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

The effects of histamine receptor stimulation on the motility of diseased human gallbladder and cystic duct were studied on tissue strips in vitro. Histamine produced concentration-dependent contractions in normal tissues and in tissues from each disease group, but the sensitivity of the strips to histamine as measured by the median effective dose was dependent upon the grade of disease: normal, 90.0 microM; mild chronic cholecystitis, 32.4 microM; advanced chronic cholecystitis, 12.5 microM; and acute cholecystitis, 3.0 microM. There were no differences in histamine sensitivity among different regions (body, neck, and cystic duct) of the biliary system. Studies with receptor-selective agonists and antagonists indicated that the contractile effects were mediated via histamine H1 receptors. Histamine H2 receptor agonists caused only small relaxant responses in about 30% of strips from gallbladder body, but were without effect in gallbladder neck and cystic duct. We conclude that the effects of histamine on the motility of diseased human gallbladder may depend upon the severity of the cholecystitis.
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PMID:Effects of histamine receptor stimulation on diseased gallbladder and cystic duct. 673 72

The value of gallbladder thickening in predicting the presence of acute cholecystitis was assessed by reviewing gallbladder sonograms for 150 normal patients, 15 fasting normal patients, 24 patients with proven acute cholecystitis, 24 patients with ascites or an alcoholic history, and 50 patients with surgically proven chronic cholecystitis and gallstones. Thickened gallbladder walls were found in all patients with ascites, 45 percent of patients with acute cholecystitis, and approximately 10 percent of those with chronic cholecystitis. The finding of gallbladder wall thickening is suggestive evidence of acute cholecystitis, but it is not a pathognomonic finding.
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PMID:The significance of sonographic gallbladder wall thickening. 676 48

Biliary, hepatic, and pancreatic surgery at the Mayo Clinic during 1973 was retrospectively examined. A total of 1,137 operations were performed in the 12-month period, with an overall hospital mortality of 2.6%. The operative mortality for 586 elective cholecystectomies for chronic cholecystitis with cholelithiasis was 0.3%--for acute cholecystitis 1.5% and for elective common duct exploration 2.9%. The present review is compared with prior reports in which similar methodology permitted comparisons. Improvement in operative mortality was noted in surgery for cholecystitis and pancreatic and hepatic lesions. The figures drawn from this and previous reports represent more than 10,000 operations on the liver, biliary tract, and pancreas performed at the Mayo Clinic.
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PMID:Surgery of the liver, biliary tract, and pancreas. 676 36

To evaluate the efficacy of ultrasonography in detecting acute cholecystitis, we retrospectively reviewed the ultrasonic findings after cholecystectomy in 34 patients with acute cholecystitis and 90 patients with chronic cholecystitis. The sonographic findings evaluated included the length and width of the gallbladder, thickening of the gallbladder wall, good identification of the wall, and the presence or absence of sludge or stone. A "halo" sign (an echo-free space around the gallbladder wall) was seen in 26% of the patients with acute cholecystitis.
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PMID:Cholecystosonography in detection of acute cholecystitis: the halo sign--a significant sonographic finding. 682 93

Scintigraphy was performed on 180 patients with suspected biliary tract disease using technetium-99m-labelled derivatives of iminodiacetic acid. Most of the patients were also evaluated by conventional techniques and the results were correlated with the findings at operation and with histological examination of tissue removed whenever indicated. The technique was very accurate in the diagnosis of acute cholecystitis. In chronic cholecystitis it was useful in the diagnosis only when the cystic duct was obstructed. Scintigraphy has no value in the diagnosis of gallstones. However, it permits visualisation of the biliary tract even in the presence of jaundice and is useful in distinguishing obstructive from non-obstructive types of jaundice.
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PMID:The value of scintigraphy in the diagnosis of biliary disease. 689 10

A group of 75 patients with acute right upper quadrant pain was evaluated with both sonography and cholescintigraphy. Accuracy in screening for gallbladder disease was significantly greater with sonography (96%) than with cholescintigraphy (74%). For selecting patients with acute cholecystitis from this population that included acute and chronic cholecystitis as well as nonbiliary pathology, PIPIDA was less accurate (77%) than might be expected based on previous reports primarily due to false positive nonvisualization caused by chronic cholecystitis. Of patients with nonbiliary pathology, sonography was able to detect the cause of the right upper quadrant pain in 21%. Patients with acute right upper quadrant pain should first be screened with sonography. If cholescintigraphy is subsequently used for suspected acute cholecystitis, positive results should be interpreted with caution before surgery is planned.
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PMID:Evaluation of acute right upper quadrant pain: sonography and 99mTc-PIPIDA cholescintigraphy. 697 66

