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)

A 31-year-old woman had cholecystectomy for recurrent acute cholecystitis. Pathologic examination of the resected gallbladder revealed unsuspected histiocytic lymphoma. A staging laparotomy seven weeks after cholecystectomy revealed disseminated disease. Lymphomatous involvement of the gallbladder is rarely diagnosed antemortem and indicates disseminated disease until proved otherwise.
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PMID:Diagnosis of lymphoma from a cholecystectomy specimen: case report and review of the literature. 32 1

Bacteriologic study of bile in 100 patients undergoing cholecystectomy for various manifestations of choletithiasis yielded 36 per cent positive cultures, with greater frequency in older individuals and those with acute cholecystitis and common duct stone; these results are comparable to those in previous studies and reaffirm the septicity of the bile. Incidence of wound infection, averanging 10 per cent in published series of cholecystectomies, was 0.5 per cent in 200 patients in whom a water-impermeable wound drape was sewn to the peritoneum to prevent contamination by potentially infected bile. This result, in patients with an infectious risk comparable to that in other series, establishes the value of meticulous wound isolation in preventing wound infection.
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PMID:Improving cholecystectomy. 32 73

100 patients with acute cholecystitis (AC) diagnosed by clinical, laboratory, and roentgenological examinations were randomly divided into 2 groups; early surgery (ES), operated within 7 days after the onset of acute symptoms, and delayed (DS), operated 2--3 months after the acute episode. Patients with elevated serum bilirubin and/or amylase were included in the trial. Two patients died during conservative treatment, and in 4 cases medical treatment was interrupted because of peritonitis, and in 3 cases because of increasing jaundice. Recurrence of AC was found in 24% of the patients in the DS group. There was no mortality in the ES group, but 2 patients died postoperatively in the DS group. Wound infection developed in 3 patients in the ES, and in 8 patients in the DS group. Retained stones remained in 3 cases of the DS and in 1 case of the ES group. The operative procedures were easier to perform in the ES group than in the DS, as estimated by the duration of operation. The operation time was 76.7 +/- 4.6 min (mean p S.E.) in the ES and 98.0 +/- 7.3 min in the DS group. There was a statistically significant difference between the 2 groups (p less than 0.01). The results suggest that early surgery in the treatment of acute cholecystitis is recommended. The complications of failed medical treatment can be avoided by early operation without added risk of mortality or complications.
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PMID:Acute cholecystitis treated by early and delayed surgery. A controlled clinical trial. 35 66

A comparison of two hepatobiliary imaging agents, 99Tcm-dihydrothioctic acid (99Tcm-DHT) and (99Tcm-pyridoxylidene glutamate (99Tcm-PG) has been carried out in 44 non-jaundiced patients. Thirty-one patients were admitted for investigation of upper abdominal pain and 13 patients were volunteers who were undergoing treatment for unrelated conditions. Satisfactory liver images were obtained with both agents in patients without liver disease, but they were inferior to those seen after 99Tcm-sulphur colloid. 99Tcm-PG produced clearer images of the gall-bladder and bile ducts than 99Tcm-DHT. Non-visualization of the gall-bladder was interpreted as gall-bladder disease; in patients with inflammatory gall-bladder disease no gall-bladder image was seen (nine 99Tcm-DHT, nine 99Tcm-PG). The gall-bladder was also not demonstrated in two of the volunteers' group (one 99Tcm-DHT, one 99Tcm-PG), nor was a gall-bladder seen in five patients whose abdominal pain was not due to acute cholecystitis. Despite this, there was agreement between the results of imaging and oral cholecystography in 21 out of 22 subjects. 99Tcm-PG is non-toxic, cheap and rapidly excreted by the liver into the bile. A 99Tcm-PG scan would be useful when rapid diagnosis is required in suspected acute cholecystitis when conventional contrast radiology is unlikely to be of value.
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PMID:Hepatobiliary imaging: a comparison of 99Tcm-dihydrothioctic acid and 99Tcm-pyridoxylidene glutamate in the non-jaundiced patient. 36 Nov 41

