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Search Results: 1 - 10 of 6525 matches for " acute cholecystitis "
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Gangrenous Cholecystitis with Atypical Presentation in an Elderly Diabetic Woman  [PDF]
Vera Clérigo, Cláudia Rocha, André Rodrigues, Lígia Fernandes, Dora Sargento, Glória Silva
Case Reports in Clinical Medicine (CRCM) , 2014, DOI: 10.4236/crcm.2014.39110

In elderly patients, numerous factors subsidize the diagnostic challenge and high incidence of complications in this specific population, taking gangrenous cholecystitis as a critical example. The aim of this work is to report an unusual case of gangrenous choleystitis in an elderly diabetic women and its atypical clinical presentation. A 79-year-old female patient came to our observation; her medical history showed nausea and vomiting of about 2 hours which rapidly ended with symptomatic therapy, without recurrence, and a 3-week history of intermittent fever associated with productive cough. No abdominal discomfort was declared. Physical examination of the abdomen was negative. Laboratory analysis revealed leukocytosis with the remaining criteria within the normal range. After 2 days, she started with a mildabdominal pain in the epigastric region that rapidly progressed to the right upper quadrant, right flank and right iliac fossa, without nausea, vomiting or fever. Abdominal computer tomography findings revealed thickness of the gall-bladder and important densification of the vascular bed. Acute cholecystitis was diagnosed. The patient was then submitted to a laparoscopic cholecystectomy under general anaesthesia with findings suggestive of gangrenous acute cholecystitis confirmed by histologic examination of the specimen. Delays in diagnosing acute cholecystitis in specific populations, such as elderly diabetics, result in a higher prevalence of morbidity and mortality due to potentially serious complications as gangrenous cholecystitis. Consequently, the diagnosis should be measured and investigated promptly in order to prevent poor outcomes.

Mirizzi Syndrome Complicating Acute Cholecystitis: CT Diagnosis  [PDF]
Kassim Sidibé, Pierlesky Elion Ossibi, Zacharia Traoré, Imane Kamaoui, Youssef Lamrani, Meryem Boubbou, Moustapha Maaroufi, Imane Toughrai, Khalid Mazaz, Siham Tizniti
Open Journal of Radiology (OJRad) , 2016, DOI: 10.4236/ojrad.2016.62013
Abstract: Mirizzi syndrome is a rare complication of gallstones with an incidence of less than 1% per year in Western countries. Imaging and endoscopy play a key role in its diagnosis. CT scan helps to eliminate any malignant lesion of the bile ducts or liver hence comes in handy in the confirmation of Mirizzi syndrome. We hereby report a case of a Mirizzi syndrome complicating acute cholecystitis in a 41-year-old patient without any history of disease.
Acute Cholecystitis: Computed Tomography (CT) versus Ultrasound (US)  [PDF]
Ee Syn Tan, Jason Friesen, Brendon Friesen
Open Journal of Radiology (OJRad) , 2018, DOI: 10.4236/ojrad.2018.82015
Abstract: Acute cholecystitis is a common surgical emergency and ultrasound (US) is currently considered the first-line diagnostic imaging test. The relative accuracy of computed tomography (CT) in detecting acute cholecystitis has received little attention in the literature. We report a case series of 113 patients who underwent emergency laparoscopic cholecystectomy at a tertiary surgical centre in Australia, between 2014 and 2016, after undergoing both US and CT examination for acute right upper quadrant pain. Both US and CT had a relatively low sensitivity in detecting acute cholecystitis in the patients with histologically proven acute cholecystitis (47% and 45% respectively) but high specificity (84% and 79% respectively). As expected, US was much more sensitive in detecting cholelithiasis (92%) in comparison to CT (55%). With the added advantage of CT in excluding other alternative intra-abdominal pathology in patients presenting with acute right upper quadrant pain, and similar accuracy in detecting acute cholecystitis, the need for ultrasound may be negated in cases where acute cholecystitis has been confirmed on CT. However, it is noted that both US and CT had a significant false negative rate for acute cholecystitis, and if there remains a clinical suspicion despite initial normal imaging, repeat delayed imaging and/or surgical opinion may be warranted.
