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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Suturing of deep ruptures of the liver frequently produces complications of hemobilia, secondary hemorrhage and intrahepatic cavitation with sepsis and liver failure. Such complications require second and third risky operations in already critically ill patients. Such wounds should not be sutured, adequate drainage should be provided, low pressure venous bleeding should be controlled with temporary gauze tampons and arterial bleeding should be stopped by hepatic artery ligation. Such treatment obviates dangerous hepatic resections and morbid thoracoabdominal incisions and prevents hematobilia, secondary hemorrhage, intrahepatic cavitation and sepsis with hepatic failure.
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PMID:The hazards of suturing certain wounds of the liver. 78 77

Fragmentation of bile duct stones by mechanical, electrohydraulic, and laser intraluminal lithotripsy has greatly facilitated the ability to remove stones that are otherwise difficult to remove by standard manipulative techniques. Even these approaches fail when stones lack access or are impacted within the biliary tree. Extracorporeal shock-wave lithotripsy (ESWL) was evaluated in the United States in a multicenter trial with 56 patients. Stone fragmentation occurred in 91 percent of patients and duct clearance in 79 percent. Adjunctive procedures were used in 54 percent. Two ESWL treatments were required for fragmentation in 28 percent. Complications were mild and relatively infrequent. Hemobilia (8 percent), gross hematuria (6 percent), and biliary sepsis (4 percent) occurred less frequently than expected. There were no deaths during the 1 to 31 days of hospitalization (mean 9 days). We conclude that ESWL is a safe and effective adjunct to the treatment of difficult-to-remove bile duct stones under the conditions observed in this trial.
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PMID:Lithotripsy for bile duct stones. 267 46

Percutaneous Transhepatic Biliary Drainage (PTHBD) was performed in 56 consecutive patients with severe acute cholangitis, during a period of one year. An immediate decompression effect with a "good" response was achieved in 46 (82.2%), who usually became afebrile within 18 to 24 hours, and "poor" response in 10 (17.8%). Five died (8.93%) in a subsequent operation. No mortality was associated with the use of PTHBD. Complications related to the procedure occurred in 12 of the 56 patients (21.4%). Hemobilia was the major complication. The other complications were intraabdominal hemorrhage, bleeding from the puncture site, transient hypotension, catheter occlusion and/or dislodgement, bile leak, pneumothorax and hemothorax. Two with hemobilia, one with intraabdominal hemorrhage and the other with bile leak required an emergency operation. PTHBD procedures can be lifesaving in biliary sepsis. Once infection and hyperbilirubinemia are controlled, rational subsequent therapy can be formulated for the underlying disease.
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PMID:Percutaneous transhepatic biliary drainage for acute cholangitis. 367 29

Hemobilia is a rare complication of percutaneous liver biopsy. We present such a case that demonstrates the usefulness of endoscopic retrograde cholangiopancreatography in establishing the diagnosis, the importance of localization of the bleeding site by angiography, and the therapeutic usefulness of arterial embolization for the control of persistent bleeding. Also, we propose a possible indication for endoscopic sphincterotomy in the rare case where retained intrabiliary blood clot causes progressive obstructive jaundice complicated by severe pain and sepsis.
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PMID:Hemobilia after percutaneous liver biopsy: role of endoscopic retrograde cholangiopancreatography and sphincterotomy. 640 24

Liver biopsy is generally considered a safe and highly useful procedure. It is frequently performed in an outpatient setting for diagnosis and follow-up in numerous liver disorders. Since its introduction at the end of the 19th century, broad experience, new imaging techniques and special needles have significantly reduced the rate of complications associated with liver biopsy. Known complications of percutaneous biopsy of the liver include hemoperitoneum, subcapsular hematoma, hypotension, pneumothorax and sepsis. Other intra-abdominal complications are less common. Hemobilia due to arterio-biliary duct fistula has been described, which has only rarely been clinically expressed as cholecystitis or pancreatitis. We report a case of a fifteen year-old boy who developed severe acute cholecystitis twelve days after a percutaneous liver biopsy performed in an outpatient setting. The etiology was clearly demonstrated to be hemobilia-associated, and the clinical course required the performance of a laparoscopic cholecystectomy. The post operative course was uneventful and the patient was discharged home. Percutaneous liver biopsy is a safe and commonly performed procedure. However, severe complications can occasionally occur. Both medical and surgical options should be evaluated while dealing with these rare incidents.
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PMID:Percutaneous liver biopsy complicated by hemobilia-associated acute cholecystitis. 1686 94

Haemobilia is a rare cause of acute upper gastrointestinal bleeding and is often associated with a history of hepatic or biliary tract injury, tumor growth, hepatic artery aneurysm, cholecystitis, or hepatic abscess. We report a case of a 79-year-old women with haemobilia due to acenocoumarol overdosage. She has been, taking 12 mg acenocoumarol by mistake for 5 days before admission because of atrial fibrillation. INR was 20 during an admission. Ultrasonographic evaluation demonstrated hepatomegaly, cholelithiasis, thick sludge in gallbladder represented blood clots and also dilated biliary tract. Cholecystectomy was carried out. The cut section of gall bladder showed stone, haemolysed blood and blood clots. Choledochotomy showed only blood clots within the duct. The treatment lasted long period and patient died because of multiorgan insufficiency in the course of sepsis.
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PMID:[Haemobilia in the course of acenocoumarol overdosage in patient with cholelithiasis--case report]. 1772 96

Pancreatic arteriovenous malformations (AVM) are extremely rare diseases frequently complicated by gastrointestinal hemorrhage. While surgical resection of affected lesion is preferred for the treatment of pancreatic AVM, angiographic intervention can be used as an alternative treatment, especially in surgically high-risk patients. We experienced a patient with pancreatic AVM manifested by hemobilia and biliary sepsis. Superior mesenteric and common hepatic arteriography showed pancreaticoduodenal AVM composed of nidus supplied by numerous fine feeding arteries and of draining veins encircling the common bile duct (CBD). Hemobilia was controlled by transportal coil embolization of draining veins of AVM around the CBD. Herein, we report this case with the review of literatures.
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PMID:[Hemobilia from pancreatic arteriovenous malformation: successful treatment with transportal coil embolization of draining veins]. 1815 92