A patient with gamma heavy chain disease (Franklin's disease) was discovered during evaluation for pancytopenia and splenomegaly. Lymphadenopathy, palatal edema, and infiltration of the bone marrow palatal edema, and infiltration of the bone marrow with abnormal cells were all absent. Serum and urine protein electrophoresis demonstrated a monoclonal protein migrating in the beta region. Immunoelectrophoresis showed that it reacted with antibodies against the Fc fragment of IgG heavy chains (gamma chains) but not with antibodies against kappa and lambda but not with antibodies against kappa and lambda light chains of Fab fragments. In the first year after detection of the disease, the patient had acute cholecystitis and disseminated herpes zoster. Sixteen months after diagnosis he died of overwhelming pneumonia caused by Pseudomonas aeruginosa and lebsiella neumoniae. A striking feature of his illness was his asymptomatic presentation, with pancytophenia and splenomegaly the only indication of this disease.
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PMID:Gamma heavy chain disease--presenting as pancytopenia and splenomegaly. 40 13

Clinical experience with inflammatory cholecystopathy recognized in 137 patients studied by infusion tomography of the gallbladder is presented. Diagnostic accuracy was 96% in positive and 94% in negative histologically proven cases. Our results show that infusion tomography of the gallbladder is an accurate, rapid, and safe diagnostic aid in the evaluation of acute cholecystitis. In cases of chronic cholecystitis, infusion tomography may be confirmatory but should not be relied on as a final diagnostic test due to a high percentage of false negative cases.
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PMID:Acute cholecystitis: 137 patients studied by infusion tomography of the gallbladder. 40 25

A canine model of acute cholecystitis was used to determine the mechanism of opacification of the gallbladder wall by infusion tomography. The experimental data indicate that opacification of the thickened wall of the gallbladder in acute cholecystitis is a function of hypervascularity and transport of the radiopaque material across the capillary wall by polymorphonuclear cells. Tissue-fluid equilibration of the contrast agent may also play a role.
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PMID:Infusion tomography of the gallbladder: mechanism of gallbladder wall opacification in experimental acute cholecystitis. 40 26

During 5 years 1311 operations for benign diseases of the biliary tract were performed. 281 patients were more than 70 years old, on the average 76,1 years. According to experience and the results the following is emphasized: 1. Complications of gallstones are relatively more frequent in old patients. 2. Cholecystectomy for chronic gall bladder disease should be performed even in old age. Our postoperative mortality rate was 2,5%, increasing to 15,1% when operation was done in a stage of complications. 3. Acute inflammatory cholecystitis should be treated by urgent operation, especially in old age. 4. Cholecystectomy is the method of choice for acute cholecystitis. Cholecystostomy is used only in few exceptional cases. 5. Cholangiometry and cholangiography are always executed, if the cystic duct can be cannulated, even in cases of acute inflammation. 6. If there are stones in the common duct or a stenosis of Oddi's sphineter is found, an acute inflammatory or perforated cholecystitis is no impediment for a one stage repair. 7. Cholangioscopy is the unsurpassable method for exploring the common duct, when it was opened or sphincterotomy was done. 8. Principally indications for transduodenal sphincterotomy are the same for all age groups. The postoperative mortality rate is not higher than after other operations involving the common duct. 9. In old age choledochoduodenostomy is sometimes a good alternative to sphicterotomy. 10. In cases of recurrent operation due to overlooked stones in the common duct or sclerosis of Oddi's sphincter the mortality rate is not higher than after primary interventions for such affections.
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PMID:[Surgery of the biliary tract in geriatric patients (author's transl)]. 41 Jan 97

An analysis of lethality in cholecystitis has been carried out. The main complications, which had resulted in the death of 238 patients, were analysed. Purulent complications served as the most common cause of fatal outcome. The authors came to the conclusion on the necessity to broaden indication for an early surgical intervention in acute cholecystitis in elderly patients.
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PMID:[Analysis of the lethality in cholecystitis and the ways for its decrease]. 42 65

The use of infusion cholecystography as an aid in the diagnosis of acute cholecystitis was investigated in 21 patients. Seventeen of 18 patients (94 per cent) with positive cholecyst-tomograms who underwent laparotomy had confirmation of acutely inflamed gallbladders both macroscopically and histologically. These findings suggest that infusion cholecystography can make a significant contribution in reducing the incidence of misdiagnosis in acute cholecystitis, and that the investigation should be part of the management of patients in whom early surgery is planned.
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PMID:Infusion cholecystography in the diagnosis of acute cholecystitis. 42 83


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