Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0149520 (acute cholecystitis)
 2,784 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This case report describes a false-positive hepatobiliary scan in a young woman suspected to have acute cholecystitis who apparently had none of the reasons stated in the literature for a false-positive scan. The literature review shows that the negative predictive value of hepatobiliary scanning for acute cholecystitis is nearly 100 percent, while the positive predictive value is also quite good if conditions known to cause false-positive scans are ruled out. Common causes of positive hepatobiliary scanning, other than acalculus cholecystitis, include chronic cholecystitis, cholecystitis, hepatitis, alcoholism, total parenteral nutrition, pancreatitis, prolonged fasting, and ingestion of food less than one hour prior to scanning. Whether the postpartum state affects the accuracy of hepatobiliary scanning is speculative.
 ...
PMID:A false-positive hepatobiliary scan: case report and literature review. 381 64

The benefit of early surgery for patients with acute cholecystitis is now accepted but rapid accurate pre-operative diagnosis is important and the single best investigation has not yet been clearly established. All 47 patients with suspected acute cholecystitis admitted to a district general hospital during a 6 month period underwent ultrasonic examination and scintigraphy with HIDA within 48 h of admission. In 23 patients acute cholecystitis was proven. Ultrasound correctly diagnosed this in 21 patients but in 2, changes attributed to chronic cholecystitis only were detected. Two false positive ultrasound results also occurred, one in a patient with adenomyomatosis and acute pancreatitis, the other in a case of duodenitis. HIDA scan was diagnostic in 19 patients but in the remaining 4 the presence of abnormal liver function tests accounted for non-visualization of the biliary tree (a non-diagnostic result). In the absence of jaundice a HIDA scan is the more specific test for confirming acute cholecystitis.
 ...
PMID:Ultrasonography, HIDA scintigraphy or both in the diagnosis of acute cholecystitis? 388 67

Hepatobiliary studies were performed over a three-year period on 139 patients suspected of having cystic duct obstruction. Each patient was infused intravenously with sincalide, a C-terminal octapeptide of CCK, 15 minutes prior to the administration of the hepatobiliary imaging agent Tc-99m paraisopropyl iminodiacetic acid (PIPIDA). Analysis of the results demonstrated significant advantages in pretreating patients with sincalide in hepatobiliary studies in a small facility with a relatively large patient load. Most of our studies were completed within 2 hours without jeopardizing the sensitivity (97%) or accuracy (96%) of the test. The specificity (88%) was comparable to percentages reported by others. Most investigators have reported that chronic cholecystitis contributed to the majority of false-positive cases. In addition, inconsistency in the documentation of criteria for the determination of acute cholecystitis (surgical, radiologic, or histologic also could be a cause for such a discrepancy. Knowledge of some important variables may help improve the specificity of the test: an awareness of the following factors during scan interpretation: 1) the effectiveness of the sincalide pretreatment dose, 2) the patient's pretest status (fasting or nonfasting, postanalgesic medication or no analgesics), and 3) time limit for gallbladder visualization. With these variables in mind, the hepatobiliary imaging using pretreatment with sincalide is proven to be a practical procedure protocol with good sensitivity and accuracy as well as specificity.
 ...
PMID:Practical hepatobiliary imaging using pretreatment with sincalide in 139 hepatobiliary studies. 401 80

Gallbladder nonvisualization in cholescintigraphy has been shown to be a reliable finding in acute cholecystitis. In some cholescintigrams, we have observed faintly increased pericholecystic hepatic activity in conjunction with gallbladder nonvisualization. To determine the frequency and significance of the pericholecystic hepatic activity finding, we evaluated 334 consecutive adult patients who had cholescintigrams with technetium-99m diisopropylphenylcarboamoyl iminodiacetic acid. Pericholecystic hepatic activity was seen in 21% of the abnormal scans demonstrating gallbladder nonvisualization but in none of the other scans. Thirteen of these patients underwent surgery; 11 (85%) were found to have acute cholecystitis, and two (15%) had chronic cholecystitis. Four patients (31%) had acute gangrenous cholecystitis, and five (39%) had cholecystitis complicated by gallbladder perforation. The pericholecystic hepatic activity sign is not specific for gangrenous cholecystitis or gallbladder perforation but does reliably indicate inflammatory gallbladder disease and is associated with a relatively high incidence of cholecystitis complicated by perforation.
 ...
PMID:Pericholecystic hepatic activity in cholescintigraphy. 402 46

