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

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

Normal human peritoneal cells (PC) collected from patients with calculous cholecystitis without clinically detectable inflammatory changes were characterized morphologically, histochemically and phenotypically by means of monoclonal antibodies. The PC consisted of 45% of monocytes/macrophages (M718 + cells). Thirty-five per cent of PC were esterase-positive and 23% acid phosphatase positive. Forty-five per cent of PC adhered to glass surface. In the lymphocyte population, 2% of CD22 B lymphocytes (M738 +) and 42% CD2 T lymphocytes (M720+) were found. CD4/CD8 ratio was 0.4. There were 8% of Leu7 + cells. The PC did not reveal interleukin 2 (OKT26a +) and transferrin receptors (OKT9 +) on their surface. No blast cells were detected in the PC suspension. Approximately 49% of the PC expressed Ia antigens (OKIa1 +). Two per cent of S100 positive dendritic cells (Z311 +) were found. Peritoneal fluid contained 9% of granulocytes, mostly neutrophils. Two per cent of PC were free mesothelial cells (M717 +). We conclude that human peritoneal cavity contains a cell population significantly differing from that which is present in peripheral blood, which strongly suggests a non-random cell accumulation in the peritoneum. Lack of any activated cells indicates that under normal conditions the peritoneum lavage fluid contains a steady-state population. We conclude that the normal peritoneal fluid cells represent a heterogeneous population capable of reacting to various antigens entering the cavity from the gut.
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PMID:Normal human immune peritoneal cells: phenotypic characteristics. 269 25

Bile reflux may occur after a variety of reconstructive procedures in the gastro-intestinal tract and biliary system. The present paper deals with reflux into the duodenum, jejunum, stomach, oesophagus and into blind loops. The demonstration of reflux by 99mTc labelled IDA acid derivatives, and a possible quantitative approach, are discussed. The advantages of an isotope method are: 1. Direct demonstration of bile reflux without any intervention in the physiological process and with little trouble to the patient, 2. The ability to use the method for various reconstructive procedures and 3. The additional information obtained which may help in the differential diagnosis of blind loops, biliary obstructions, cholecystitis or liver metastases if there has been a gastrectomy for a malignant tumour. In combination with a second administration of a radio-isotope tracer, one may be able to demonstrate abnormalities in the motility of the stomach or gut, or pyloric stenosis or gastro-oesophageal reflux.
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PMID:[Scintigraphic image of bile reflux following gastric and intestinal surgery]. 640 29

Acute cholecystitis is initially a chemical inflammation, but regularly complicated by bacterial invasion from the gut. Escherichia coli, Klebsiella and Streptococcus faecalis dominate among aerobic bacteria, whereas Bacteroides fragilis and clostridia are commonly encountered anaerobes. Mixed infections are prevalent. Bactibilia occurs in at least 60% of the early stage of acute cholecystitis and is particularly prevalent in the elderly. Also, bactibilia is very common in recurrent cholecystitis. A close connection is found between the presence of bactibilia and infectious complications. Although antimicrobial treatment does not sterilize the bile of an obstructed gall bladder, most authors favour such treatment in cases of febrile cholecystitis, particularly in the elderly, in order to prevent septic complications. Various regimens of preoperative antimicrobial prophylaxis have significantly reduced the infectious complications, in spite of persistent bactibilia. Prophylactic courses should not exceed one or two days, one single preoperative dose is probably adequate. The choice of antimicrobial drugs for prophylaxis varies with local experience and patterns of bacterial resistance. A combination of broad spectred betalactam antibiotics and nitroimidazole would generally seem to provide an appropriate and atoxic coverage.
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PMID:Cholecystitis--etiology and treatment--microbiological aspects. 661 Sep 21

Abdominal ultrasonography in acute conditions gives sometimes the definite diagnosis or at least indicates a strategy for further examinations. This technique is constantly accurate for the upper part of the abdomen, and its classical indications are dominated by cholecystitis, biliary and urinary lithiasis, pancreatic and aortic painful circumstances. However, its role has been emphasized recently, after famous publications about the usefulness of high resolution ultrasonography for appendicitis and various gut-related acute conditions. The efficacity of abdominal ultrasonography is enhanced by color-doppler and power-doppler, to characterize some inflammatory or ischemic diseases. For the pelvis, endocavitary examination is a "must" for studying uterus and adnexae. The main drawbacks of abdominal ultrasonography are well known: its physical limitations and mainly its operator-dependence.
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PMID:Acute abdomen. Is ultrasonography useful, essential or unnecessary? 890 58

