Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 54-year-old man with a 15-year history of liver disease, was found by his family physician to have multiple tumors in the right lobe of the liver and a large right retroperitoneal tumor. He was referred and admitted to our institute where a preoperative diagnosis of liver cirrhosis complicated by hepatocellular carcinoma and probable right adrenal metastasis was made. Because his hepatic functional reserve was so poor, only resection of the right adrenal tumor with a splenectomy for hypersplenism and a cholecystectomy for the prevention of cholecystitis secondary to the scheduled transcatheter arterial embolization was performed. The patient was discharged in good clinical condition 5 weeks after surgery.
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PMID:Hepatocellular carcinoma with a solitary adrenal metastasis and poor hepatic functional reserve: report of a case. 800 71

CA 19-9 is used as a tumour marker of the upper gastrointestinal tract. However, extremely elevated CA 19-9 levels are found also in patients with benign diseases. Cholestasis was present in 97.1% of patients with high elevated CA 19-9, independent of their primary disease. 50% of patients with non-malignant diseases and increased CA 19-9 levels showed liver cirrhosis, cholecystitis, pancreatitis and/or hepatitis. In 8.8% no explanation was found for the extremely high CA 19-9 level. The results provide evidence of different factors influencing the CA 19-9 level.
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PMID:The reliability of highly elevated CA 19-9 levels. 808 16

During the past 5 years, traditional open cholecystectomy was performed on 344 patients with gallbladder stones at our hospital. Using the data obtained, we studied the indications and results of traditional open cholecystectomy. In the cases of gallbladder stones with a history of cholecystitis, cholecystectomy was performed as a rule by laparoscopic cholecystectomy. However, traditional open cholecystectomy was chosen in cases which were complicated by perforation, pericholecystic abscess, internal biliary fistra, cirrhosis, or suspicious carcinoma of gallbladder. Investigation of the time of operation revealed that early operation tended to be performed easily. However, cases with gallbladder stones were often complicated with carcinoma of alimentary tracts, therefore before operation we must examine the alimentary tract. Cases in which gallbladder could not be visualized under ERCP, and those accompanied by pericholecystic abscess under US were difficult to operate on by laparoscopic cholecystectomy. Thus many cases required laparotomy. Postoperative complications of open cholecystectomy were rare, it was concluded that traditional cholecystectomy is one of the most valuable procedures for the treatment of gallbladder stones.
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PMID:[Traditional open cholecystectomy]. 836 5

In a retrospective study of 1101 patients (302 men, 799 women; mean age 56,7 [19-88] years) with symptomatic cholelithiasis who had undergone elective cholecystectomy and intraoperative liver biopsy, histological examination revealed inflammatory changes in the gallbladder in 96.7%, chronic fibrotic cholecystitis in 94.5% and a severe form of cholecystitis in 8.8%. Clinically relevant changes in the liver parenchyma were present in 27.9%, most frequently intrahepatic cholangitis (21.8%). The latter was significantly more common in choledocholithiasis than in isolated cholecystolithiasis. 27 patients had signs of severe liver disease, namely viral hepatitis, cirrhosis or fatty liver. Since the gall-bladder in cholelithiasis is almost always inflamed, cholecystectomy is the treatment of choice. Not uncommonly liver biopsy will reveal clinically relevant changes in the liver parenchyma. This will be useful information, especially in the management of symptoms which persist postoperatively.
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PMID:[Histopathological changes of gallbladder and liver parenchyma in symptomatic cholelithiasis]. 850 22

The paper deals with combined diagnosis of hepatic and biliary diseases, involving a wide range of nosological entities. It shows the potentialities of currently available diagnostic techniques for the most common diseases. The authors examined 175 patients with acute and chronic hepatitis, 120 with hepatic cirrhosis, 486 with cystic changes, 324 with benign tumors, 292 with malignant tumors, 21 with hepatic abscess, 527 with cholecystitis, 566 with cholelithiasis. Cancer of the gall-bladder was in 10 patients, its polyps were in 18, cancers of the common bile duct and bile papilla were in 6 and 4 patients, respectively. A complex of the used diagnostic techniques involved ultrasonic scanning, X-ray computed tomography, hepatobiliary scintigraphy, angiography, retrograde cholangiopancreatography, transhepatic cholangiography, etc. The authors have demonstrated that each method used is highly diagnostically effective. At the same time they have shown the limits of each technique in the diagnosis of certain diseases. The authors' data suggest that the total efficiency of the applied complex of diagnostic means approaches 100%.
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PMID:[X-ray diagnosis of liver and biliary tract diseases]. 892 1

Eleven patients (4 males, 7 females) with Wilson's disease who presented before 18 years of age are described. The mean age onset of symptoms was 11.2 +/- 3.9 (SD) years. The mean age at diagnosis was 13.3 +/- 3.4 (SD) years. All patients had hepatic manifestations of the disease when diagnosed: cirrhosis (6 patients), chronic hepatitis (2) and fulminant hepatic failure (3). Three patients were asymptomatic at diagnosis. Two of the symptomatic patients presented with new undescribed manifestations: one with blurred vision and the other with acalculous cholecystitis. At diagnosis, 6 patients had Kayser Fleischer rings and 5 had hemolytic anemia. The three patients with fulminant hepatic failure had hemolysis with relatively low serum aminotransferase and alkaline phosphatase levels, possibly helpful findings for rapid diagnosis of Wilson's disease in such presentation. Ten patients were treated with penicillamine. Liver transplantation was performed in 4 patients, 2 of which presented with fulminant hepatic failure. One patient died while waiting for liver transplantation, the remainder of the patients live free of symptoms. It is important to be aware of the different manifestations of Wilson's disease in the pediatric population, in order to make appropriate evaluations in a timely manner to facilitate early diagnosis and appropriate treatment.
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PMID:Pediatric Wilson's disease: presentation and management. 915 61

