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

The effectiveness of ultrasound, computed tomography, hepatobiliary scintigraphy and nuclear magnetic resonance in diseases of the biliary tract is described. Ultrasound should be the first examination in clinical suspicion of cholelithiasis and has a higher accuracy than oral cholecystography. Computed tomography is very expensive and should be carried out in suspected gallbladder carcinoma, cholecystitis with abscess formation, tumour in the porta hepatis and pancreatic head and in sonographically unclear cases. Nuclear magnetic resonance can determine the ability of the gallbladder to concentrate bile. Ultrasound can distinguish with high accuracy between obstructive and inflammatory jaundice. In clinical suspicion of bile duct lesions an infusion cholangiogram must be carried out, if bilirubin is lower than 5 mg%; if bilirubin is higher, an ERC or PTC should be performed. If in biliary obstruction a suspicion of tumour in porta hepatis or head of the pancreas is present, computed tomography should be effected.
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PMID:[Value of sonography, computer tomography, hepatobiliary scintigraphy and nuclear magnetic tomography in diseases of the gallbladder and bile ducts]. 638 72

It is reported on 5 patients with Mirizzi syndrome. This syndrome is defined by the trias "chronic cholecystitis, cholelithiasis and benign stenosis of the hepatic duct with jaundice". The biliobiliary fistulas are the more severe forms of this syndrome. There is no typical anamnesis. The diagnosis can be assumed by sonography or computed tomography. A biliobiliary fistula can be demonstrated by direct cholangiography (ERC or PTC). The malignant tumor of the gallbladder or the bile duct is a difficult differential diagnosis. The cholecystectomia simplex is the therapy of choice in the uncomplicated Mirizzi syndrome. In case of a biliobiliary fistula one should try to close the defect of the hepatic duct with a "cuff of the gallbladder". If this procedure is technically impossible, several methods of biliodigestive anastomosis can be chosen.
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PMID:[Mirizzi syndrome: anamnesis, diagnosis and therapy based on 5 cases]. 639 29

The authors report a case of massive hematobilia due to hemorrhagic cholecystitis. Hematobilia is a rare pathology which affects the biliary tract and gallbladder. The first authors to describe hematobilia defined it as a hemorrhage of the gastroenteric tract due to the communication of blood vessels with the intra and extra-hepatic biliary tract and in some rare cases to the communication of the branches of the cystic artery within the gallbladder wall. Sandblom, in particular, specified that bleeding must be within the biliary tract and not secondary to an enterobiliary fistula. In 55% of cases the pathogenesis of hematobilia is traumatic, whereas in the remaining 45% the cause may be attributed to a variety of pathologies. Trauma include both non-surgical and surgical traumas; in the first group the most frequent cause is hepatic trauma, although it is worth taking into account the presence of post-traumatic arteriobiliary fistulas, lesions of arterial vessel walls with subsequent necrosis and rupture within the biliary vessels. Surgical traumas comprise lesions caused by therapeutic or diagnostic transparenchymal manoeuvres (PTC, biopsy). Non-traumatic causes include pathologies of vascular, cholecystic, inflammatory-infective and neoplastic origin. Symptoms are varied and take the form of anemia, massive bleeding with the onset of jaundice and pain in the hypochondrium and sometimes the epigastrium, whereas enterorrhagia is manifested by melena and more rarely hematemesis. The diagnosis must be made as quickly as possible; mortality increases with the delay in controlling hemorrhage. Differential diagnosis must take into account other causes of enterorrhagia, obstructive jaundice and anemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Massive hemobilia caused by necrotic hemorrhagic cholecystitis. Report of a case]. 824 99