1/11. Purulent pericarditis presenting as acute abdomen in children: abdominal imaging findings.Purulent pericarditis is rapidly fatal if untreated [1,2]. With increased development of bacterial resistance to antibiotics, severe bacterial infections in children are becoming more frequent [3,4]. We report two children with purulent pericarditis who presented in a 1-month period for evaluation of acute abdominal distention and signs of sepsis. In both, one evaluated with computed tomography (CT) and one with ultrasound, abdominal findings included periportal edema, gallbladder wall thickening, and ascites secondary to right heart failure from cardiac tamponade. Radiologists should be aware that children with purulent pericarditis may have a normal heart size on radiographs, present with acute abdominal symptoms, and demonstrate findings of right sided heart failure on abdominal imaging.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/11. gallbladder torsion: case report and review of 245 cases reported in the Japanese literature.We report here a case of torsion of the gallbladder in a 73-year-old woman. The patient was admitted to our hospital with right hypochondralgia. ultrasonography and computed tomography demonstrated a distended gallbladder, with a multilayered wall, which contained no stones. Since the symptoms did not respond to antibiotics, laparotomy was performed. The gallbladder was found to be twisted around its pedicle and to be gangrenous. cholecystectomy was performed, and the patient had an uneventful postoperative course. We also reviewed 245 cases reported in the Japanese literature. The clinical features of gallbladder torsion, which include low frequency of fever and jaundice, poor response to antibiotic therapy, and acute onset of abdominal pain, may be helpful in the differential diagnosis from acute cholecystitis. Moreover, a highly suggestive sign of gallbladder torsion observed by ultrasonography or computed tomography is a markedly enlarged "floating" gallbladder with a continuous hypoechoic line indicating edematous change in the wall.- - - - - - - - - - ranking = 6keywords = gallbladder (Clic here for more details about this article) |
3/11. Acute abdomen caused by salmonella typhimurium infection in children.Salmonella spp. infections can be particularly challenging when they manifest as acute abdominal problems and lead to emergency surgery. Examples of such serious conditions are Salmonella-related intestinal perforation, gallbladder involvement, salpingitis, and peritonitis. mesenteric lymphadenitis associated with salmonella typhimurium mimics acute appendicitis and can make it difficult to establish a timely and definitive diagnosis in young patients who present with right lower abdominal pain. Paralytic ileus is a fairly common manifestation of Salmonella infection at all ages, but complete intestinal obstruction requiring surgical intervention is very rare. Because of the nature of the diagnostic process, a significant number of patients with Salmonella infection present with acute abdomen and undergo needless operations. This report describes the cases of 2 pediatric patients who underwent surgery to address persistent pain in the right lower abdominal quadrant and complete intestinal obstruction, respectively. The first patient had inflamed mesenteric lymph nodes that caused appendicitislike symptoms, and the second had dense adhesions between the mesentery and the terminal segments of the ileum that led to intestinal blockage. serology results showed that both patients' titers for BO ("B and O agglutinating [BO]") antibodies rose to 1:640 in the week after their admission to hospital, a pattern and level that is indicative of S typhimurium infection. J Pediatr Surg 36:1849-1852.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
4/11. Gall stone: a rare cause of acute abdomen in a seven years old girl.Jamila Khatun a seven years old girl from Shurjunagar, Rajbari, presented with acute pain in the right side of her abdomen. blood test was normal except mild elevation of serum bilirubin. Chest X-ray reveals no fluid level & no gas under the dome of diaphragm. Ultrasonogram of the abdomen reveled multiple stone in the gallbladder.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
5/11. Stump resections resulting from incomplete operations.Stump viscera caused by an incomplete operation can present the same symptoms as before the first operation. Furthermore, as an acute clinical event, these incomplete resections may sometimes cause acute abdomen and may need emergency surgical intervention. A 34-year-old woman with a history of laparoscopic cholecystectomy 5 days before was admitted with acute abdominal symptoms. Abdominal exploration revealed that she had undergone incomplete resection of the gallbladder. Another patient, a 21-year-old man, was admitted with complaints of fluid drainage from his appendectomy incision scar. He was diagnosed as having enterocutaneous fistula. Abdominal exploration revealed a stump appendix fistulizing to the abdominal wall. The third patient was a 32-year-old man with an appendectomy scar who was admitted with complaints of acute appendicitis. The patient was diagnosed as having acute appendicitis and underwent an appendectomy. A stump appendix was removed during the operation. Surgeons should be aware of stump pathologies and keep in mind a possible incomplete operation to prevent delayed diagnosis and treatment.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
