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Query: UMLS:C0031154 (peritonitis)
15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of severe pancreatitis and deep shock are reviewed. In the first case measures to relieve the shock state were unsuccessful. Laparatomy was, therefore, performed and revealed acute haemorrhagic pancreatitis with diffuse purulent peritonitis. After insertion of a drain and irrigation of the abdominal cavity the incision was closed. Twice-daily lavage of the pancreatic fistula via a drain was continued until, after 5 months, the fistula healed spontaneously. In the second case intensive therapy succeeded after 9 days in controlling the acute stage of the disease. Conservative treatment was continued for 6 weeks and the patient was then discharged from hospital. He was re-admitted 3 weeks later because of suspicious clinical and biochemical signs of obstructive jaundice. Laparatomy disclosed inflammatory stenosis of the distal portion of the common bile duct and Vater's papilla and also a pancreatic pseudocyst the size of a child's head. The latter was removed and a drain was inserted. There were no postoperative complications.
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PMID:[Severe acute pancreatitis; course and response to intensive therapy (author's transl)]. 7 34

Temporary pre-operative and post-operative as well as permanent palliative percutaneous biliary-tract drainage was performed in 12 patients with biliary tract obstruction; in three the drainage was internal and in nine external. Main indication of the method is permanent palliative decompression in cases of inoperable malignant tumour with obstructive jaundice. Pre-operatively, percutaneous biliary tract drainage serves as a temporary measure in order to perform an operation after decompression of the biliary tract and improving the patient's general condition. The only serious complication was biliary peritonitis after a drainage catheter had slipped out.
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PMID:[Percutaneous drainage of the biliary tract by means of a fine needle (author's transl)]. 8 29

A case is reported of spontaneous perforation of the common bile duct in a 59-year-old woman. Recurrent episodes of epigastric and right hypochondriac pain over one year culminated in the onset of obstructive jaundice. There were not signs of peritonitis, and laparotomy revealed an abscess surrounding a perforation in the common bile duct just distal to the cystic duct. A cholesterol gallstone was present at the site of perforation. A paracolon bacterium, providence alcalifaciens, was isolated from the abscess. The patient made an uncomplicated recovery after cholecystectomy and drainage of the bile duct.
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PMID:Spontaneous perforation of the common bile duct: report of a case. 28 2

An 18-week-old baby boy suffered an episode of acute abdominal symptoms followed by a silent period with mild obstructive jaundice, abdominal distension and failure to thrive. During the clinical work-up he deteriorated suddenly, with progressive abdominal distension and ascites. At laparotomy a perforation of the common bile duct with bile peritonitis was found. Spontaneous perforation of the common bile duct is seldom listed as a cause of obstructive jaundice. The clinical picture is characteristic. Awareness of this diagnosis may help to avoid time-consuming and unnecessary investigations and to lead to surgical treatment in good time.
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PMID:Spontaneous perforation of the common bile duct. 46 49

The Chiba technique of percutaneous transhepatic cholangiography (PTC) can be easily learned and does not require much technical equipment; it is thus widely used now in the diagnosis of suspected obstructive jaundice. The procedure is generally regarded as safe; thus standby availability of a surgical outfit is not considered to be necessary. However fever, cholangitis, septicemia, biliary peritonitis and bleeding have been reported in patients who underwent PTC. A case report is given of a patient who had biliary peritonitis following PTC, in order to demonstrate the need for careful selection of patients undergoing this procedure. PTC should not be done in patients with coagulopathy, cholangitis and known allergic reactions against the cntrast medium to be injected. If a dilated duct can be visualized bile should be aspirated and only small amounts of contrast medium be injected. If extrahepatic biliary obstruction has been diagnosed or if the patient complains about pain after the procedure surgery should be done within 24 hours.
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PMID:[Biliary peritonitis after percutaneous transhepatic cholangiography with the Chiba technique (author's transl)]. 48 Oct 59

Percutaneous transhepatic cholangiography (PTC) for jaundice of undetermined etiology was performed with the Chiba needle in 30 patients. Successful visualization of the biliary ductal system was accomplished in 26 patients (86.7%); two of six patients (33.3%) with normal biliary systems had ducts visualized, and the ducts were visualized in the 24 patients (100%) with obstruction. Bile leakage of 50 to 500 ml (average, 200 ml) was observed at laparotomy or autopsy in 12 patients (40%), nine (30%) of whom had symptoms of peritonitis. Six (20%) of these were transient and three (10%) progressed to an acute abdomen. Bacteremia occurred in seven patients (23.3%), in three (10%) it progressed to septic shock, with one death (3.3%). There were no complications in patients with nonobstructed ducts. This study suggests that PTC with the Chiba needle has little advantage over the larger sheathed needles, and surgical standby is indicated in suspected cases of obstructive jaundice.
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PMID:Bile leakage following percutaneous transhepatic cholangiography with the Chiba needle. 88 44