Resultados del tratamiento laparoscópico de la colecistitis aguda
de la Concepción de la Pe?a,Ada Hilda; Soberón Varela,Iris; Hernández Varea,José Antonio; Cremata Bruna,Mario;
Revista Cubana de Cirug?-a , 2009,
Abstract: introduction: from introduction of laparoscopic cholecystectomy, many authors have verified advantages of this technique on open cholecystectomy, and it is consider the standard approach for treatment of non-complicated cholelitiasis. however, there was some resistance by surgeons when to be about the acute cholecystitis. aim of present paper was to present results achieved with early laparoscopic treatment of acute cholecystitis in our service. methods: from a total of 142 patients admitted diagnosed with acute cholecystitis, 49 of them were operated on by means emergent laparoscopic cholecystectomy from february 2003 to february 2007. five criteria was established for patients selection: start of symptoms before 72 hours, clinical and ultrasound diagnosis of acute cholecystitis, non-dilated main biliary route, lack of suggestive image of choledochal lithiasis, lack of high abdomen surgery, and patients with contraindications for laparoscopic surgery. results: average surgical time was of 65 minutes. there was a lesion of main biliary route detected at surgery (choledochal wound), two wound infections, and two patients needed conversion: one by biliary route lesion and another by vesicular roof bleeding. average hospital stay was or 2, 5 days. there were neither re-interventions nor mortality in this series. conclusions: we conclude that laparoscopic method in case of acute cholecystitis, when it is early prescribed, is safe and feasible. we suggested that it be the first therapeutical option in these patients.
Colecistitis aguda en paciente con situs inversus totalis
Pinilla González,Rafael; López Lazo,Sarah; Quintana Díaz,Juan Carlos; González Rivera,Armando;
Revista Cubana de Cirug?-a , 2011,
Abstract: the objective of present paper is to present a case of situs inversus and cholecystitis diagnosed and treated in the "al wahda mabar thamar" hospital of yemen. a female patient aged 50 with epigastric pain after ingestion of fatty foods; two days before its admission increase its intensity and remains in left hypochondrium and also vomiting. with the use of perioperative antibiotic-therapy, a left subcostal incision is made detecting an acute cholecystitis with a choledochal slight dilatation. a cholecystectomy and choledochotomy with a good postoperative evolution were performed.
Cr. Lupascu
Jurnalul de Chirurgie , 2005,
Abstract: Early laparoscopic cholecystectomy within 5 days of onset of symptoms of acute cholecystitis has proved better to open cholecystectomy. Feasability is already well established; the conversion rate to open cholecystectomy and the post-operative morbidity are not higher than with the delayed laparoscopy after the initial medical management. Total hospital stay is, on the other hand, significantly shorter. Only one study showed an increase in operative time with early surgery (on average 15 minutes). Both preoperative or perioperative risk factors for conversion to laparotomy were identified. Prompt laparoscopic intervention avoids the complications which may arise with initial medical management, such as failure of medical management or biliary peritonitis. Early laparoscopic cholecistectomy should be considered the “gold standard” for management of acute cholecystitis.
Emphysematous cholecystitis
Lupinacci, Renato Micelli;Chafai, Najim;Tiret, Emmanuel;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2009, DOI: 10.1590/S0102-67202009000400011
Abstract: background: emphysematous cholecystitis is life-threatening condition characterized by gas-forming infection of the gallbladder. it is mostly seems in old male patients with systemic, specially diabetes and vascular diseases. case report: - a 30-year-old man without previous diseases was admitted because of right upper quadrant pain and nausea. on admission the patient was febrile (38.7o) with normal bilirubin levels. the white blood count was 26700/μl and reactive protein c was 470. axial sections of single slice computed tomography imaging (section thickness 5 mm), revealed gallbladder wall enhancement after i.v. contrast, as well as dilatation of the gallbladder with intraluminal air. the patient underwent open cholecystectomy. the culture of the bile showed clostridium perfringes. the postoperative course of the patient was uneventful. conclusion: this is a rare form of cholecystitis that carries a high mortality and usually present insidious clinical signs. ct is the most accurate imaging technique. antibiotic therapy should begin quickly and include coverage of common pathogens, particularly clostridia. surgical intervention should take place as early as possible.
