• Title, Summary, Keyword: cholecystitis

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Clinical Report of Acute Cholecystitis with Gagamsaenggan-tang (급성 담낭염 환자의 가감생간탕 치험례)

  • Shin, Yong-Soo;Cho, So-Hyun;Kim, Nam-Uk;Han, Yang-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1465-1469
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    • 2009
  • Acute cholecystitis represents an acute inflammation of the gallbladder, caused in most instances by obstruction of the cystic duct, resulting in acute inflammation of the GB wall. Acute cholecystitis usually occurs with right upper quadrant pain and tenderness. This study was designed to evaluated of oriental medicine on acute cholecystitis. The patient who were suffering from acute cholecystitis was treated with herbal medicine such as Gagamsaenggan-tang. After using Gagamsaenggan-tang, we could find remarkable effect on clinical symtoms and lap findings and Abdominipelvic Ultrasonography study. According to results we suggest oriental medical treatment was effective for this patient with acute cholecystitis, but more extensive research is needed.

Acalculous Cholecystitis Following Multiple Trauma with Fractures (골절을 동반한 다발성 외상 환자에서 발생한 비결석성 담낭염)

  • Kim, Ki Hoon;Kyung, Kyu Hyouk;Kim, Jin Su;Kim, Kwan U;Kim, Woon-Won;Kim, Ji Wan
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.203-208
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    • 2012
  • Purpose: The purpose of this study is to investigate the incidence of acalculous cholecystitis after multiple trauma with fractures and to analyze the characteristics of cholecystitis. Methods: We performed a retrospective study of multiple trauma patients with fractures between April 2010 and April 2012. Sixty- nine patients were identified, and the average age was 46.8(range: 15-74) years. Data were collected regarding associated injury, injury severity score (ISS), the diagnosis time after trauma, diagnostic tool, and management Results: There were three cases(4.3%) of cholecystitis among the 69 cases, and cholecystitis was diagnosed an average of 20.7(range: 8-33) days after injury. Two patients complained of abdominal pain at diagnosis, but the other patient who had undergone surgery for small bowel perforation at the time of the injury had no abdominal pain. All three patients had abnormal liver function tests (LFTs) at diagnosis. The cholecystitis was confirmed with ultrasonography or computed tomography, and all cases were acalculous cholecystitis. At first, percutaneous transhepatic gallbladder drainage was performed; then, laparoscopic cholecystectomy (LC) was tried an average of 12(range: 11-13) days later. An laparoscopic cholecystectomy was successfully done in only one case, the other cases being converted to an open cholecystectomy due to severe inflammation. Conclusion: The incidence of acaculous cholecystitis was 4.3% after multiple trauma with fractures. We should consider cholecystitis in patients with abdominal pain, fever and elevated LFTs after multiple trauma.

Oriental Medical Treatment of chronic Acalculous Cholecystitis (무결석성(無結石性) 만성담낭염(慢性膽囊炎)(Chronic Acalculous Cholecystitis) 환자 치험례)

  • Park, Jung-Han;Cho, Hyun-Seok;Kim, Jung-Chul;Wi, Jong-Seong;Baik, Tae-Hyun;Lee, Hae-Yeon
    • Journal of Pharmacopuncture
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    • v.7 no.3
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    • pp.131-136
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    • 2004
  • Chronic acalculous cholecystitis gets possession of about 12 to 13 percent of patients with chronic cholecystitis. Pathologically it is characterised by chronic inflammation and thickening of the gallbladder wall but doesn't come across stones. Clinical symptoms are vague and include abdominal discomfort and distension, nausea, flatulence and intolerance of fatty foods. A patient on chronic acalculous cholecystitis diagnosed from his clinical symtoms and abdominal ultrasonogram was treated by Geonbihwan, acupuncture and herbal acupuncture. Satisfactory symptomatic improvement was achieved and findings of abdominal ultrasonogram came also normal.

Acalculous Hemorrhagic Cholecystitis with Chronic Intraluminal Hematoma: MRI Findings (혈종을 동반한 무결석 출혈성 담낭염: 자기공명영상소견)

  • Oh, Sang-Young;Park, Mi-Hyun;Jee, Keum-Nahn;Jeon, Gyeong-Sik;Kim, Hong-Ja
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.195-198
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    • 2009
  • Acalculous hemorrhagic cholecystitis is a rare complication of acute cholecystitis and is associated with a high mortality rate. We present a case of acalculous hemorrhagic cholecystitis with hematoma in the gallbladder lumen, which was diagnosed using magnetic resonance imaging (MRI). The T1- & T2-weighted MRI revealed gallbladder distension with a hypointense intraluminal hematoma. The excellent tissue contrast provided by MRI is useful for detecting hematomas in the cases of hemorrhagic cholecystitis.