Technetium-99m IDA cholescintigraphy has provided a new, noninvasive means of visualizing biliary tract function. It has become the procedure of choice in patients with suspected acute cholecystitis because of its ability to most accurately detect functional obstruction or patency of the cystic duct as opposed to ultrasound's ability to detect only anatomic changes such as the presence of calculi or a thickened gallbladder wall. These latter findings are more important in establishing the diagnosis of chronic cholecystitis where ultrasound shares a position of prime importance with the oral cholecystogram. Tc-99m IDA cholescintigraphy has also been particularly useful in evaluating bile leaks, biliary-enteric anastomosis patency and the post-cholecystectomy patient with recurrent pain. In the patient with cholestasis, ultrasound is usually the procedure of choice since it establishes whether or not ductal dilatation is present and frequently can determine the cause of obstruction. Cholescintigraphy has played an ancillary role in many cases by demonstrating the level of partial obstruction, but it does not have the anatomic resolution to visualize the cause of obstruction. Occasionally, in the evaluation of cholestasis, cholescintigraphy has proven to be the only modality which has identified the presence of acute common duct obstruction or localized intrahepatic ductal obstruction. All in all, Tc-99m IDA cholescintigraphy has had a dramatic impact upon hepatobiliary diagnosis.
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PMID:Role of 99mTc-IDA cholescintigraphy in evaluating biliary tract disorders. 699 26

Cholescintigraphy with technetium-labeled biliary agents has great value in evaluation of the patient with suspected acute cholecystitis. Visualization of the gall bladder virtually excludes acute cholecystitis and obstruction of the cystic duct. Nonvisualization of the gall bladder, however, is not specific for acute cholecystitis and may also occur in some patients with chronic cholecystitis or pancreatitis. Interpretation of gall bladder nonvisualization, therefore, must be correlated with the clinical presentation. Biliary tract imaging is also useful in evaluation of some focal abnormalities within the liver, neonatal jaundice, detection of bile leaks or bile reflux, and biliary-enteric shunts. The role of technetium-labeled biliary agents in the evaluation of patients with jaundice is less clear. Excretion of tracer into the gut excludes complete biliary tract obstruction, but the test may be nonconclusive at higher serum bilirubin levels. If persistent common bile duct activity is observed with delayed excretion into the gut, the diagnosis of partial obstruction may be made, but this procedure will be inconclusive if the common bile duct is not visualized and/or significant hepatocellular disease is present. Ultrasonography and abdominal CT are the preferred tools for the diagnosis of biliary tract obstruction at present, but newer biliary tract agents which achieve better hepatic extraction and greater bile concentration at high serum bilirubin levels may improve the diagnostic efficacy of cholescintigraphy.
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PMID:Radionuclide imaging of the biliary tract. 703 71

Ninety-five patients with clinically suspected acute cholecystitis underwent hepatobiliary scanning with 99mTc-PIPIDA. A positive scan (nonvisualization of the gallbladder with visualization of the common bile duct and gut) was found in 29 patients; 25 of them (86%) had surgically proven acute cholecystitis and 4 (14%) had chronic cholecystitis. Five of the 25 with acute cholecystitis had acalculous disease. A negative examination (gallbladder visualization) occurred in 63 patients; 18 (29%) had chronic cholecystitis and 45 (71%) were subsequently found to have nonbiliary disease. Three indeterminate studies (nonvisualization of both the gallbladder and gut) were obtained in patients with choledocholithiasis and chronic cholecystitis. In the evaluation of acute cholecystitis, the 99mTc-PIPIDA hepatobiliary scan was 100% sensitive and 94% specific.
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PMID:Hepatobiliary scanning with 99mTc-PIPIDA in acute cholecystitis. 705 32

The authors present the incidence of the typical ultrasonographic signs of acute cholecystitis (46 cases), chronic cholecystitis (25 cases), cholecystosis (9 cases), empyema (28 cases) and carcinoma of the gallbladder (30 cases). Ultrasonography, together with the clinical picture, enables the identification of the lesion, its extension and evolution in most of the cases. Rarely do differential diagnostic problems exist. The ultrasonographic follow-up examination has been useful in acute inflammatory diseases to evaluate the efficiency of medical therapy and to detect complications which require immediate surgery. The authors emphasize the value of high-resolution real-time technique.
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PMID:Ultrasonographic aspects of inflammatory and neoplastic diseases of the gallbladder. 712 6


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