Fifty-three samples of gallbladder bile were obtained at the time of cholecystectomy from patients with the clinical diagnosis of acute or chronic cholecystitis. Five bile samples from patients with clinically normal gallbladders also were obtained. Proton magnetic resonance (MR) relaxation times, protein content, and water content were determined for the bile samples, and the data were grouped according to pathologic diagnosis, which disclosed 11 cases of acute cholecystitis, 41 cases of chronic cholecystitis, and six normal gallbladders. There was no significant difference in the mean T1 and T2 values between the groups with acute and chronic cholecystitis. Patients with chronic cholecystitis were found to have more concentrated bile than those with acute cholecystitis. Protein content varied widely within both groups of patients. We conclude that T1 and T2 relaxation times do not reliably differentiate acute from chronic cholecystitis.
 ...
PMID:Gallbladder bile in cholecystitis: in vitro MR evaluation. 404 55

The patterns of radionuclide hepatobiliary scans in nine children with sickle cell disease and acute right upper quadrant abdominal pain were reviewed. The most common pattern observed was delayed gall bladder visualization, consistent with chronic cholecystitis. The value of hepatobiliary imaging in distinguishing acute cholecystitis from crisis is presented.
 ...
PMID:Biliary scintigraphy in children with sickle cell anemia and acute abdominal pain. 405 65

Mortality and morbidity of surgical treatment of gallstones are analysed through a series of 5 433 operations : 3 885 for chronic cholecystitis; 844 for choledocholithiasis, 564 for acute cholecystitis, 96 for odditis, 31 for internal fistula, 13 for gallstone ileus. The overall mortality rate is 1,53%, the morbidity rate 8,32 % but significant differences are found related to sex, age, stage of disease and operating procedure: for example cholecystectomy for chronic cholecystitis in patients beyond 60 years has a mortality rate of 0,2%; in choledocholithiasis, after 70 years the mortality rate is 9,8% . Analysis of deaths and complications shows that mortality and morbidity can be reduced by a better selection of cases and various preventive measures.
 ...
PMID:[Operative risk in cholelithiasis. 5 433 surgical interventions (author's transl)]. 626 7

The authors analyze the application of the radioisotopic method for examining the liver in 413 patients; with acute cholecystitis (97), chronic cholecystitis (195), chronic pancreatitis (12) and cirrhosis of the liver (109). The scanning and functional investigations of the liver allowed detection of substantial disorders in the functional state of the liver in patients with acute cholecystitis and obturation jaundice which suggests a necessary correction of the liver function in the pre- and postoperative periods.
 ...
PMID:[Radioisotope diagnosis of the hepatic changes in biliary tract diseases]. 628 80

To test the ability of cefazolin, given in a single dose preoperatively, to prevent infection in high-risk patients after biliary tract surgery, the authors conducted a double-blind, prospective, randomized, controlled study. Of 92 patients operated on for acute cholecystitis or bile-duct disease, 46 were given 2 g of cefazolin intravenously before operation. Bile was contaminated with bacteria in 36% to 50% of patients with acute cholecystitis, obstructive jaundice, bile-duct disease without jaundice, or over 50 years old compared with only 5% of patients with chronic cholecystitis or under 50 years of age. Postoperative sepsis was eight times more frequent in patients with contaminated bile than in those without. Only 1 patient who received cefazolin had a wound infection, but 9 of the 46 patients in the control group did. The bacteria causing wound sepsis were similar to those in the contaminated bile. The authors conclude that a single dose of cefazolin given intravenously before operation provides effective prophylaxis against infection in high-risk biliary tract surgery.
 ...
PMID:A single preoperative dose of cefazolin prevents postoperative sepsis in high-risk biliary surgery. 638 Jun 93

Gallbladders of 12 cases with chronic cholecystitis showing pseudopyloric glands (PPG) and of 18 cases with acute cholecystitis or chronic cholecystitis but without PPG were examined by the peroxidase - antiperoxidase (PAP) method using rabbit antibody against human lysozyme (LM). LM-immunoreactivity was detected in the cytoplasm of PPG and, to a lesser extent, in the pits of epithelial crypts that gave rise to PPG. No LM was found in normal gallbladders; in cases of cholecystitis without PPG, LM-immunoreactivity was restricted to infiltrating inflammatory cells. The presence of LM in PPG suggests that PPG represent functional metaplastic areas, involved in the non-specific defence mechanisms through participation of LM.
 ...
PMID:Immunohistochemical demonstration of lysozyme in pseudopyloric glands in chronic cholecystitis. 640 87


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>