351
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Bishop WP, Kao SC. Prolonged postprandial abdominal pain following Kawasaki syndrome with acute gallbladder hydrops: association with impaired gallbladder emptying. J Pediatr Gastroenterol Nutr 1991; 13:307-11. [PMID: 1791510 DOI: 10.1097/00005176-199110000-00013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Acute hydrops of the gallbladder is a well-recognized complication of Kawasaki syndrome. We report a case of a child with this syndrome whose gallbladder hydrops slowly resolved after intravenous gamma-globulin therapy. However, he continued to experience postprandial right upper quadrant abdominal pain. Hepatobiliary scintigraphy revealed normal filling of the gallbladder but marked impairment of meal-stimulated gallbladder emptying. Endoscopy with biopsy of the esophagus, stomach, and duodenum was normal, ruling out peptic complications of his aspirin therapy. This child's discomfort improved slowly over several months, finally ending approximately 6 months after the onset of his illness. A repeat gallbladder emptying study done ultrasonographically at that time revealed near-normal meal-stimulated gallbladder emptying. We conclude that poor emptying of the gallbladder may be associated with prolonged abdominal pain in Kawasaki syndrome. Meal-stimulated gallbladder emptying can be assessed by a simple ultrasonographic technique and should be considered in any patient with Kawasaki syndrome and abdominal pain.
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352
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Iacconi P, Reginato E. Spontaneous rupture of the gallbladder and haemoperitoneum in a patient with cardiac valve prostheses. THE ITALIAN JOURNAL OF GASTROENTEROLOGY 1991; 23:426-8. [PMID: 1742541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A case is reported of isolated spontaneous rupture of the gallbladder with obstructed cystic duct and a stone in the cystic cavity, in a patient on anticoagulant treatment after cardiac valve replacement. The mechanism of the onset, the diagnosis and the treatment of the lesion are discussed together with a review of the literature.
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353
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Suda T, Oya M, Hatakeyama S, Abe A, Saito H, Takagi K, Koyama T, Sekiya M. [A case of biloma induced by spontaneous rupture of gallbladder]. NIHON SHOKAKIBYO GAKKAI ZASSHI = THE JAPANESE JOURNAL OF GASTRO-ENTEROLOGY 1991; 88:1375-9. [PMID: 1890765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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354
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Moriai T, Hasegawa T, Fuzita M, Kimura A, Tani T, Makino I. Successful removal of massive intragastric gallstones by endoscopic electrohydraulic lithotripsy and mechanical lithotripsy. Am J Gastroenterol 1991; 86:627-9. [PMID: 2028958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We describe a case of massive gallstones discharged into the stomach through a cholecystoduodenal fistula and the successful removal of these stones by endoscopic electrohydraulic lithotripsy (EEHL) and endoscopic mechanical lithotripsy (EML) for the prevention of gallstone ileus. A 60-yr-old woman was admitted with epigastric pain and nausea. Upper gastrointestinal tract examination demonstrated backflow of contrast medium from the duodenal bulb into the gallbladder. Endoscopic examination revealed a large fistula on the anterior wall of the duodenal bulb, and two brown stones (about 3 cm in diameter) were found in the stomach. To prevent gallstone ileus, removal of these stones was attempted. They were broken into pieces by EEHL, then crushed into smaller pieces by EML and removed orally. Chemical analysis showed the composition of the gallstones to be at least 98% cholesterol. The patient was discharged one month after removal of the gallstones and has remained asymptomatic.
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355
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Haleem S, Ansari MM, Khan TZ, Beg MH. Cholecysto-cardiac link. Indian J Med Res 1991; 94:47-9. [PMID: 2071183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Thirty normotensive patients (ASA class I) and 30 treated hypertensives without any cardiac problem (ASA class II) were subjected to elective cholecystectomy under general anaesthesia. Patients' age ranged from 25-50 yr, and male:female ratio was 1:11. There were significant increases in heart rate and mean arterial pressure in both the groups (P less than 0.05) during surgical manipulations for removal of the diseased gall bladders. The alterations in the treated hypertensive patients were not only much more than in the normotensives, but also were associated with tachyarrhythmias in 33.33 per cent of hypertensive patients. All changes returned to the pre-induction level at the end of the surgery. Mediation through fifth thoracic spinal segment, a common source of sympathetic supply to heart and gallbladder, explained the observed cholecystocardiac link. Anaesthetists therefore need to be vigilant during cholecystectomies.
