in which bleeding from a pseudo-aneurysm of the gastroduodenal artery was successfully treated by embolisation using metal coils.- - - - - - - - - - ranking = 0.5keywords = cholecystitis (Clic here for more details about this article) |
10/33. gallbladder perforation: preoperative diagnosis by combined imaging techniques.gallbladder perforation represents the most serious complication of cholecystitis. Rapid preoperative diagnosis is necessary because of the high morbidity and mortality associated with it. The authors present a case of gallbladder perforation in a 64-year-old man who had been on high doses of steroids. This case was diagnosed preoperatively by combined radiologic imaging methods.- - - - - - - - - - ranking = 0.5keywords = cholecystitis (Clic here for more details about this article) |
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