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

Eight patients have been admitted with gallstone ileus (GSI) to the Herning Central Hospital during the period 1960--1977. All of the patients were subjected to enterolithotomy only. One patient died postoperatively. On follow-up examination 6 months to 11 1/2 years after operation, one patient complained of a recurrence of cholecystitis, but refused operation. The other patients had no biliary tract complaints. We still consider, due to the above, that enterolithotomy alone is a sufficient primary procedure, and that only in cases of new biliary tract complaints can cholecystectomy and closure of an eventual fistula be considered.
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PMID:Gallstone ileus. A retrospective study. 46 37

Gastrointestinal complications developed in 29 (6%) of 510 patients following renal transplantation. Thirteen patients (45%) died as a result. Gastrointestinal bleeding, usually considered the commonest complication, was seen in only 7 cases. Other complications included pancreatitis and hyperamylasemia, massive ileus, fistulas with abscesses, bowel infarction, peptic ulcers without bleeding, obstruction, gangrenous cholecystitis, esophagitis, spontaneous perforation of the sigmoid colon, and pneumatosis cystoides intestinalis. Six patients had no clinical or laboratory findings suggesting the underlying gastrointestinal complication; it was the radiographic findings that called attention to the acute problem.
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PMID:Gastrointestinal complications following renal transplantation. 109 14

Cholecystoenteric fistulas, not associated with gallstone ileus syndrome, are relatively common complications occurring during the natural history of cholelithiasis and cholecystitis. The etiology, pathogenesis as well as common and uncommon forms of gallbladder fistulas are presented and discussed. The roentgenographic findings are reviewed and a simple classification into two major groups is offered. The majority are acute, transitory, short-lived fistulas, which are self-limiting and relatively common events that usually remain undiagnosed. A minority fail to heal, become chronic and permanent fistulas and are associated with obstruction of the common duct.
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PMID:Cholecystoenteric fistulas:s ignificance and radiographic diagnosis. 127 47

Gallstone ileus is an uncommon but severe complication of cholecystitis, which can only occur following perforation of the gallbladder and formation of a cholecystoenteric fistula. The diagnosis can be established by means of abdominal plain film when the classic triad described by Rigler (small-bowel obstruction, ectopic gallstone and pneumobilia) is observed. A patient with abdominal obstruction and equivocal findings on plain film X-ray and abdominal sonography is presented, in whom the gallstone ileus was reliably diagnosed by CT.
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PMID:[A cholecysto-enteric fistula with a gallstone ileus diagnosed by CT]. 156 93

Melanoma frequently disseminates to the gastrointestinal tract, being found post-mortem in 60 per cent of patients with disseminated disease, while during life it is diagnosed in only 4 per cent. During the period 1981-87, 835 melanoma patients were referred and 30 developed complaints caused by gastrointestinal metastatic melanoma. Twenty-three patients were treated surgically. The interval between treatment of the primary melanoma and detection of intestinal involvement was a median of 34 months (range 2-87 months). In four patients recurrence in the gut was the first evidence of dissemination. Major complaints were nausea and vomiting, abdominal pain, signs of anaemia, and blood in the stools. Complications were bleeding (ten cases), ileus due to intussusception (five cases), bowel perforation (four cases) and cholecystitis (one case). The metastases, mainly localized in the small bowel, were removed by relatively simple procedures. Symptoms were reduced in 19 patients. Two patients died after operation: one from sepsis due to suture leakage, the other from pneumonia and a cerebrovascular accident. Of the remaining patients, 16 survived a median of 7.5 (range 0.7-32.0) months. Five patients are still alive 72, 72, 70, 7 and 2 months after the metastasectomy, three of whom are tumour-free. The actuarial 5-year survival of all patients is 19 per cent. These results support surgical intervention for patients with complaints and/or complications attributable to gastrointestinal metastatic melanoma.
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PMID:Surgery for melanoma metastatic to the gastrointestinal tract. 168 96

The authors discuss 25 patients with gallstone ileus, which is a quite frequently encountered complication of cholelithiasis and is recorded in 0.64% of patient who underwent operation for calculous cholecystitis. The diagnosis and treatment of this complication have some specific features whose knowledge is extremely important in rendering emergency surgical care. Better results can be achieved by a timely and adequate diagnosis, individual choice of the operative method, and subsequent follow-up of the patients who were operated on. Regular medical examination and planned preventive treatment of patients with cholelithiasis are the main trends in the prophylaxis of this disease. Postoperative mortality was 24%.
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PMID:[Gallstone ileus]. 177 52