Colecistitis aguda asociada a sepsis por Staphylococcus aureus en un recién nacido
León del P,Jorge; Bancalari M,Aldo; Enríquez G,Juan;
Revista chilena de pediatría , 2006, DOI: 10.4067/S0370-41062006000100007
Abstract: background: acute cholecystitis is an uncommon pathology in newborns. objective: report the case of a newborn with acute cholecystitis secondary to staphylococcus aureus sepsis. case report: a 23 days-old female newborn with clinical symptoms of sepsis associated with clinical signs of acute abdomen. an exploratory laparatomy was performed, finding an inflamated hydropic gallbladder that required cholecystectomy. the biopsy confirmed diagnosis. conclusion: acute cholecystitis is an uncommon pathology in newborns. clinical findings include acute abdomen and palpable abdominal mass. the diagnosis is suspected by ultrasonography and confirmed with laparotomy
Estudos dos fatores de risco pré-operatórios para bacteriobilia em doentes portadores de colecistite aguda calculosa
Linhares, M.M.;Paiva, V.;Castelo Filho, A.;Granero, L.C.S.;Pereira, C.A.;Machado, A.M.O.;Goldenberg, A.;Matos, D.;
Revista da Associa??o Médica Brasileira , 2001, DOI: 10.1590/S0104-42302001000100033
Abstract: objective: to determine an association between the preoperative clinical status and the result of bile and gallbladder wall cultures. material and methods: 28 variables regarding history, physical examination and laboratorial assessment in 38 patients with acute calculosis cholecystitis submitted to urgency surgery were prospectively studied during a 19-month period, between november 1995 and may 1997. cultures for aerobic and anaerobic agents from both the gallbladder wall and the bile were performed, in three different culture media (bactec 9240, bhi and hemobac). results: bacteria were isolated in at least one culture medium, in 68.2% of the patients. at univariate analysis, five preoperative factors were identified as predictors of bactibilia: over 55 years of age, a greater than 0.4°c difference in the axillary-rectal temperature, a greater than 12.000 cels/m3 blood leukocyte count, a greater than 75% neutrophil percentage and a greater than 4% rod neutrophil percentage. owing to the small sample size, statistical significance of the series could not be noted by logistic regression, although a trend to preoperative determination could be observed in 98% of the subjects with positive culture, by means of the model based on age and percentage of rod neutrophil. by analyzing predictive factors jointly, it was noted that patients with more than one predictive factor have a significantly greater possibility to yelding positive culture when compared to those with up to one predictive factor for bactibilia. conclusions: we concluded that, in patients with acute calculosis cholecystitis, bactibilia may be predicted yet at the preoperative period, by using simple and easily obtained data.
Complicaciones de colecistitis aguda en pacientes operados de urgencia
Castro,Felipe; Galindo,Juliana; Bejarano,Mónica;
Revista Colombiana de Cirugía , 2008,
Abstract: introduction: acute cholecysyitis is the second cause of acute abdomen worldwide, and multiple studies have been conducted on the clinical findings pertinent to its prompt diagnosis and the prevention of complications. our objective was the categorization of patients that underwent emergency operation towards identifying factors associated with complications. materials and methods. clinical records of patients operated on at clínica rafael uribe (cali, colombia) in the period july 1 and december 31, 2007, were studied. age, gender, days of symptomatology, number of previous medical consultations, symptoms, operative findings, and complications were recorded. statistical analysis included central trends, analysis of association by odds ratio and logistic regression. results. the population study included 108 patients that underwent emergency operation, the majority women (66.7%). more complications developed in men (55.5%) in the age group 61 to 70 years. pain was the reason for consultation in all patients, and vomiting appeared as the only symptom statistically associated with complications. no relationship was found between the rate of complications and the greater number of previous consultations. discussion. we cannot state that there is relationship between the time period of the present illness, neither with the number of previous consultations and the risk of developing complications of acute cholecystitis. it is recommended that all patients be operated on at the first emergency service visit, and that antibiotic therapy be started on admission because of the high rate of complications in this group of patients
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