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Query: UMLS:C0008325 (cholecystitis)
 3,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report on the case of a 44-year-old female patient as well as a 51-year-old male patient, who were taken to hospital with abdominal complaint of unknown origin. The symptoms in the case of the female patient suggested cholecystitis, whereas in the case of the male patient chronic pancreatitis. Following detailed examinations the authors have explored nutritional lead poisoning of a married couple. Within a short time--after Ca-EDTA treatment--they have become free of complaint. After a survey of the literature the authors analyse the diagnostic possibilities of the patients with the symptoms of abdominal colic pain and the way to the diagnosis, respectively.
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PMID:[Nutritional lead poisoning--a differential diagnostic problem in abdominal pain]. 776 Oct 76

Difficulties of examining the external secretion of the pancreas by direct secretin-pancreozymin test prompted us to try 4 probe-free methods for functional assessment of the pancreas in 33 patients with chronic acalculous cholecystitis, 50 patients with reactive pancreatitis concomitant with duodenal ulcer, chronic duodenal obstruction, etc., and in 22 patients with primary chronic pancreatitis during a relapse. The Benda-Zheltvai method with assessment of the debit of uric excretion of alpha-amylase during three 30-min intervals before and after standard food loading and calculation of the pancreozymin induction coefficient, assessment of the ratio of alpha-amylase and creatinine clearance from their content in the urine, the proserine provocation urotest, and Lasus test for hyperaminoaciduria resultant from exocrine insufficiency of the pancreas were used. The Benda-Zheltvai method proved to be a sensitive and specific test for the diagnosis of exocrine insufficiency of the pancreas; moreover, it can be used for assessing the treatment efficacy. The proserine test helps assess the type and severity of disorders of pancreatic external secretion. The ratio of alpha-amylase to creatinine clearance demonstrates just the most expressed disorders of pancreatic exocrine secretion during the relapse of primary chronic pancreatitis. Lasus test for hyperaminoaciduria detects pancreatic dyscrinia and provides valuable information about the function of the pancreas.
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PMID:[Diagnostic evaluation of tubeless methods in the study of external secretions of the pancreas]. 937 19

Up to present time there is no common view on the role of diverticuli of the papillar region of the duodenum (DPRD) in development of the strictures of terminal parts of the common bile duct and major pancreatic duct. The main method for the diagnosis of DPRD is fibroduodenoscopy (FDS). Relaxational FDS is the most informative method for detailed examination of diverticulum and for assessment of its interrelations with longitudinal crease and the major duodenal papilla (MDP). During the last 2 years all patients with DPRD underwent ERCPG, which helped to obtain more complete information of the presence and the character of the strictures of terminal parts of the common bile duct and the pancreatic duct. DPR has been revealed in 5% of patients with calculous cholecystitis and in 9.5% of patients with choledocholithiasis. Of the patients, admitted to the Institute for postcholecystectomy syndrome from 1994 to 1999, DPRD were revealed in 30% of cases. The patients with DPR and chronic pancreatitis of nonalcoholic and nonlithogenic etiology, made up 9% of all patients with DPR and chronic pancreatitis. In 87 patients with DPR, suffering from various surgical diseases, following changes of bile and pancreatic ducts were revealed: choledocholithiasis (47%), stenosis of the large bile duct (15%), strictures of terminal parts of the large bile duct and major pancreatic duct (10%). There is evidence, that para- and peripapillary diverticuli deteriorate evacuatory function of the bile and pancreatic tracts due to compression of terminal parts of the choledochus and the pancreatic ducts with strictures formation, which promote disturbances of the bile and pancreatic juice passage. Biliary stasis and pancreatic juice passage disturbances create favorable conditions for lithogenesis and promote development of cholangitis, mechanical jaundice and chronic pancreatitis. Patients with choledochal and major pancreatic duct strictures and stenoses of the papilla in DPR underwent EPST with favorable initial and long-term results. The authors suggest, that DPR are an important etiopathogenetic link in the development of many diseases of the organs of hepatobiliary region, associated with biliary and pancreatic hypertension.
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PMID:[Diverticuli of duodenal papillar region and their role in development of choledocholithiasis and strictures of bile and pancreatic ducts]. 1076 74

