Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0008370 (cholestasis)
 9,378 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Technetium 99m-pyridoxylideneglutamate (99mTc-PG) administered intravenously is excreted by hepatocytes into the bile canaliculi and enters the gallbladder through the cystic duct and consequently, can be used for scanning the hepatobiliary ductal system. A total of 166 patients representing 27 normal subjects, 84 patients referred for investigation for pain in the upper right quadrant of the abdomen and 55 jaundiced patients were evaluated with 99mTc-PG. In normal human volunteers, the agent reached the liver in five minutes, and the common bile duct, gallbladder, and duodenum within 15 minutes. Satisfactory images of the hepatobiliary tract were obtained using small dosages of 99mTc-PG. The gallbladder was not visualized when the cystic duct was occluded. In the presence of acute cholecystitis, cystic duct obstruction, or in chronic cholecystitis where other roentgenographic studies showd a nonfunctioning gallbladder, there was no concentration of 99mTc-PG in the gallbladder. In partial common bile duct obstruction is distended common bile duct was visualized along with delay in transit of radioactivity into the duodenum. Complete common bile duct obstruction was associatedwith no radioactivity in either the biliary or the gastrointestinal tracts up to 24 hours after injection. Hepatocellular disease was characterized by delayed liver clearance and delayed visualization of biliary and gastrointestinal tracts. 99mTc-PG scanning proved capable of differentiating between hepatocellular disease and extrahepatic biliary tract obstruction.
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PMID:Hepatobiliary scanning using 99mTc-pyridoxylideneglutamate. 83 70

Liver biopsy was done at the time of operation in 125 consecutive upper abdominal procedures to assess the incidence of unsuspected or undiagnosed hepatic abnormalities. Specifically excluded were hepatic lesions unexpectedly identified at laparotomy. Sixty-seven percent of the liver biopsy specimens were abnormal, the most frequent findings being fatty metamorphosis, cholestasis, triaditis, fibrosis, inflammatory infiltrate, cholangitis, cirrhosis, and hepatitis. The most frequent operation performed was cholecystectomy. In 63 patients with chronic cholecystitis, there was a 51% incidence of abnormal liver histology, while in nine patients with acute cholecystitis, the incidence was 78%. In 83% of all other operations, abnormal liver biopsy specimens were identified. Bile leakage, hemorrhage, and infection did not occur in this series, despite inclusion of patients with severe biliary obstruction, abnormal clotting factors, and intra-abdominal sepsis. New techniques of histochemical enzyme analysis and electron microscopy are expected to enhance the clinical correlation of occult hepatic lesions. We conclude that liver biopsy in a safe, informative adjunct to all upper abdominal procedures.
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PMID:'Routine' liver biopsy in upper abdominal surgery. 88 45

Clinical evaluation of hepatobiliary scanning using 99mTc-PG was done in twenty normal volunteers and eighty-three patients with liver and biliary tract disease. Satisfactory images of the biliary tract were obtained using small dosages of this agent. In normal humans, the agent reached the liver in 5 minutes, and the common bile duct, gallbladder, and duodenum in 10 to 20 minutes. The gallbladder was not visualized when the cystic duct was obstructed in patients with acute and chronic cholecystitis. In patients with partial common bile duct obstruction, a distended duct was visualized and there was delay in transit of radioactivity into the duodenum. With complete common bile duct obstruction, no radioactivity was seen in the biliary or gastrointestinal tracts up to 24 hours after injection. Hepatocellular disease was characterized by delayed liver clearance and delayed visualization of the biliary and gastrointestinal tracts. There were no toxic or other untoward effects in any patients.
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PMID:Clinical evaluation of 99mTc-pyridoxylideneglutamate for hepatobiliary scanning. 99 53

Cholescintigraphy has proven useful in diagnosis of acute and chronic cholecystitis and evaluation of common bile duct obstruction. Common bile duct obstruction may be due to mechanical obstruction such as impact stone in the common duct or functional obstruction due to sepsis with intra-hepatic cholestasis or acute viral hepatitis. We present a cholescintigram of a patient with acute pancreatitis showing complete common bile duct obstruction.
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PMID:Cholescintigraphic demonstration of transient and functional common bile duct obstruction in a patient with acute pancreatitis. 160 Mar 63

It is widely known that narcotics, such as morphine, cause spasm of the sphincter of Oddi, increasing pressure in the common bile duct. This pharmacologic effect has been applied to hepatobiliary scintigraphy in patients with chronic cholecystitis or cholestasis to reducing the time required for a diagnostic study. However, this feature of narcotics could result in delayed or nonvisualization of the small bowel, simulating a distal common bile duct obstruction, in patients requiring parenteral narcotic analgesics who must undergo hepatobiliary scintigraphy. We report on three patients where administration of intravenous naloxone hydrochloride (Narcan), a narcotic antagonist, was helpful in distinguishing narcotic-induced spasm of the sphincter of Oddi from true obstruction of the common bile duct.
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PMID:Naloxone reverses pattern of obstruction of the distal common bile duct induced by analgesic narcotics in hepatobiliary imaging. 167 67