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Chronic Heavy Metal Exposure and Gallbladder Cancer Risk in India, a Comparative Study with Japan

  • Chhabra, Deepak;Oda, Koji;Jagannath, Palepu;Utsunomiya, Hirotoshi;Takekoshi, Susumu;Nimura, Yuji
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.187-190
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    • 2012
  • Background: High incidence of gallbladder cancer (GBC) is reported from North India, with elevated concentrations of heavy metals in water and soil. This Indo-Japan collaborative study compared presence of heavy metals in gallbladder tissues. Methods: Heavy metal concentrations were estimated in Indian GBC and cholecystitis tissues and compared with Japanese GBC and cholecystitis tissues. Spectrophotometry was done for 13 Indian gallbladder tissues (8 GBC, 5 cholecystitis) and 9 Japanese (5 GBC, 4 cholecystitis). Transmission electron microscopy (TEM) thin foil element analysis was done in 10 Indian samples (6 GBC, 4 cholecystitis). Results: Chromium, lead, arsenic and zinc were significantly high in Indian GBC compared with Japanese GBC. Chromium, lead and arsenic were significantly high in the Indian cholecystitis tissues compared to the Japanese. TEM of Indian tissues demonstrated electron dense deposits in GBC. Conclusion: Heavy metals-chromium, lead, arsenic and zinc are potential carcinogens in Indian GBC from endemic areas. This preliminary study links presence of heavy metals in gallbladder cancer tissues in endemic areas.

Clinical Application of $^{99m}Tc-HIDA$ Cholescintigraphy in the Cholecystitis (담낭염 환자에서의 $^{99m}Tc-HIDA$ Scan의 진단적 의의)

  • Park, R.J.;Ahn, I.M.;Jang, Y.B.;Hong, K.S.;Yoon, Y.B.;Cho, B.Y.;Koh, C.S.
    • The Korean Journal of Nuclear Medicine
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    • v.15 no.2
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    • pp.11-17
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    • 1981
  • Cholescintigraphic studies with $^{99m}Tc-HIDA$(dimethyl iminodiacetic acid) were performed in 22 cases of normal subjects, 21 of acute cholecystitis, 12 of chronic cholecystitis and 12 others, with the results of, 1) In normal control group, liver and intrahepatic biliary tree, CBD and gall bladder, and G-I tract appeared at 10, 20 and 30 minutes after intravenous injection of $^{99m}Tc-HIDA$ respectively, 2) In acute cholecystitis, 20 among 21 cases showed non-visualization of gall bladder with the diagnostic accuracy, sensitivity and specificity of 93.2%, 95.2% and 100% respectively. 3) In chronic cholecystitis, 5 among 12 cases showed non-visualization of gall bladder and remained 7 among 12 cases showed poor contraction of gall bladder (4), delayed visualization of gall bladder (1) and normal findings (2). 4) In the other disease group, the 12 cases which initially suspected as acute cholecystitis, revealed normal scan findings to exclude the cystic duct obstruction easily, With the above results, this scintigraphic procedure was found very rapid, accurate and easily available method for the determining of the cystic duct patency.

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Clinical Use of Cholescintigraphy in Aeute Cholecystitis: A Comparative Study with Ultrasonography (급성담낭염에서 담낭신티그라피의 임상적 이용)

  • Seo, Kwang-Hee;Chung, Hye-Kyeong;Kim, Myeong-Gon;Chung, Duck-Soo;Sung, Nak-Kwan;Kim, Ok-Dong
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.81-87
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    • 1993
  • Retrospective analysis of cholescintigraphy and ultrasonography was done in 76 patients with clinically suspected acute cholecystitis to assess the relative value of the two modalities. Excluding the Patients with obstructive jaundice, the overall results of cholescintigraphy(sensitivity 100%, specificity 95%, false positive rate 5%, false negative rate 0%, accuracy 97%) are nearly identical with or rather superior to those of the ultrasonography(sensitivity 94%, specificity 100%, false positive rate 0%, false negative rate 5%, accuracy 97%). We recommend the cholescintigraphy as the initial modality in patients with clinically suspected acute cholecystitis, and ultrasonography can be used in jaundiced patients to exclude the possibility of the false positive of cholescintigraphy.

