11/14. Duodenal gallstone ileus producing Boerhaave's syndrome.A case of duodenal obstruction by biliary calculus associated with esophageal rupture is described. CT demonstrated air in the gallbladder, an impacted gallstone in the duodenum, pneumomediastinum, and hydropneumothorax. The present report describes the CT findings of these two rare conditions in the same patient.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
12/14. Consequences of lost gallstone.Laparoscopic cholecystectomy has become the treatment of choice in the management of calculus gallbladder disease. Intraperitoneal gallstone loss is not uncommon; it occurs in up to 40% of cases. Often, the stones are left unretrieved and are thought to be inconsequential. We present a series of patients who have had serious sequela from gallstones in the peritoneal cavity. We performed a retrospective study of the management of six patients with complications from intraperitoneal gallstones. The patients presented with a variety of complaints, from fevers to pneumonia to a colo-cutaneous fistula. Presentation ranged from immediately postoperatively to 18 months after surgery. diagnosis included perihepatic abscesses and colo-biliary fistula. General anesthesia was usually necessary for removal of the stones. All patients have resolved following the removal of the gallstones. Our recommendation is to attempt to avoid spillage through careful dissection and retrieve any lost stones. The defect in the gallbladder can be closed with a clip. Whether the procedure should be converted to an open one to retrieve all the stones remains open to debate. The surgeon should be aware of the possible consequences of the lost gallstone.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
13/14. Spontaneous nephro-duodenal fistula.Nephroduodenal fistulas are an uncommon clinical entity characterized by upper abdominal pain and associated with pyelonephritis and renal calculus formation. Most of the recent cases reported are secondary to inflammatory changes in the kidney. Two cases are reported here, one of a nephroduodenal fistula and another of a combined nephroduodenal and nephrocolic fistulae. Carefully monitored X-ray studies determined in both cases the exact site and extent of the fistulae. The optimal treatment is nephrectomy.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
14/14. Bouveret's syndrome: diagnosis by helical CT scan.Calculous cholecystitis severe enough to result in pyloric outlet obstruction is a rare occurrence. Impaction of a large calculus in the duodenum or stomach as a consequence of fistula formation is usually diagnosed on upper gastrointestinal series. Computed tomography is uncommonly used to diagnose this condition and was diagnostic in our patient.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
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