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356
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Akhunbaeva NI, Esengel'diev ME. [Successful surgical treatment of diffuse echinococcosis of the abdominal cavity]. Khirurgiia (Mosk) 1990:141-2. [PMID: 2079800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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357
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Civardi G, Fornari F, Cavanna L, Sbolli G, Di Stasi M, Buscarini L. Ultrasonically guided percutaneous drainage of abdominal fluid collections: a long-term study of its therapeutic efficacy. GASTROINTESTINAL RADIOLOGY 1990; 15:245-50. [PMID: 2187732 DOI: 10.1007/bf01888786] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Fifty patients underwent ultrasonically guided percutaneous drainage (US-GPD) either with needle aspiration or catheter drainage. The procedures resulted in 70% complete recovery, 20% partial success and 10% of failures. The same patients were followed with clinical examination and sonography for a mean time of 36.3 months (minimum follow-up: 12 months). During the follow up period, 10 relapses occurred and one patient, considered for surgery after partial percutaneous treatment of a pyogenic liver abscess, recovered completely under conservative treatment. An analysis of the factors potentially related to the recurrence was made. It was found that one-step needle aspiration of abdominal abscesses and percutaneous treatment of chronic pancreatic pseudocysts are more prone to relapses. We conclude that US-GPD is an efficacious therapy for abdominal fluid collections, but an adequate drainage technique and a careful selection of the patients is crucial to avoid the possibility of relapse.
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358
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Singhal A, Raju N, Serjeant GR. Empyema of gallbladder in a child with homozygous sickle-cell disease. W INDIAN MED J 1990; 39:243-4. [PMID: 2082570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A 13-year-old boy with homozygous sickle-cell (SS) disease followed from birth in a cohort study of sickle-cell disease developed empyema of the gallbladder after a known 3-year history of gallstones. At this age, gallstones occur in 30% of cohort study children with SS disease but this is the first patient with specific symptoms.
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359
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Uzzau A, Risaliti A, Terrosu G, Intini S, Noce L, De Anna D. [Hemocholecyst: a rare cause of hemoperitoneum]. G Chir 1990; 11:570-2. [PMID: 2288847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A rare case of haemoperitoneum due to gallbladder rupture with intraluminal bleeding is reported. The importance of a coagulopathy in the etiology of the disease is pointed out: in the present case it was related to cirrhosis and anticoagulant treatment during dialysis sessions.
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360
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Corell Planelles R, García Calvo R, Gibert Gerez J, Villalba Munera V, Manzanet Andrés G. [Porto-cholecysto-duodenal fistula as an infrequent cause of upper gastrointestinal hemorrhage]. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS : ORGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE PATOLOGIA DIGESTIVA 1990; 78:248-50. [PMID: 2083126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A case of porto-cholecysto-duodenal fistula which caused a severe upper gastrointestinal haemorrhage is presented. The difficulties involved in diagnosis and surgical treatment are discussed.
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361
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Lointier PH, Kauffmann P, Francannet P, Pezet D, Chipponi J. Management of intrahepatic calculi in Caroli's disease by extracorporeal shock wave lithotripsy. Br J Surg 1990; 77:987-8. [PMID: 2207589 DOI: 10.1002/bjs.1800770909] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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362
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Haffner SM, Diehl AK, Mitchell BD, Stern MP, Hazuda HP. Increased prevalence of clinical gallbladder disease in subjects with non-insulin-dependent diabetes mellitus. Am J Epidemiol 1990; 132:327-35. [PMID: 2196792 DOI: 10.1093/oxfordjournals.aje.a115662] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The association between non-insulin-dependent diabetes mellitus (NIDDM) and the prevalence of gallbladder disease remains controversial. The authors investigated this association in 1,250 men and 1,656 women from the San Antonio Heart Study (1984-1988) a population-based study of diabetes and cardiovascular disease. A total of 68% of the subjects were Mexican American, a population at high risk for both gallbladder disease and NIDDM. Gallbladder disease was assessed by self-report, and the prevalence of diabetes was determined using National Diabetes Data Group criteria. NIDDM was significantly associated with gallbladder disease in Mexican-American men and women and in non-Hispanic white women. After adjustment for age, body mass index, ratio of waist-to-hip circumference, and ethnicity, using multiple logistic regression, the odds of gallbladder disease in women was 1.6 times higher if NIDDM was present (odds ratio = 1.60, 95% confidence interval 1.08-2.37). Mexican-American women also had a significantly increased prevalence of gallbladder disease relative to non-Hispanic white women (odds ratio = 2.21, 95% confidence interval 1.50-3.28). In nondiabetic women, fasting insulin was significantly related to prevalence of gallbladder disease in univariate analyses, but not in multivariate analyses. The authors conclude that women with diabetes have an increased prevalence of gallbladder disease relative to nondiabetic women and that this association is not explained by the greater adiposity or unfavorable body fat distribution of the diabetic subjects.