The total activity of lactatedehydrogenase (Merck tests) and its isoenzymes (electrophoretic fractionation by Helm) were studied in the blood sera of 202 patients with various hepato-biliary diseases (viral hepatitis, chronic persisting and chronic active hepatitis, cirrhosis of liver, chronic cholecystitis, benign cholestasis, malignant formations with and without cholestasis, Gilbert's syndrome and hemolytic jaundice). The referent limits are determined in the sera of 43 clinically healthy subjects (22 females and 21 males). The anaerobic fifth fraction of lactatedehydrogenase (LDH) was most increased in viral hepatitis (about 15 times), in the group with malignant formations with cholestasis (about 2 times) and in benign cholestasis (about 5 times). The determination of isoenzymes of LDH, is presumed, to be obligatorily included in the spectrum of modern enzyme constellation for hepatobiliary diseases.
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PMID:[Lactate dehydrogenase isoenzymes in the diagnosis of hepatobiliary diseases]. 653 74

Hepatobiliary scintigraphy as an investigative procedure has a definite role in the investigation of the surgical patient with various biliary problems. As it outlines the functional anatomy of the biliary tract, it has been employed for some time in the diagnosis of acute cholecystitis. In addition, it has a place in the investigation of patients with chronic cholecystitis, common bile duct obstruction and biliary leaks and in evaluating the integrity of biliary bypass procedures.
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PMID:Hepatobiliary scintigraphy in surgical patients. 654 10

Technetium-99m IDA cholescintigraphy has provided a new, noninvasive means of visualizing biliary tract function. It has become the procedure of choice in patients with suspected acute cholecystitis because of its ability to most accurately detect functional obstruction or patency of the cystic duct as opposed to ultrasound's ability to detect only anatomic changes such as the presence of calculi or a thickened gallbladder wall. These latter findings are more important in establishing the diagnosis of chronic cholecystitis where ultrasound shares a position of prime importance with the oral cholecystogram. Tc-99m IDA cholescintigraphy has also been particularly useful in evaluating bile leaks, biliary-enteric anastomosis patency and the post-cholecystectomy patient with recurrent pain. In the patient with cholestasis, ultrasound is usually the procedure of choice since it establishes whether or not ductal dilatation is present and frequently can determine the cause of obstruction. Cholescintigraphy has played an ancillary role in many cases by demonstrating the level of partial obstruction, but it does not have the anatomic resolution to visualize the cause of obstruction. Occasionally, in the evaluation of cholestasis, cholescintigraphy has proven to be the only modality which has identified the presence of acute common duct obstruction or localized intrahepatic ductal obstruction. All in all, Tc-99m IDA cholescintigraphy has had a dramatic impact upon hepatobiliary diagnosis.
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PMID:Role of 99mTc-IDA cholescintigraphy in evaluating biliary tract disorders. 699 26

A prospective computed tomography (CT) study of a group of patients suspected of having gallbladder disease was performed. Ten patients were evaluated who had gallbladder nonvisualization on two consecutive oral contrast medium administrations. Evaluation of the gallbladder and common bile duct by CT disclosed specific abnormalities including gallstones, unsuspected common bile duct obstruction, and acute and chronic cholecystitis. Additional information on the physiologic processes involved in gallbladder nonvisualization is offered.
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PMID:Computed tomography of the nonvisualizing gallbladder. 721 39

Although cholecystectomy is routinely performed as a part of treatment for gallstone pancreatitis, detailed histopathologic features of the gallbladder have not been described. In this study, the pathologic findings of 53 gallbladders from patients with clinical and laboratory evidence of gallstone pancreatitis are described. The presence of intraepithelial neutrophilic aggregates, a histologic finding associated with common bile duct obstruction, was identified in 32 (60.4%) cholecystectomy specimens and was the most common pathologic findings. Changes of acute cholecystitis and chronic cholecystitis were found in 15 (28.3%) and 6 (11.3%) gallbladders, respectively. Fat necrosis, which is characteristically associated with acute pancreatitis, was the most specific histologic change, but it was seen in the adventitia of only four gallbladders. The similarities of pathologic findings in gallstone pancreatitis and common bile duct obstruction emphasize the role of choledocholithiasis in the pathogenesis of pancreatitis associated with cholelithiasis.
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PMID:Pathology of the gallbladder in gallstone pancreatitis. 772 28


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