Acute acalculous cholecystitis (AAC) is marked by a very high mortality rate but its relative rarity makes its features obscure to many physicians. This often contributes to a delayed diagnosis. In this study, we review one center's experience, examine the clinical features of the disorder, and describe the progression of pathological events that culminate in AAC. We performed a 10-year retrospective review of cases of AAC reported at our institution between 1988 and 1998. Fifteen cases of AAC were identified from this period, during which 5804 cardiovascular operations were performed. The mortality rate was 46.6%. Multiple organ failure was present in 12 of the 15 cases, and 9 of the patients were over 60 years of age. Prolonged hypotension occurred in 13 patients, and fever in all 15. Nine cases of gangrenous gallbladder occurred. Gram-negative septicemia was present in 12. Visceral arterial hypoperfusion was frequently evident at operation or necropsy. Thirteen patients showed clinical jaundice, a disproportionate elevation of the alkaline phosphatase, or both. Heart failure was found in 9 patients. Open cholecystectomy was most often the definitive intervention. Arterial hypoperfusion of the gut and or sepsis appear central to the pathogenesis of AAC in our series. Gallbladder inflammation and cholestasis result and bacterial invasion of the organ ensues, culminating in AAC, frequently with gangrene. A model of the pathogenesis of AAC is discussed.
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PMID:Acute acalculous cholecystitis associated with systemic sepsis and visceral arterial hypoperfusion: a case series and review of pathophysiology. 1462 41

In childhood, almost all swallowed objects that successfully navigate the esophagus pass through the gut without complications. In a 15-year-old male adolescent with the initial working diagnosis of acalculous cholecystitis, computed tomography revealed a thickened wall of the second duodenal portion, some infiltration of the periduodenal tissue, and a hyperdense needle-shape structure probably passing through the duodenal wall. Endoscopy revealed a wooden toothpick perforating the duodenum that was carefully retracted. An uneventful recovery followed the endoscopic removal of the foreign body. A computer-based search of the literature to examine the injuries caused by ingested toothpicks since 1960 found only 4 reports in 5 children.
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PMID:Toothpick ingestion causing duodenal perforation. 2062 31

Pneumobilia denotes an abnormal connection between the gastrointestinal and the biliary tracts. In the absence of surgically created anastomosis between the bowel and the bile duct, the common causes for pneumobilia are gallstone obstruction, endoscopic interventions or emphysematous cholecystitis. We present the case of a young male with traumatic pneumobilia with gastric perforation and a tear in the mesentery of the small gut following penetrating trauma in the form of stab in the abdomen.
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PMID:Pneumobilia After Penetrating Trauma Abdominal Wall with no Injury to the Biliary Tree- A Case Report. 2442 38

Colorectal cancer is one of the most common cancer worldwide .Its incidence is reported to be increasing in developing countries. It commonly presents with weight loss, anaemia, lump abdomen, change of bowel habit, obstruction or fresh rectal bleeding. Beside these common modes of presentations, there are some rare manifestations which masqueraded as different disease like obstructive jaundice, empyema gall bladder or cholecystitis. A 60-year-old male presented to hospital with right sided pain abdomen. On abdominal examination mild tenderness was present in right hypochondrium. Intra operatively gall bladder was separated from the adjoining gut, peritoneum and liver bed and was removed. On further exploration, there was a large mass in the vicinity of the gall bladder related to transverse colon. Extended right hemicolectomy was done. Histopathological examination of gut mass revealed adenocarcinoma of transverse colon with free margins and gall bladder showed cholecystitis with no evidence of malignancy. We present an interesting case of colon cancer colon that caused diagnostic confusion by mimicking as cholecystitis. Colorectal cancer constitutes a major public health issue globally. Therefore, public awareness, screening of high-risk populations, early diagnosis and effective treatment and follow-up will help to reduce its occurance and further complications.
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PMID:Carcinoma transverse colon masquerading as carcinoma gall bladder. 2477 45

Surgical complications of typhoid fever usually involve the small gut, but infrequently typhoid fever also involves the gallbladder. Complications range from acalculous cholecystitis, gangrene to perforation. Here, we present a case of enteric fever with concomitant complication of multiple ileal perforations at its terminal part with acalculous cholecystistis with gangrenous gall bladder. The primary closure of the perforations and cholecystectomy was performed. Post-operatively patient developed low-output faecal fistula that was managed conservatively.
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PMID:Multiple ileal perforations and concomitant cholecystitis with gall bladder gangrene as complication of typhoid fever. 2503 1


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