Laparoscopic cholecystectomy is a minimally invasive procedure whereby the gallbladder is removed using laparoscopic techniques. The indications are similar to those for elective traditional cholecystectomy, but selection of patients is important for success. Contraindications are currently evolving. Patients with advanced cholecystitis, abdominal sepsis, ileus, bleeding disorders, pregnancy, and morbid obesity should not undergo this procedure. The procedure requires good traditional surgical skills, as well as additional laparoscopic (and laser) skills. Operative time is slightly longer than for traditional cholecystectomy, but decreases with experience. Morbidity is low, but there is a concern about bile duct injuries. Mortality is very low (0%) and is comparable to traditional cholecystectomy (0.4%). The major advantages of laparoscopic cholecystectomy are the short hospital stay (average: 2 days) and early return to normal activity (7 days). This results in a reduction in hospital costs. Adequate training and credentialing are important processes to foster good patient outcomes.
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PMID:Traditional versus laparoscopic cholecystectomy. 182 53

Six cases of lung cancer combined with the disease which has needed semi-emergency operation, two cases of unstable angina, two of ileus due to colon cancer, one of impending rupture of abdominal aortic aneurysm and one of purulent cholecystitis with cholelithiasis, were discussed. Mean age was 62.0 years (range, 36 to 73); four were male and two were female. Case 1 and 2 were admitted with anterior chest pain, Case 3 with lumbago and abdominal pain, Case 4 and 5 with an abnormal shadow on chest x-ray film and Case 6 with abdominal pain. Of the two with unstable angina, one was operated on with right upper lobectomy during the first months after aorto-coronary bypass. Of the two with colon cancer, one was operated on with right upper lobectomy during about 5 weeks after right hemi-colectomy. Case 3 with abdominal aortic aneurysm operated on with left upper lobectomy during 4 weeks after replacement of abdominal aorta. Case 4 with cholecystitis was operated on with left pneumonectomy during about 3 weeks after cholecystectomy. The postoperative course of 4 cases and the post-chemotherapy condition of 2 cases were uneventful.
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PMID:[Evaluation of treatment of lung cancer combined with the disease which has needed a semi-emergency operation]. 188 16

With the advent of cyclosporine A, heart transplantation has become a widely accepted treatment for patients with end-stage cardiac disease that is not amenable to medical or surgical treatment. Between July 1982 and December 1985, 86 heart transplantations were performed at the Texas Heart Institute with cyclosporine A and prednisone used for immunosuppression. Thirty patients had complications requiring general surgical consultation. The pancreas and biliary tracts were most commonly affected. Pancreatitis developed in sixteen patients; five patients required operative intervention, resulting in a 40% mortality rate. Five of nine patients with cholecystitis required cholecystectomy. All patients survived the procedures. Other gastrointestinal complications included colonic ileus, bowel perforation, gastrointestinal bleeding, gastric outlet obstruction, and perirectal abscess. Patients who have undergone cardiac transplantation are susceptible to life-threatening infections and are at risk of serious complications requiring general surgical intervention. Better results can be obtained in these complex clinical situations when complications are identified early and managed aggressively through the adjustment of immunosuppression, adequate selection of antimicrobial agents, and proper timing of surgical intervention.
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PMID:Complications in cardiac transplant patients requiring general surgery. 327 29

From 1975 to 1985, a total of 1596 coronary artery bypasses or valve replacements resulted in 18 gastrointestinal tract complications in 16 patients at Good Samaritan Hospital in Cincinnati. Twelve patients were treated surgically (hemorrhagic duodenal ulcer, one patient; perforated duodenal ulcer, one patient; cholecystitis: acalculous, gangrenous, two patients, and calculus, one patient; perforated cecum, one patient; ischemic colitis, one patient; and perforated diverticulitis of the colon, five patients). Six patients were treated conservatively by either nasogastric intubation or nothing by mouth and intravenous therapy (ileus, three patients; acute sigmoid diverticulitis, one patient; and active peptic ulcer disease, two patients). Multisystem failure caused two deaths. The etiology of hollow viscus complications seems to be related to a low-flow state, impairing normal tissue perfusion that can initiate an ischemic change. This change can lead to acute inflammation, perforation, or both or late stricture. When evidence of an acute abdominal disorder is observed or when conservative treatment falls to alleviate symptoms, prompt surgical intervention should be performed.
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PMID:Gastrointestinal complications after cardiac surgery. 349 Feb 46


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