11/34. atrophy of left lobe of the liver associated with hepatolithiasis and cholangiocarcinoma.A case of liver atrophy associated with hepatolithiasis and cholangiocarcinoma is presented. Intraductal calculus and left hepatic lobar atrophy were seen on both ultrasound and computerised tomography examinations. The lobar atrophy was accompanied by hypoplasia of left common hepatic artery. cholangiocarcinoma was diagnosed on histology. There have been several reported cases of hepatolithiasis and cholangiocarcinoma. To our knowledge, there has been only one reported case of hepatolithiasis and cholangiocarcinoma with liver atrophy (Nishihara K et al 1986) but this was not angiographically demonstrated.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
12/34. The mirizzi syndrome: preoperative diagnosis by sonography and transhepatic cholangiography.Common hepatic duct obstruction from an impacted calculus in the cystic duct is an uncommon cause of jaundice. The complimentary role of both transhepatic cholangiography and sonography can facilitate and assist the physician in making a preoperative diagnosis of mirizzi syndrome and prevent an unnecessary choledochotomy and exploration of the common bile duct.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
13/34. Biliary lithotripsy with a mechanical lithotripter.A simple device for easy and safe mechanical disintegration of hard and large (1-2.5 cm in diameter) biliary calculi, the mechanical lithotripter, has been designed for use with a Dormia or similar type of basket. This device is capable of generating a steady increase in tension in the basket wires, which in turn breaks up the calculus. It may be introduced through a T-tube tract or by a percutaneous transhepatic approach. The lithotripter has been successfully tested in vitro with ten mixed gallstones obtained soon after cholecystectomy and has been successfully employed in six patients with biliary calculi, three with T tubes and three without. In the latter three patients, a percutaneous transhepatic biliary procedure was performed to enable introduction of the lithotripter. There were no complications.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
14/34. Gallstone ileus with two separate biliary-enteric fistulae.A patient with gallstone ileus associated with two separate biliary-enteric fistulae has been reported. The patient had exploratory laparotomy with removal of the gallstone from the distal ileum, repair of the two fistula tracts, and cholecystectomy. The pathology report showed adenocarcinoma of the gallbladder. The patient was discharged 14 days after surgery. It is important to point out that the diagnosis was not suspected prior to surgery, although the patient was elderly with known cholelithiasis, no prior abdominal surgery, and clinical symptoms of bowel obstruction. The plain abdominal film showed a partial small bowel obstruction pattern with a pair of air-fluid levels in the right upper quadrant, no air in the biliary tract, and no visible calculus. When there is a clinical suspicion of gallstone ileus and the plain abdominal film is not diagnostic, there are several modalities available that have been proven to be useful (ie, contrast medium examinations, ultrasound, and hepatobiliary scan).- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
15/34. Transcholecystic endoscopic choledocholithotripsy: successful management of retained common bile duct stone.Removal of large common bile duct stones has been a continuing challenge. The feasibility and efficacy of transcholecystic endoscopic choledocholithotripsy in a high-risk patient are demonstrated in this report. The procedure requires an established cholecystostomy track, catheter dilatation of the cystic duct, and the application of electrohydraulic shock waves to the calculus. The use of a choledochofiberscope permits the passage of the electrohydraulic probe and minimizes complications by direct monitoring. Stone fragments are removed by basket retrieval. This procedure in conjunction with minicholecystostomy may obviate the need for surgery in selected high-risk patients with combined gallbladder and common bile duct stones.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
16/34. Acute cholecystitis secondary to unusual gallstones.Gallstone formation around metallic foreign bodies is an unusual cause of acute cholecystitis. Two cases of penetrating abdominal trauma are described in which metallic fragments served as the nidus for calculus formation and later precipitated an acute abdominal problem.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
17/34. gallstones presenting as mental and physical debility in the elderly.Within 1 year six elderly patients (aged 80-89 years) were admitted because of non-specific deterioration in mental or physical well-being. In no instance was hepatobiliary disease suspected at the time of hospital admission. One patient presented with intermittent confusion only. The other five were referred with "falls" or having "gone off legs", with malaise, confusion, or incontinence. All had raised alkaline phosphatase levels of 159-1230 IU/l, which led to investigation of the biliary tree. At endoscopic retrograde cholangiopancreatography all were shown to have biliary disease (three common duct stones, one gallbladder calculus, one an abscess, and one a widely dilated common bileduct ). With appropriate treatment (endoscopic sphincterotomy for two, surgery for two, and antibiotics alone for two), all showed a gratifying return of mobility and mental function. Biliary disease is a treatable cause of chronic ill health in the elderly and should be excluded, even in the absence of "classical" symptoms, when there is abnormal liver function.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
18/34. Extrahepatic biliary obstruction due to stone.jaundice developing after the neonatal period requires prompt investigation. Surgical causes of cholestatic jaundice, apart from extrahepatic biliary atresia and choledochal cyst, are rare. We describe a case of bile duct dilatation associated with an impacted calculus at the ampulla of vater in a haemophiliac. The ultrasound finding of a dilated duct was an indication to proceed to surgery.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
19/34. Large solitary gallbladder calculus resembling multipolypoid cholesterolosis: case report.A condition diagnosed as multiple cholesterolosis was discovered at surgery to be caused by a very unusual large solitary gallstone. This case demonstrates the potential hazard of omitting the plain KUB film and provides another possible etiology for the appearance of multiple fixed intraluminal defects on oral cholecystography.- - - - - - - - - - ranking = 4keywords = calculus (Clic here for more details about this article) |
20/34. Gallstone ileus. A case report from Baragwanath Hospital.Gallstone ileus is a rare complication of cholelithiasis and even rarer in negroid people, in whom cholelithiasis is far less common than in Whites. A case of gallstone ileus in a Black patient is reported. The clinical presentation was typical and spontaneous resolution with rectal passage of the calculus occurred on conservative management.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
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