138 patients with chronic papillooditis were investigated, 15 of them in a stage of decompensation. In 83.3% of the cases, the diagnosis was not clinically determined (including 68 of 92 endoscoped before their hospitalization--82.9%). 34 patients were diagnosed as having chronic gastroduodenitis, 15--ulcer, 42--chronic cholecystitis, 11--chronic pancreatitis, 4--cholangitis, 9--postcholecystectomic status. All these diseases developed simultaneously with the papillitis. In a second endoscopic check-up with an examination of papilla Vateri, the patients were in all the cases diagnosed without difficulties and the diagnose was confirmed by biopsy. In 21 patients there was confirmed primary papillooditis and in 127--accompanying disorders: chr. gastroduodenitis--29, chr. atrophic gastritis--18, ulcer--15, chr. cholecystitis--42, postcholecystectomic status--9, choledocholithiasis--14, chr. pancreatitis--11. Most often misdiagnosis occurs if: 1) during the routine endoscopic investigation the endoscopist does not examine papilla of Vater; 2) chr. papillitis exists simultaneously with one of the already mentioned diseases that are easier of approach for diagnostics and explanation of the disorders; 3) the clinical picture of papillitis cannot be differentiated from the one of the basic or accompanying disease; 4) the bile drainage is not prevented; 5) the result of the venous biligraphy does not lead to the diagnosis and ERCP is carried out only in a case of a clinical suspicion.
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PMID:[Clinical difficulties and errors in making a diagnosis of chronic papillo-odditis]. 1098 69

We report 2 patients with an unusual form of chronic pancreatitis, both of whom were treated for clinical suspicion of pancreatic malignancy. The surgical specimens revealed a dense lymphoplasmacytic infiltration of the main and interlobular branches of the pancreatic duct, causing sclerosis of the duct wall, diffuse irregular lumenal narrowing, extensive parenchymal fibrosis, and organ enlargement. Neither case showed calcifications, fat necrosis, or cyst formation, features usually seen in alcoholic pancreatitis, nor was there any evidence of neoplasia. One patient had an unusual form of acalculous cholecystitis, but without cystic duct inflammation or fibrosis. Both patients recovered well from the surgical procedure and have not had any complications or relapse of their symptoms. To the best of our knowledge, these cases are representative of the recently described non-alcoholic duct destructive chronic pancreatitis, which is thought to be immune-mediated.
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PMID:The characteristic appearance of non-alcoholic duct destructive chronic pancreatitis: a report of 2 cases. 1103 92

The authors evaluated the results assembled in 5397 patients where between Jan. 1 1999 and Oct. 31 2000 sonographic examinations of the abdominal cavity and retroperitoneum were made with the objective to assess whether there are any statistically significant differences of results in diabetic patients, as compared with a group without this disease. The group of patients was divided into a sub-group of 4287 patients without diabetes and a sub-group of 1100 diabetics. For statistical evaluation of the significance of differences in the incidence of the investigated parameters Fisher's exact test was used. The image of "light liver" was significantly more frequent in diabetics type 1 and 2, as compared with non-diabetics (p < 0.001). The sonographic picture, consistent with the diagnosis of cirrhosis of the liver, was at the same level of significance more frequent in non-diabetics, similarly as the incidence of haemangioma. The finding of cholecystolithiasis and the number of patients with a history of CHCE on account of cholecysolithiasis was significantly higher (p < 0.05) only in type 1 diabetics as compared with non-diabetics. The incidence of sonographic changes consistent with acalculous cholecystitis was statistically higher in both groups of diabetics (p < 0.001), as compared with non-diabetics. On examination of the pancreas only the incidence of changes consistent with acute or chronic pancreatitis was significantly higher (p < 0.05) in the group of type 2 diabetics as compared with non-diabetics. Evaluation of sonographic findings of the kidneys revealed statistically significant differences only in the higher incidence of cysts in the group of type 2 diabetics as compared with type 1 diabetics and as compared with non-diabetics (p < 0.01). The impact of the presented findings and their comparison with data reported in the literature is discussed.
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PMID:[Are ultrasonic images in diabetics different?]. 1139 78

