• Title/Summary/Keyword: gallstones

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Medical Imaging of Hepatolithiasis in a Dogs (개에서 간관내 담석의 영상의학적 진단례)

  • Wang, Ji-Hwan;Park, Ki-Tae;Lee, Kyung-Woo;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.91-94
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    • 2009
  • A 6-year-old, intact female mixed dog was referred to Veterinary Medical Teaching Hospital of Gyeongsang National University due to vomiting, anorexia, depression of 1 month's duration. On abdominal radiography, numerous irregularly marginated mineralized branching structures were present within the liver. On ultrasonography, irregular hyperechoic spots with an strong acoustic shadow was identified, but evidence of ductal dilatation was absent. Based on radiography and ultrasonography, intrahepatic gallstones were diagnosed incidentally.

Aging and Gasroenterrogi Changes (노화에 따른 위장관 기능의 변화)

  • 조우균
    • The Korean Journal of Food And Nutrition
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    • v.6 no.3
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    • pp.219-230
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    • 1993
  • This research aims to study the changes In gastrointestinal function attributed to aging In human. The thresholds for recognition and detection of flavors became elevated and salivary gland acinar cells decreased in the old age. But most esophageal function remained relatively Intact. Although gastric emptying time has been slowed with aging, the total intestinal transit time did not differ. Atropic gastritis due to H. pylori in old man decreased secretion of acid and Intrinsic factor and absorbability of calcium and iron. Pancreatic secretion is droned in older persons. Prevalence of gallstones rised with age. Liver size and portal blood flow decreased significantly with age. Mucosal surface area has been reported to be slightly diminished in the aging man. Glucose transporters decreased and Insulin tolerance Increased. Absorption of aromatic amino acid is diminished with age. Dietary protein In that aging human increased fecal nitrogen excretion. Vitamin A tolerance increased. Vitamin D receptor concentration decreased and resistance to 1,25-(OH)2D3 action increased. Permeability of aging small Intestine Increased. Zinc balance dirt not differ Copper absorption appeared not to be significantly affected by age. Neurotensin secretion decreased thus slowed colonic peristaltic movements and Intestinal mucosal growth.

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Gallbladder polyps: evolving approach to the diagnosis and management

  • Kim, Kook Hyun
    • Journal of Yeungnam Medical Science
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    • v.38 no.1
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    • pp.1-9
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    • 2021
  • Gallbladder (GB) polyp is a mucosal projection into the GB lumen. With increasing health awareness, GB polyps are frequently found using ultrasonography during health screening. The prevalence of GB polyps ranges between 1.3% and 9.5%. Most patients are asymptomatic and have benign characteristics. Of the nonneoplastic polyps, cholesterol polyps are most common, accounting for 60%-70% of lesions. However, a few polyps have malignant potential. Currently, the guidelines recommend laparoscopic cholecystectomy for polyps larger than 1 cm in diameter due to their malignant potential. The treatment algorithm can be influenced by the size, shape, and numbers of polyps, old age (>50 years), the presence of primary sclerosing cholangitis, and gallstones. This review summarizes the commonly recognized concepts on GB polyps from diagnosis to an algorithm of treatment.

Choledochal Cyst in Children (소아의 담관낭종)

  • Lim, Sae-Woung;Lee, Suk-Koo;Kim, Hyun-Hahk
    • Advances in pediatric surgery
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    • v.5 no.2
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    • pp.121-125
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    • 1999
  • To study the role of anomalous pancreatico-biliary ductal union (APBDU) in the development of choledochal cyst, we reviewed 23 cases. APBDU is defined as a long common channel(>0.4 mm). The patients ages ranged from 1 week to 112 months and the mean age was 22.5 months. Right upper quadrant pain was the most prevalent symptom. The diagnosis was made by ultrasonography and operative cholangiography in most patient. The preoperative diagnosis was made in 100 % of the cases. Gallstones were found in 5 cases. Todani type I and type IV were prevalent. A long common channel was found in all cases. The operative treatment consisted of cyst excision and Reux-en-Y hepaticojejunostomy or choledochojejunosotmy. One patient had postoperative pancreatitis. There was no mortality. We conclude that detection of choledochal cyst is occurring at a younger age and APBDU seems to play an important role in the pathogenesis of type I and IV cysts. Cyst excision is the treatment of choice to eliminate repeated cholangitis and malignant transformation.