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363
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Ruzyłło E, Godziemba-Maliszewska E, Tacikowski T. Natural history of peptic ulcer disease in Poland. Part VIII. Peptic ulcer disease and diseases of the liver, bile ducts and gallbladder. MATERIA MEDICA POLONA. POLISH JOURNAL OF MEDICINE AND PHARMACY 1990; 22:225-32. [PMID: 2132431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The data obtained from the databank Ulcer showed that among 5813 patients with peptic ulcer 472 (8.11%) had concomitant liver diseases, and 540 (9.28%) had concomitant disease of the bile ducts. A detailed analysis of the data confirmed the presence of symptoms and signs known to occur in these diseases.
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364
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Benage D, O'Connor KW. Cholecystocolonic fistula: malabsorptive consequences of lost bile acids. J Clin Gastroenterol 1990; 12:192-4. [PMID: 2324484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
A patient with the painless onset of a cholecystocolonic fistula associated with virtually complete common bile duct obstruction due to stones provided a unique opportunity to assess the consequences of prolonged bile acid depletion on the digestion and absorption of nutrients. Over 2 years, the patient insidiously developed steatorrhea, osteomalacia with an atraumatic pelvic fracture, and congestive heart failure complicated by polymorphic ventricular tachycardia (torsade de pointes) all of which could be attributed to malabsorption of fat and fat-soluble vitamins.
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365
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Safran D. Massive hemoperitoneum from transhepatic perforation of gallbladder. Surgery 1990; 107:356. [PMID: 2309155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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366
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Hannesschläger G, Schwarzl G, Reschauer R. [Bilateral gallbladder rupture after blunt abdominal trauma]. Dtsch Med Wochenschr 1989; 114:1964-7. [PMID: 2598793 DOI: 10.1055/s-2008-1066855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A 65-year-old man under the influence of alcohol sustained blunt trauma to the abdomen in an accident while riding a motorcycle. An intramural haematoma of the gall-bladder was demonstrated by computed tomography: peritoneal lavage was negative. About five hours later the gall-bladder ruptured, as confirmed at laparotomy. The postoperative course after cholecystectomy was uneventful.
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367
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Donadio F, Vajo M, La Ganga V, Campanella G, Moreno S, Granello M, Suriani R. [Complicated torsion of the gallbladder. Presentation of a clinical case]. MINERVA CHIR 1989; 44:2347-9. [PMID: 2626200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A case of gallbladder torsion complicated by sigmoid volvulus and sub-torsion of the ileus is reported because of the difficulty of diagnosis, conditioned by polymorphic symptomatology, the expression of a variety of causes and contributing causes that play an important role in the greater or less onset of dramatic symptomatology, and because of the rarity of the pathology.
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368
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Yamamoto M, Nakajo S, Tahara E. Dysplasia of the gallbladder. Its histogenesis and correlation to gallbladder adenocarcinoma. Pathol Res Pract 1989; 185:454-60. [PMID: 2602218 DOI: 10.1016/s0344-0338(89)80062-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
A total of 50 cases of gallbladder dysplasia found adjacent to carcinoma were examined histologically and immunohistochemically for metaplastic changes in order to elucidate the characteristics of the dysplasia of the gallbladder. The incidence of metaplastic changes in the dysplastic mucosa such as the occurrence of endocrine cells, lysozyme-immunoreactive cells, goblet cells, and Paneth cells were 58%, 74%, 32%, and 22%, respectively. Based on the presence or absence of metaplastic changes, these 50 cases of dysplasia were divided into 40 cases (80%) of metaplastic type dysplasia showing at least one marker of metaplasia and 10 cases (20%) of non-metaplastic type dysplasia showing no metaplasia. On the other hand, these 50 cases of carcinoma were divided into 10 cases of non-metaplastic type carcinoma and 40 cases of metaplastic type carcinoma based on the presence or absence of metaplasia in the tumor tissue. The incidence of metaplastic changes in the dysplastic lesions was compared between the dysplasia adjacent to non-metaplastic type carcinoma and that adjacent to metaplastic type carcinoma. The incidence of metaplasia in the dysplastic mucosa adjacent to metaplastic type carcinoma was higher than that adjacent to non-metaplastic type carcinoma with a statistically significant difference. Moreover, the presence or absence of metaplastic changes was also examined in the surrounding dysplasia and non-tumorous mucosa in each case. Most cases of metaplastic type carcinoma were surrounded by dysplasia with metaplastic changes and by metaplastic epithelium, whereas most cases of non-metaplastic type carcinoma were surrounded by dysplasia without metaplasia.(ABSTRACT TRUNCATED AT 250 WORDS)
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369
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Zampriolo P, Paroni R, Astuni M, Tognoli S, Baroni C, Luppi C, Pisa G. [Massive hemoperitoneum caused by spontaneous rupture of the gallbladder during anticoagulant treatment]. G Chir 1989; 10:586-90. [PMID: 2518299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The Authors report main complications of anticoagulant treatment. Particularly, they describe a rare case of hemoperitoneum by spontaneous rupture of the gallbladder. They discuss etiopathogenesis and consequent clinico-therapeutic implications.