The study analyses different situations encountered throughout the authors personal operative experience, susceptible to generate technical and tactical difficulties during laparoscopic cholecystectomy such as: postoperative perivisceritis, obesity, difficult liver mobilization, lipomatosis, acute and scleroatrophic cholecystitis, "porcelain gallbladder". They also point out different causes capable of generating important bleeding during the operation: cirrhosis, accidental adhesion tearing, anatomical arterial variations. Above all, the study presents the possible technical and tactical solutions which they applied when dealing with the already mentioned critical situations.
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PMID:[Difficult laparoscopic cholecystectomy]. 929 58

Acute cholecystitis is a common disease which may carry the risk of complications, including empyema, perforation, abscess, peritonitis and sepsis. Percutaneous transhepatic drainage of the gallbladder (PTGBD) with antibiotics can provide prompt decompression of gallbladder in acute cholecystitis and interrupt the natural history of the disease effectively. From July 1986 to June 1996, 154 patients with acute cholecystitis were reviewed retrospectively in Kaohsiung Medical College Hospital. The chief symptoms and signs were pain (98.1%), fever (57.1%) and jaundice (37.7%). WBC count more than 10,000 was noted in 116 (75.3%) patients. Associated diseases included empyema: 42 (27.3%), septic shock: 14 (9.1%), diabetes mellitus: 13 (8.4%), pancreatitis: 10 (6.5%), perforation: 7 (4.5%), liver cirrhosis: 6 (3.9%) and respiratory failure: 1 (0.6%). All of them underwent ultrasound-guided PTGBD immediately after the diagnosis was established. The symptoms and signs disappeared soon after this procedure. Bacterial culture was found positive in 104 (67.5%) of 154 patients in which Escherichia coli (51.9%) was the most common organism, followed by Klebsiella pneumonia (20.2%). After acute stage, 138 patients obtained the cholangiography via PTGBD tube. Gallbladder stones were only noted in 56 (40.6%) patients, gallbladder stone concomitant with common bile duct stone in 26 (18.8%), cystic duct obstruction in 25 (18.1%), acalculous cholecystitis in 21 (15.2%), gallbladder perforation in 1 (0.7%), choledochocyst in 1 (0.7%), and cholecystocolonic fistula in 1 (0.7%). There were 135 patients to undergo surgery after the clinical condition was stable. The operative findings included gallbladder stones only in 88 (65.2%), gallbladder stone concomitant with common bile duct stone in 34 (25.2%), acalculous cholecystitis in 13 (9.6%), choledochocyst in 1 (0.7%), and cholecysto-colonic fistula in 1 (0.7%). The postoperative complications included wound infection 8 (5.9%), UGI bleeding 3 (2.2%), acute renal failure 1 (0.7%) and acute respiratory failure 1 (0.7%). The postoperative mortality rate was 0.7% (1/135), which was much lower than those of previous reports, which not undergoing PTGBD initially. It led us to conclude that PTGBD, as an initial preoperative modality to treat acute cholecystitis, is effective in decreasing postoperative morbidity and mortality.
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PMID:Ultrasound-guided percutaneous transhepatic drainage of gallbladder followed by cholecystectomy for acute cholecystitis--10 years' experience. 951 85

In acute viral hepatitis, ultrasound examination of the liver also reveals pathologic changes of other organs, especially of the gallbladder and, less frequently, of the pancreas and regional lymph hilar nodes. Ninety patients divided into 3 groups of 30 patients each, suffering from viral hepatitis (group 1), acute calculous cholecystitis (group 2) or liver cirrhosis (group 3), were prospectively analyzed. An increased gallbladder wall thickness of 4.67 +/- 0.66 mm was recorded in all group 1 patients. In the group with acute viral hepatitis, gallbladder wall thickening was only present during the first week of the disease, and was almost two-fold thinner than that found in the group with acute calculous cholecystitis, where it ranged from 4.3 to 10.3 mm. The gallbladder wall thickening in cirrhosis patients was found to depend on liver decompensation during the course of cirrhosis.
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PMID:Ultrasound diagnosis of acute viral hepatitis. 968 98

A case of hepatobiliary dysfunction as the initial manifestation of disseminated cryptococcosis is described. The patient was admitted with symptoms of hepatitis with cholestatic jaundice. Antibody tests for hepatitis B and C and human immunodeficiency virus were negative. The patient continued to deteriorate clinically. Eventually, the patient succumbed to hepatic failure. Autopsy disclosed systemic cryptococcosis that caused extensive necrosis of the liver. In review of the literature, only nine cases of cryptococcal infection presenting as hepatitis, cholangitis, and cholecystitis as initial manifestation were reported. Four of these patients had been subjected to exploratory laparotomy for clinical suspicion of acute abdomen. One patient developed cirrhosis as a result of cryptococcal hepatitis. Two patients succumbed to hepatic failure. Cryptococcosis is known to occur commonly in immunocompromised patients, yet only two reported cases presenting as hepatitis were associated with immunocompromised status.
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PMID:Hepatobiliary dysfunction as the initial manifestation of disseminated cryptococcosis. 1019 23


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