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Endoscopic Ultrasound-Guided Gallbladder Drainage Using a Lumen-Apposing Metal Stent for Acute Cholecystitis: A Systematic Review

  • Jain, Deepanshu;Bhandari, Bharat Singh;Agrawal, Nikhil;Singhal, Shashideep
    • Clinical Endoscopy
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    • v.51 no.5
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    • pp.450-462
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    • 2018
  • Surgery remains the standard treatment for acute cholecystitis except in high-risk candidates where percutaneous transhepatic gallbladder drainage (PT-GBD), endoscopic transpapillary cystic duct stenting (ET-CDS), and endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) are potential choices. PT-GBD is contraindicated in patients with coagulopathy or ascites and is not preferred by patients owing to aesthetic reasons. ET-CDS is successful only if the cystic duct can be visualized and cannulated. For 189 patients who underwent EUS-GBD via insertion of a lumen-apposing metal stent (LAMS), the composite technical success rate was 95.2%, which increased to 96.8% when LAMS was combined with co-axial self-expandable metal stent (SEMS). The composite clinical success rate was 96.7%. We observed a small risk of recurrent cholecystitis (5.1%), gastrointestinal bleeding (2.6%) and stent migration (1.1%). Cautery enhanced LAMS significantly decreases the stent deployment time compared to non-cautery enhanced LAMS. Prophylactic placement of a pigtail stent or SEMS through the LAMS avoids re-interventions, particularly in patients, where it is intended to remain in situ indefinitely. Limited evidence suggests that the efficacy of EUS-GBD via LAMS is comparable to that of PT-GBD with the former showing better results in postoperative pain, length of hospitalization, and need for antibiotics. EUS-GBD via LAMS is a safe and efficacious option when performed by experts.

Premalignant Lesions of Gallbladder Carcinoma and Treatment (담낭암 발생 관련 질환과 치료)

  • Yun, Sung-Su
    • Yeungnam University Journal of Medicine
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    • v.23 no.2
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    • pp.152-161
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    • 2006
  • Carcinoma of the gallbladder is an uncommon but highly malignant tumor with a poor five year survival rate. Early detection is very important for successful treatment because this tumor is very hard to cure in cases where it has advanced beyond the reach of surgical treatment. The purpose of this review was to evaluate risk factors for carcinoma of the gallbladder and determine the best management approach.. Solitary polys, more than one cm are considered to be predisposing factors for gallbladder carcinoma when they are found to be echopenic, sessile, and with a high cell density. Anomalous union of the pacreato-biliary duct(AUPBD) without a choledochal cyst is also considered to increase risk for gallbladder carcinoma. A polyps size of more than one cm and an AUPBD are indications for prophylactic cholecystectomy. The presence of gallstones is a well-established risk factor for the development of gallbladder carcinoma; risk appears to correlate with the stone size and the duration of chronic cholecystitis. Metaplastic changes of the gallbladder epithelium present with chronic cholecystitis and may indicate a premalignant lesion. Abnormal forms of cholecystitis such as xanthogranulomatous or a porcelain gallbladder also have malignant potential; cholecystoenteric fistula as well as bacterial infection of the gallbladder(typhoid, helicobacter species) also has malignant potential. In this review, the risk factors associated with carcinoma of the gallbladder are summarized with special attention to gallstones, polyps, AUPBD, and chronic inflammation.

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A Case of Churg-Strauss Syndrome with Diffuse Alveolar Hemorrhage Presenting as Acute Acalculous Cholecystitis (미만성 폐포 출혈을 동반한 급성 담낭염으로 발현한 Churg-Strauss 증후군 1예)

  • Kim, Ji Eun;Kim, Ki Uk;Park, Hye-Kyung;Jeon, Doo Soo;Kim, Yun Sung;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.225-229
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    • 2009
  • Churg-Strauss syndrome (CSS) is a disorder that is characterized by asthma, hypereosinophilia and systemic vasculitis affecting a number of organs. The manifestations of acute cholecystitis and diffuse alveolar hemorrhage are rarely reported in CSS. A 22-year-old woman with bronchial asthma visited our hospital complaining of right upper quadrant pain with a sudden onset. The abdominal computed tomography (CT) scan revealed gall bladder edema consistent with acute cholecystitis. On the initial evaluation, marked hypereosinophilia was observed in the peripheral blood smear. The nerve conduction velocity measurements and a skin biopsy performed to confirm the organ involvement of disease indicated typical mononeuritis multiplex and necrotizing vasculitis, respectively, which was complicated with CSS. On the 12th hospital day, ground glass opacity and consolidations were newly developed on both lung fields. The bronchoalveolar lavage (BAL) fluid showed increasing bloody return in sequential aliquots that were characteristic of a diffuse alveolar hemorrhage. We report a case of CSS with acute cholecystitis and diffuse alveolar hemorrhage.