The purpose of this study was to evaluate the computed tomography (CT) and magnetic resonance imaging (MRI) features of juxtapapillary diverticulum. CT and/or MRI examinations of 12 patients were evaluated. The size, location of the diverticula and imaging findings of associated pancreaticobiliary disease were assessed. On CT, oral contrast air level was the characteristic imaging feature. On MRI, T2-weighted images demonstrated the air fluid level with hyperintense fluid and signal void air level above. Associated imaging findings were dilated common bile duct (CBD), cholecystitis, cholecystolithiasis and chronic pancreatitis.
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PMID:Juxtapapillary diverticulum: findings on CT and MRI. 1263 72

A duodenum-preserving pancreatic head resection technique was first reported in 1980, but the indications have been limited to benign pancreatic disease as it involves a subtotal pancreatic head resection. In 1988 we detailed a duodenum-preserving total pancreatic head resection (DPTPHR) technique. This procedure involved a total pancreatic head resection and as such expanded the indications for this approach to include tumorigenic masses. The original method involved closure of the proximal pancreatic duct and an anastomosis of the pancreatic duct of the distal pancreas to a newly created small hole in the duodenum (we termed this a "pancreatoduodenostomy"). Our current technique involves a duct-to-duct anastomosis of the proximal pancreatic duct and the distal pancreas to better preserve anatomic structure. DPTPHR was performed in 26 patients from 1988 to 2002, including 12 cases of DPTPHR with pancreatoduodenostomy and 14 cases of DPTPHR with pancreatic duct-to-duct anastomosis. No differences were observed between the two methods with respect to operative time or blood loss during surgery. Postoperatively, there was one case of cholecystitis and one case of pancreatitis in a patient who underwent a pancreatoduodenostomy; both of these patients were treated conservatively with curative intent. No complications were observed in the group undergoing duct-to-duct anastomosis. The advantage of duct-to-duct anastomosis is that the pancreatic head is totally resected, thus allowing removal of neoplastic disease such as an intraductal papillary mucinous tumor and also therapy for chronic pancreatitis. A key benefit of this procedure is that sphincter function of the duodenal papilla is preserved permitting drainage of pancreatic/bile juice into the duodenum, preserving a more physiologic state than is the case after a pancreatoduodenostomy.
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PMID:A duodenum-preserving and bile duct-preserving total pancreatic head resection with associated pancreatic duct-to-duct anastomosis. 1503

The authors present case of patient with biliary stent dislocation after chest injury and fracture of VIII. rib. Polymorbid patient with cirrhosis, chronic pancreatitis, portal hypertension (Child Plugh B) and biliary stent insertion came with acute abdominal pain and inflammatory signs. Progressive signs of acute abdomen have led to laparotomy. Perforation of duodeno-jejunal-loop due to dislocated biliary stent, small loop adhesions and thickened intestine wall were found. Postsurgical period was complicated with obstructive ileus, cholecystitis and cholangiolitis and the second biliary stent was inserted. Present-day status of the patient is satisfactory.
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PMID:[Jejunal perforation by a plastic biliary stent after injury]. 1508 18

This is the case of a 32-year-old male patient, diagnosed with end stage renal disease secondary to a focal and segmental glomerulonephritis. After four years of haemodialysis, he received a renal graft from a cadaveric donor. During the following sixteen years, he developped many different complications. In the early post-transplant period, he developed a severe acute tubular necrosis and two episodes of acute rejection took place, both of them with later recovery. Among the outstanding infectious complications were a virus herpes zoster dorsal infection and a Pseudomonas aeruginosa nosocomial pneumonia. Twelve months later, a series of severe digestive complications took place: cholecystitis that required cholecystectomy, pancreatic pseudocyst which required laparotomy because of an abdominal complication, two separate episodes of upper digestive bleeding that finally required gastric surgery, and an hemorrhagic subphrenic abscess that required a second laparotomy. Currently he has developed a calcified chronic pancreatitis. Moreover, metabolic complications must be mentioned carbohydrate intolerance, cataracts and an avascular bone necrosis, all of them closely related to the immunosuppressive therapy. In spite of these multiple complications, he mantains a good renal function and his quality of life is acceptable.
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PMID:[Multiple complications after renal transplantation]. 1521 64


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