Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nineteen cases (male 6, female 13) of acute obstructive suppurative cholangitis (AOSC) were divided into 2 groups and were studied, Group A; over 70 yrs old (12), Group B; under 70 yrs old (7). The most frequent etiology of AOSC was choledocholithiasis (Group A 75%, Group B 43%). Urgent biliary drainage was performed in 18 cases, and which were clinically improved. The decreasing rate of bilirubin were fair in both groups and only 2 cases in Group A were dead. Concerning with the laboratory findings on admission, Group A had a higher level of BUN than Group B, and there were no other significant differences. Complications were frequently occurred in Group A (Shock 83%, DIC 83%, Renal failure 42%). The diameter of choledochus at biliary drainage was below 9 mm in 45% of cases in Group A, which implied the rapid progression to AOSC from the onset of biliary obstruction. Early diagnosis and urgent biliary drainage were essential for the management of AOSC in the old age.
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PMID:[Clinical features of acute obstructive suppurative cholangitis (AOSC) in the old age]. 157 7

We investigated the 58 cases of cholecystolithiasis including 8 cases of choledocholithiasis treated with laparoscopic cholecystectomy. All patients received spiral CT scanning with drip infusion cholangiography (DIC-SCT), and 1.6 patients received endoscopic retrograde cholangiography (ERC), and the detection rates of the gallbladder, the bile duct and the cystic duct were compared. The gallbladder could be seen in 86.2% of cases with DIC-SCT and in 63.8% of cases with conventional DIC. The junction between the cystic duct and the common bile duct could be seen in 18 of 58 cases with DIC and in 49 of 58 cases with DIC-SCT. The DIC-SCT showed significantly superior anatomical details compared with images with conventional DIC. A comparison of DIC, ERC and DIC-SCT revealed that the junction between the cystic duct and the common bile duct could be identified in 14 of 16 cases undergoing ERC, in 13 of 16 cases receiving DIC-SCT and in 4 of 16 cases receiving DIC. Significant differences were noted among DIC-SCT, ERC and conventional DIC. We concluded that DIC-SCT is easy, non-invasive and useful for the preoperative assessment of laparoscopic cholecystectomy and also helpful for avoiding damage to the bile duct.
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PMID:[Computed tomography with continuous transport and continuous scanner rotation for laparoscopic cholecystectomy]. 759 42

An autopsy case of pseudosarcoma in the common bile duct is reported. An 82-year-old Japanese male complaining of jaundice was admitted to our hospital; he was examined by abdominal ultrasonography (US), revealing biliary calculus, dilatation of the common bile duct, and choledocholithiasis, considered to be the possible cause of the obstructive jaundice. Endoscopic retrograde biliary drainage (ERBD) and cholangioscopy were performed concurrently, revealing a vaguely whitish tumor near the papilla of Vater. Two months later, the patient died from complications of the liver, infection, and disseminated intravascular coagulation (DIC). An autopsy study revealed tumor cells with extreme pleomorphic changes, growing diffusely, very like sarcoma. Further examination revealed epithelioid arrangements in the metastatic lymph node. Twelve kinds of immunohistochemical examination showed a positive reaction, reflecting the presence of an epithelioid cytoskeleton. Of 28 cases of true and pseudosarcoma of the biliary system reported in the Japanese literature, only 1 case was reported, in 1990, to involve the common bile duct. We therefore report the present case of pseudosarcoma of the common bile duct.
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PMID:An autopsy case of pseudosarcoma of the common bile duct. 795 67

Non-operative methods to treat obstructive jaundice and cholangitis caused by cholelithiasis are endoscopic and percutaneous biliary drainage. Usually, endoscopic papillotomy and stone removal by basket catheter is available for treating choledocholithiasis. It is necessary to place a drainage catheter into the bile duct in patients who have severe cholangitis or remaining stones. On the other hand, percutaneous biliary drainage is useful in case of emergency and in patients reconstructed by the Billroth II method. Biliary drainage is necessary to treat severe cholangitis as soon as possible, for it sometimes causes endotoxin shock, disseminated intravascular coagulation (DIC) and multiple organ failure (MOF).
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PMID:[Non-surgical biliary drainage for cholelithiasis]. 836 6

In order to assess the efficacy of helical CT in drip-infusion cholangiography (DIC-CT) for diagnosis of choledocholithiasis, 82 patients with biliary diseases, including 25 patients with a definite diagnosis of choledocholithiasis obtained by direct cholangiography, were investigated by DIC-CT and EUS. Comparative investigation showed that, of the 25 cases, 94.7% could be imaged by DIC-CT and 87.5% by EUS, with respective sensitivities of 94.7% and 87.5%. The specificities in both cases were 100% and accuracies were 97.8% with DIC-CT and 96% with EUS respectively. Therefore, in diagnosis the choledocholithiasis, DIC-CT displays similar diagnostic efficiency as EUS or ERC, and can be recognized as the non-invasive and useful procedure for pre-operative diagnosis of cholecystolithiasis.
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PMID:[Usefulness of DIC-CT in choledocholithiasis]. 1039 35

A 50-year-old woman was admitted to the emergency room. An appendectomy was done. On the sixth day the patient's general state deteriorated and she became somnolent with jaundice due to distal obstructive choledocholithiasis. The results of laboratory tests were platelets 12 x 10(9)/L, prothrombin time 13 seconds, international normalized ratio 1.19, activated partial thromboplastin time 31.8 seconds, and fibrinogen 8.78 g/L. There was no evidence of disseminated intravascular coagulation. In view of the patient's clinical condition, surgery was considered to be indicated. Because it was a life-threatening situation and at the time there was no platelet concentrate available for immediate transfusion, she was treated with a single dose of recombinant factor VIIa (rFVIIa) (60 microg/kg). The dose of 60 microg/kg was selected on the basis of experience with rFVIIa in the treatment of hemophilic patients. In this case, use of rFVIIa was a valid alternative to control the bleeding in a patient with thrombocytopenia. However, despite the efficacy of the treatment, it should not be forgotten that it was used because of the unavailability of platelets and that we were dealing with a life-threatening situation. Clinical trials should be carried out to verify the safety, effectiveness, and efficiency of rFVIIa in these cases.
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PMID:Recombinant factor VIIa is an effective therapy for abdominal surgery and severe thrombocytopenia: a case report. 1571 94