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Comparison of Diets of Urban American Indian and Non-Hispanic Whites: Populations with a Disparity for Biliary Tract Cancer Rates

  • Glew, Robert H.;Wold, Rosemary S.;VanderJagt, Dorothy J.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3077-3082
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    • 2012
  • Aim: The incidence of biliary tract cancer (BTC) is many-fold higher for American Indians (AI) relative to non-Hispanic whites (NHW). Neither gallstones nor genetics can account for this difference. There is speculation that certain fatty acids in bile may play a role in preventing BTC. Since diet may influence composition of bile, we compared the dietary intakes of urban AI and NHW adult women in New Mexico. Methods: Design, a cross-sectional study of the diets of lactating AI and NHW women was conducted. Setting, the University of New Mexico Hospital. Participants, healthy lactating women 18 to 39 years of age were recruited. Main outcome measures, a three-day diet record for each participant was analyzed. Results: The AI women consumed less calcium (p = 0.04) and significantly less short and intermediate chain-length fatty acids (C4-C12), but nearly twice as much proinflammatory arachidonic acid as the NHWs (p <0.01). The intake of dairy products by AI women was less than NHW women (p = 0.01) while the intake of processed meat products was higher (p <0.01). Conclusion: Dietary factors may account for the difference in the risk of BTC between AI and NHW women.

A Review of the Techniques, Current Status and Learning Curves of Laparoscopic Bile Duct Exploration

  • Poh Benjamin Ruimin;Tan Siong San;Lee Lip Seng;Chiow Adrian Kah Heng
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.37-43
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    • 2017
  • Laparoscopic cholecystectomy is of one the most common general surgical operations performed today. Concomitant choledocholithiasis occurs in roughly 10-20% of patients with symptomatic gallstones. Laparoscopic bile duct exploration (LBDE) offers a single-stage minimally-invasive solution to the management of choledocholithiasis. LBDE may be performed either via the transcystic route or via laparoscopic choledochotomy. A number of strategies to improve success are available to the surgeon to help in the problem of complicated choledocholithiasis, these range from simple maneuvers to the use of laser or mechanical lithotriptors. With the advances in laparoscopic surgery, it is also possible to handle complex surgical conditions such as Mirizzi syndrome or recurrent pyogenic cholangitis laparoscopically, even though these have yet to be accepted as standard of care. Following laparoscopic choledochotomy, options for closure include: primary closure, closure over a T-tube, and closure over an endobiliary stent. T-tube placement has been associated with increased operating time and hospital length of stay compared to primary closure, with no significant differences in morbidity. Based on the available literature, LBDE appears comparable to ERCP with regards to procedural efficacy and morbidity. LBDE remains relevant to the general surgeon and is best viewed as being complementary to endoscopic therapy in the management of choledocholithiasis.

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Duplicated extrahepatic bile duct (type Vb): An important rare anomaly

  • Vaibhav Kumar Varshney;Sabir Hussain;N. Vignesh;B. Selvakumar;Lokesh Agarwal;Taruna Yadav
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.220-225
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    • 2023
  • Congenital duplication of the extrahepatic bile duct (DEBD) is an unusual anomaly of the biliary system. It occurs due to inability of the embryological duplex biliary system to regress. DEBD has various subtypes depending on the morphology and opening of the aberrant common bile duct. It can have distinct complications. We encountered a 38-year-old lady who experienced pain in the right upper abdomen along with a low-grade fever. Magnetic resonance cholangiopancreatography revealed DEBD with multiple calculi in the right hepatic duct (ductolithiasis) and joining of the right hepatic duct with the left hepatic duct in the intrapancreatic region. Endoscopic retrograde cholangiography failed to clear the calculi from the right duct. They were then managed by common bile duct exploration and roux-en-Y right hepaticojejunostomy for biliary drainage. Her postoperative period was uneventful. She is currently doing well after three months of follow-up. Hence, a proper preoperative delineation of such rare anomalies is essential. It could avoid inadvertent injury to the bile duct and operative complications.