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370
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Wimmer B, Lausen M. [Computed tomography of complications of cholecystitis]. Radiologe 1989; 29:349-53. [PMID: 2756126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In cases of acute cholecystitis, especially with cholecystolithiasis, the diagnosis is usually quickly made. In contrast, the symptoms in the presence of such complications as penetration, perforation and local abscess are often unspecific, and diagnostic procedures may be time-consuming, extending into weeks. One reason for this is the rareness of the entity. The same is true for emphysematous cholecystitis, although this presents with more acute symptoms. Computed tomography seems to be the most effective imaging method. Therefore, it should be used in cases of nonspecific problems in the upper abdomen.
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371
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Snyder CL, Ferrell KL, Saltzman DA, Warwick WJ, Leonard AS. Operative therapy of gallbladder disease in patients with cystic fibrosis. Am J Surg 1989; 157:557-61. [PMID: 2729516 DOI: 10.1016/0002-9610(89)90698-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We retrospectively studied 20 patients with cystic fibrosis who underwent surgery for gallbladder disease from 1973 to 1986. A long delay between the onset of symptoms and the diagnosis was noted (mean 7.4 months). This delay was attributed to masking of the symptoms of biliary disease by the malabsorption and pulmonary symptoms seen in this patient population. There was a notable lack of common bile duct disease in our patients as well as in those reported in the literature. This may have been due to a combination of factors: the increased viscosity of the mucus, the small caliber of the gallbladder and ductal system, and the hypotonicity of the gallbladder. We do not recommend routine intraoperative cholangiography in patients with cystic fibrosis and gallbladder disease. Cystic fibrosis is a disease with progressive pulmonary deterioration. Cholecystectomy can be performed in these patients with relative safety if careful preoperative and postoperative care is provided. We recommend early operative intervention in the patient with gallbladder disease and cystic fibrosis.
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372
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Bil'o M, Dzupa K. [Acute obstruction of the pylorus by a gallstone]. ROZHLEDY V CHIRURGII : MESICNIK CESKOSLOVENSKE CHIRURGICKE SPOLECNOSTI 1989; 68:258-60. [PMID: 2749392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The authors describe a case of spontaneous cholecystoduodenal fistula with passage of a stone which caused acute pyloric obliteration. Based on their own experience, they draw attention to some pitfalls of diagnosis and therapy in this relatively rare complication of biliary surgery.
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373
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Syme RG, Thomas EJ. Massive hemoperitoneum from transhepatic perforation of the gallbladder: a rare complication of cholelithiasis. Surgery 1989; 105:556-9. [PMID: 2928958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A 74-year-old woman with known cholelithiasis arrived at our emergency department with mild abdominal pain. During investigation she collapsed with abrupt hypotension. A peritoneal tap revealed frank blood. At urgent laparotomy, there were several liters of blood in the peritoneal cavity and two free gallstones, despite an apparently intact gallbladder. We report the second recorded instance of transhepatic perforation of the gallbladder presenting as massive hemoperitoneum.
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374
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Friesen CA, Gamis AS, Riddell LD, Roberts CC, Jackson MA. Bilirubinuria: an early indicator of gallbladder hydrops associated with Kawasaki disease. J Pediatr Gastroenterol Nutr 1989; 8:384-6. [PMID: 2709270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
We report four cases of gallbladder hydrops associated with Kawasaki disease diagnosed over a 7.5 year period. Despite varying clinical presentations, all four of these patients had the common finding of bilirubinuria prior to clinical symptoms or at the time of admission. Review of 40 other cases of Kawasaki disease without evidence of hydrops over this time period revealed that urinalysis had been performed in each and bilirubinuria was present in only one case. Bilirubinuria appears to be an early indicator of hydrops in these patients.
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375
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Shalowitz JI. Gallstone emesis. Am J Gastroenterol 1989; 84:334-6. [PMID: 2645768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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