To obtain a histopathologic diagnosis at the site of a biliary obstruction, we recently have performed 24 cases of biliary biopsy using gastrofiberscopic biopsy forceps (Olympus, Tokyo, Japan) via transhepatic tracts provided in the course of the procedure of percutaneous biliary drainage. Histopathologic diagnosis was successfully made at the first attempt of biopsy procedure but a second trial was made a week later in 6 cases who were negative for malignant cells on the first attempt. The histological results from the biopsy specimens were 18 adenocarcinomas, 5 chronic inflammations and one normal epithelium. Of 6 cases who were negative for malignant cells on forceps biopsy specimen, three cases were confirmed as adenocarcinoma of the ampulla of Vater, adenocarcinoma of the pancreas and chronic pancreatitis by surgical biopsy. The latter was a true negative result, which was diagnosed as chronic inflammation on forceps biopsy and verified as chronic pancreatitis by surgery. The remaining two cases were diagnosed as malignant obstructive jaundice by clinical and radiological follow-up findings. Major complications (bile peritonitis, bleeding, and hemopneumothorax) occurred in 3 patients, which mainly arose in the earlier period of study. This procedure can be performed at the same time as percutaneous transhepatic biliary drainage with low morbidity or mortality, and although the potential for perforation of bile ducts and injury to adjacent blood vessels is considered it is a useful addition to existing biopsy techniques for yielding material sufficient for histologic analysis.
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PMID:Percutaneous transhepatic biliary biopsy using gastrofiberscopic biopsy forceps. 129 35

Amongst 876 cases suffering from ascariasis 662 cases were managed conservatively and 214 cases were treated by surgery. Surgical complications were found to be more common in males in the age group of 6-10 years. Principal clinical features included pain abdomen (99.54%), constipation (80.25%), vomiting (67.46%), abdominal distension (47.03%), palpable worm masses in abdomen (35.50%), visible peristalsis (27.63%), worms in vomitus (24.20%) and palpable worm clumps on rectal examination (20.09%). Principal clinical diagnosis were worm colics (48.74%), sub-acute intestinal obstruction (27.74%), acute intestinal obstruction (11.42%) and acute intestinal obstruction with strangulation (5.71%); rest of the cases included worm cholecystitis (2.63%), obstructive jaundice (1.71%), bile peritonitis (0.91%), intestinal perforation (0.68%) and acute appendicitis (0.46%). Surgical procedures performed were milking of worms (34.12%), resection anastomosis of small intestine (23.36%), enterotomy with removal of worms (16.36%), cholecystectomy with T-tube drainage (12.15%), cholecystectomy (8.41%), appendectomy (1.87%), resection anastomosis with excision of Meckel's diverticulum (1.40%), repair of intestinal perforation with peritoneal toilet (1.40%) and cholecystectomy with choledochoduodenostomy (0.93%). In surgically managed patients 35 cases died of septicaemia and in conservatively managed cases 3 died of encephalitis with an overall mortality of 4.34%.
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PMID:Surgical manifestations and management of ascariasis in Kashmir. 140 71

The authors describe the technical results in 127 patients who underwent diagnostic gallbladder puncture and percutaneous cholecystostomy. The procedures were performed for a variety of indications including treatment of acute calculous or acalculous cholecystitis, drainage of obstructive jaundice or gallbladder perforation, percutaneous removal or dissolution of gallstones, diagnostic cholecystocholangiography, and gallbladder biopsy. Successful completion of the intended procedure was achieved in 125 of 127 patients (98.4%). Major complications occurred in 11 patients (8.7%); these included bile peritonitis, bleeding, vagal reactions, hypotension, catheter dislodgement, and acute respiratory distress. Minor complications were noted in five patients (3.9%). The 30-day mortality rate was 3.1% (four patients); the deaths were due to the underlying diseases. The data help support percutaneous cholecystostomy as a primary interventional radiologic procedure that has an extremely high likelihood of technical success. Recommendations to minimize or avoid complications are presented.
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PMID:Percutaneous gallbladder puncture and cholecystostomy: results, complications, and caveats for safety. 154 66

Information on the use of isolated lymphocytes for assessment of a severity degree of endotoxicosis in peritonitis, pancreatitis, obstructive jaundice is presented. It is possible to assess a severity degree of endotoxicosis by intensity of the external lymphocytic receptors block.
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PMID:[Screening-diagnosis of endotoxicosis in suppurative-inflammatory processes in the abdominal cavity]. 156 95


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