The Potential of Yangdorak Diagnosis Application of Gallstone (담석증에 대한 양도락 진단의 활용 가능성)

  • Han, Gyu Eon
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.139-149
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    • 2024
  • Objectives: The aim of the study was to investigate the potential of Yangdorak diagnosis application against gallstone scanned by Ultrasound diagnosis. Method: For this aim, among 97 patients who had visited Julip Korean Medicine Clinic from July 2016 to June 2023, 30 patients with no gallstone as a control group and 67 patients with gallstone and diagnosed by ultrasonography, were subjected to Yangdorak diagnosis. Then, the changes in Gallbladder Meridian (GB) value as F5 AVE(average of left and right GB value) by Yangdorak were comparatively analyzed between gallstone and non-gallstone groups and statistical significance was evaluated by Tukey's multiple comparison test using Prism software. Results: After all subjects were evaluated by the Yangdorak and ultrasonography to assess the potential of the Yangdorak diagnosis for gallstone, it was noteworthy that the Yangdorak values relevant to F5 AVE of female gallstone group(N=36) were significantly (p<0.001) decreased compared to the control group (N=30), while there was no significance in male gallstone group(N=31). Also, it was recognized significant difference between male and female groups. Conclusion: Based on these results, if the Yangdorak value can be estimated from a decrease with clinical symptom in female patient, it is recommended to follow up the ultrasonography test for diagnosing the gallstone.

The Assessment of Gallbladder with Various Fatty Meal in Oral Cholecystography (경구담낭조영술의 지방식에 관한 비교평가)

  • Yeon, Jeong-Hum;Kwon, Lee-Seon;Kim, Myung-Sook;Chung, Kyung-Mo;Kim, Hea-Sung;Cheung, Hwan
    • Journal of radiological science and technology
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    • v.16 no.1
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    • pp.89-94
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    • 1993
  • However, technical advances in ultrasono imaging have had a remarkable impact on the study of biliary system oral cholecystography is a contrast of the gallbladder which is very frequently performed even with the application of Extra Shock Wave Lithotripsy(ESWL) in clinical use. Oral GB requires a stringent preparation if it is to be fully successful and a considerable amount of time to complete all its procedures and its objects of the radiographs. 1) to obtain a firm diagnosis of the presence of gallstones. 2) to essess function of the gallbladder that is, its ability to concentrate and store bile. After a times sequence of X-ray exposures taken in various positions to show the gallbladder to be satisfactorily filled, the patient is given a fatty meal, for instances two eggs or a cup of milk. The gallbladder which is drained by the cystic duct stores and concentrates the bile and is stimulated to contrast and excrete the bile by hormone "cholecystokinin" secreted in the intestinal mucosa. To evaluate the effect of the fatty meal which caused the gallbladder to constrict and empty, and by so doing the contrast medium passes through the cystic and bile ducts which are shown in radiographs exposed from 15-30 minutes after the variety practice of fattymeal, such as soft-boiled 2 eggs, raw 2 eggs, 100g of peanuts, and 200ml of milk. If the concentration of the opaque medium in the gallbladder is adequate, then not only the size, shape and position of the gallbladder will be shown from firms taken at intervals, the rate of concentration of the opaque medium and of the emptying of gallbladder has been measured and analyzed.

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Pediatric Cholecystectomy: Clinical Significance of Cases Unrelated to Hematologic Disorders

  • Kim, Hae-Young;Kim, Soo-Hong;Cho, Yong-Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.2
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    • pp.115-120
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    • 2015
  • Purpose: Cholecystectomy is rarely performed in the child and adolescent. However, it is associated with several conditions. This study was conducted to describe the characteristics of pediatric patient who underwent cholecystectomy unrelated to hematologic disorders, and then to suggest its clinical significance in management by comparing a simple and complicated gallbladder disease. Methods: We reviewed cases of cholecystectomy in pediatric patients (under 18 years old) at a single institution between January 2003 and October 2014. There were 143 cases during the study period and 24 were selected as the subject group. Results: There were 7 male (29.2%) and 17 female (70.8%) patients. The mean age was 13.1 years old, and 66.6% of patients were older than 12 years. Mean body weight was 52.7 kg, and body mass index was $21.7kg/m^2$, with 41.7% of patients being overweight or obese. We could identify a female predominance and high proportion of overweight or obesity in a complicated disease. There were also significantly increased levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and bilirubin in this group. Most patients (87.5%) underwent laparoscopic cholecystectomy. Conclusion: Cholecystectomy for diseases unrelated to hematologic disorders is rarely performed in the child and adolescent. In general, female patients who are overweight or obese, and those older than 12 years old, require laparoscopic cholecystectomy owing to multiple gallstones. This condition has a tendency to show a complicated gallbladder disease and significantly increased levels of AST, ALT, ALP, and bilirubin.