6/11. Kawasaki disease complicated by gallbladder hydrops mimicking acute abdomen: a report of three cases.Three cases of gallbladder hydrops associated with Kawasaki disease are presented. The initial manifestations were high fever, jaundice and distended abdomen with guarding. The first two cases received laparotomy under the impression of suppurative cholecystitis with peritonitis. A markedly distended acalculous, nongangrenous gallbladder was noted. A cholecystostomy for drainage was performed. Diagnosis of Kawasaki disease was made only when the clinical manifestations became full-blown postoperatively. Both patients led an uneventful postoperative course. The third case had apparent features of Kawasaki disease at admission though the abdominal symptoms were rather prominent. With supportive care, the patient stabilized by the sixth hospital day without complication and did not require surgical intervention. We suggest that the preferred treatment of abdominal symptoms in Kawasaki disease is medical, and surgical intervention is deserved only for the complications of the hydrops. Simple cholecystostomy seems to be safe and sufficient for such occasion. ultrasonography is helpful for the correct diagnosis of gallbladder hydrops and can exclude dilatation of the intrahepatic biliary trees and cholelithiasis.- - - - - - - - - - ranking = 7keywords = gallbladder (Clic here for more details about this article) |
7/11. Acute surgical abdomen and myelofibrosis.Extramedullary hematopoiesis associated with fibrosis is found frequently in the liver and spleen, but seldom in other organs. Acute abdomen due to extramedullary hematopoiesis has been reported in two patients with intestinal obstruction because of heavy infiltration of the terminal ileum. This report describes the case of a 71-year-old woman with myeloid metaplasia involving the gallbladder mimicking acute cholecystitis. As far as we know, involvement of the gallbladder by extramedullary hematopoiesis has never been reported before.- - - - - - - - - - ranking = 2keywords = gallbladder (Clic here for more details about this article) |
8/11. A case of vasculitic cholecystitis associated with Schonlein-Henoch purpura in an adult.A case of Schonlein-Henoch purpura (SHP) in a 32 year-old female, showing gastrointestinal manifestations including acute vasculitic cholecystitis was reported. In the course of hospitalization urgent laparotomy was performed because of the severe abdominal pain. The gallbladder was inflamed with a brownish-red edematous wall and subserosal hemorrhage, and was resected. Histological examination of the resected gallbladder specimen revealed leucocytoclastic vasculitis. The patient was treated with prednisolone postoperatively, and symptoms abated over two weeks. Acute cholecystitis with SHP is extremely rare, and as far as the authors know this is the second case of this disorder documented by histological examination. patients with acute abdomen associated with SHP should be managed with consideration of the complications of acute cholecystitis.- - - - - - - - - - ranking = 2keywords = gallbladder (Clic here for more details about this article) |
9/11. infarction of the gallbladder--an unusual cause of acute abdomen in the neonate.infarction of the gallbladder, while rare, must now be included in the growing list of possible and proven complications of umbilical artery catheterization.- - - - - - - - - - ranking = 5keywords = gallbladder (Clic here for more details about this article) |
10/11. Abnormal 99mTc-PIPIDA scans mistaken for common duct obstruction.99mTc-PIPIDA scans were obtained in three patients with acute abdominal pain. The appearance of the scans suggested partial common duct obstruction. Two patients underwent surgery. One had acute appendicitis and the second had infarction of the distal ileum. In both cases, the gallbladder and biliary tract were normal. The third patient had been treated with morphine, which is known to increase biliary tract pressure and may cause contraction of the sphincter of oddi. An ultrasound study of the gallbladder was normal and all symptoms resolved within 24 hours. Subsequently, three additional patients without biliary disease have been seen who had similar hepatobiliary scans. All three had received meperidine prior to the study. It is concluded that acute abdominal disease or the administration of morphine sulfate or meperidine can result in a scan pattern suggesting partial distal common duct obstruction in the absence of gallbladder or biliary tract disease.- - - - - - - - - - ranking = 3keywords = gallbladder (Clic here for more details about this article) |
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