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Query: UMLS:C0085593 (chills)
 4,268 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case is described of a 32-year old woman with an 8 year history of oral contraceptive (OC) use who developed vascular complications. Significant findings in the patient's history included an appendectomy and repeated biliary colic dating back 7 years. The patient sought help for an attack of hepatic colic with vomiting, chills, and fever, dyspepsia, and intolerance of fats. Pain was noted on palpation and the clinical and sonographic findings indicated hepatomegaly. Based on the other clinical and laboratory findings, a preliminary diagnosis of infected hepatic hydatidic cyst was made and the intrahepatic hematoma was drained. The postoperative diagnosis was a large hematoma occupying the greater part of the right hepatic lobe. A pleural hemorrhage occurred during postoperative hospitalization and was treated medically, but 4 days after discharge from the hospital the patient returned with a pleural hemorrhage that required drainage. Hydatidosis is endemic in the region of Spain where the case occurred, and the grounds for differential diagnosis are specified. Several illustrations including sonograms, X-rays, and results of computerized axial tomography are included and explained. With the increasing use of OCs in Spain, it is likely that more such cases will be seen.
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PMID:[Hepatic hematoma and pleural hemorrhages caused by prolonged ingestion of oral contraceptives]. 687 43

Surgical clip migration into the common bile duct with subsequent stone formation is a rare complication following laparoscopic cholecystectomy. Very few cases have been reported in the literature. We report a case of bile duct stone formation around a migrated surgical clip 16 years after laparoscopic cholecystectomy. The patient presented with right upper quadrant pain, fever, and chills for one week. Investigation with abdominal ultrasound showed dilatation of the common bile duct and moderate dilatation of the intrahepatic bile ducts. The diagnosis was confirmed by endoscopic retrograde cholangiopancreatography and the patient was managed successfully with sphincterotomy and stone extraction. The exact mechanism of clip migration is not fully understood. Presenting symptoms are similar to non-clip-induced choledocholithiasis. Time of presentation can vary significantly with an average of 26 months. Most cases reported in the literature required surgical intervention. Clip migration should be considered in the differential diagnosis of postcholecystectomy biliary colic and cholangitis. Management with endoscopic retrograde cholangiopancreatography is the treatment of choice.
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PMID:Common Bile Duct Stone Formed around a Migrated Clip: An Unexpected Complication of Laparoscopic Cholecystectomy. 2986 95

Staphylococcal toxic shock syndrome (STSS) is a rare, potentially lethal infection, with a clinical picture of multiple organ dysfunction and shock. The etiology is Staphylococcus aureus exotoxin, while enterotoxins act as superantigens. Most cases are identified in women using a vaginal tampon. A 51-year-old female, with a past medical history of biliary dyskinesia, presented in the emergency room complaining of sudden onset of abdominal pain, vomiting, headache, myalgia, and chills. The initial diagnosis was biliary colic and was treated parenterally with Amoxi-clavulanate and fluid replacement. Initially, progress was unsatisfactory. Four days after admission she developed a systemic inflammatory syndrome, diffuse rash, jaundice, oliguria, confusion, persistent hypotension and biological evidence of thrombocytopenia, nitrogen retention, and cholestasis. She was admitted to the intensive care unit. A gluteal phlegmon induced after intramuscular injections was identified and surgically treated. Blood bacteriological cultures were negative, though MRSA was isolated in phlegmon pus. A diagnosis of STSS was based on CDC criteria. The risks of similar infections could be prevented by limiting intramuscular treatments and monitoring invasive procedures.
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PMID:Nosocomial Staphylococcal Toxic Shock. Case Report. 2996 53