11/129. Endoscopic extraction of an ejaculatory duct calculus to treat obstructive azoospermia.Calculous obstruction of an ejaculatory duct is an uncommon cause of azoospermia or low-volume oligospermia in the infertile man. We report the case of a 32-year-old man with azoospermia, low ejaculate volume, and transrectal ultrosonography (TRUS) findings of bilateral seminal vesicle distention. On cystoscopy for planned transurethral resection of the ejaculatory ducts, a calculus obstructing the right ejaculatory duct at the verumontanum was discovered and removed. Three months later, semen analysis showed improvements in volume, sperm concentration, and sperm motility. An ejaculatory duct calculus should be included in the differential diagnosis of obstructive azoospermia or low-volume oligospermia. magnetic resonance imaging or TRUS may be advisable to identify ductal calculi.- - - - - - - - - - ranking = 1keywords = obstruction, duct (Clic here for more details about this article) |
12/129. Transduodenal extended sphincteroplasty and removal of ventral duct pancreatic calculi.The surgical treatment of chronic pancreatitis and associated ductal calculi typically involves drainage of the main pancreatic duct or parenchymal resection. Treatment of isolated symptomatic pancreatic duct calculi is usually approached by endoscopic techniques. Herein is described a case report of operative transduodenal extraction of symptomatic pancreatic calculi of the ventral pancreas in a patient with a prior distal pancreatectomy. This case represents an uncommon yet valuable option in selected patients in whom endoscopic treatments have failed or are unavailable.- - - - - - - - - - ranking = 0.68030093608269keywords = duct (Clic here for more details about this article) |
13/129. Calcified intraluminal meconium in newborn males with imperforate anus. Enterolithiasis in the newborn.Five cases are reported and reference is made to 3 previous similar cases of calcified intraluminal meconium in newborn males with "imperforate anus." A rectourinary fistula was found in most of the patients; none of the cases had meconium peritonitis. The calcifications may develop in areas of prolonged stasis; the possible added role of the mixture of urine and meconium in utero is raised.- - - - - - - - - - ranking = 0.31638774062933keywords = stasis (Clic here for more details about this article) |
14/129. Tropical pancreatitis.Tropical pancreatitis is an uncommon cause of acute, and often chronic, relapsing pancreatitis. patients present with abdominal pain, weight loss, pancreatic calcifications, and glucose intolerance or diabetes mellitus. Etiologies include a protein-calorie malnourished state, a variety of exogenous food toxins, pancreatic duct anomalies, and a possible genetic predisposition. Chronic cyanide exposure from the diet may contribute to this disease, seen often in india, asia, and africa. The pancreatic duct of these patients often is markedly dilated, and may contain stones, with or without strictures. The risk of ductal carcinoma with this disease is accentuated. Treatment may be frustrating, and may include pancreatic enzymes, duct manipulations at endoscopic retrograde cholangiopancreatography, octreotide, celiac axis blocks for pain control, or surgery via drainage and/or resection.- - - - - - - - - - ranking = 0.38874339204725keywords = duct (Clic here for more details about this article) |
15/129. Enterolith obstruction of the ileum as a complication of jejunal diverticulitis. Report of a case.A case of intestinal obstruction due to impaction of an enterolith in the distal ileum is reported. The patient had jejunal diverticulosis. One of the diverticula showed evidence of acute inflammation and another showed signs of fibrosis suggesting previous inflammation. Apparently the enterolith had been released from the acutely inflamed diverticulum. One of the diverticula contained a smaller enterolith. The impacted enterolith was removed by enterotomy and the smaller one milked into the intestine. Chemical analysis of the removed stone showed that it consisted of mainly cholic, desoxycholic and fatty acids.- - - - - - - - - - ranking = 0.62663683946844keywords = obstruction (Clic here for more details about this article) |
16/129. Intermittent small bowel obstruction by jejunal enteroliths in a patient with a Crohn's disease stricture.Small bowel obstruction is most frequently due to postoperative or inflammatory adhesions, intestinal neoplasms, hernias, or bezoars. Intermittent small bowel obstruction may be secondary to a Crohn's disease stricture or to chronic adhesive peritonitis. Enterolithiasis, usually associated with jejunal diverticulosis or with a meckel diverticulum, should be considered in patients who have not previously undergone abdominal surgical procedures. X-ray evidence of stones in the abdominal field, outside the common sites, i.e. gallbladder, kidney, bladder, should suggest a diagnosis of enterolithiasis. The authors report a case of multiple enteroliths in a patient with a segmental ileal stricture and ulcerations (diagnosed as Crohn's disease) causing frequent, intermittent occlusive symptoms, treated by segmental ileal resection.- - - - - - - - - - ranking = 0.75196420736213keywords = obstruction (Clic here for more details about this article) |
17/129. Enterolith ileus as a complication of jejunal diverticulosis: two case reports and a review of the literature.BACKGROUND: In a period of 5 years, 2 patients with enterolith ileus, caused by jejunal diverticulosis, were treated in our hospital. In order to learn more about treatment options, the literature was reviewed. methods: The case history of the 2 patients is described. Relevant articles were identified using medline and pubmed. Data regarding patient gender, age, operative findings, therapeutic measures and outcome were collected. RESULTS: Including patients reported in the literature, 34 cases of intestinal obstruction due to enteroliths expelled from jejunal diverticula were identified. A distinction is made between complicated and uncomplicated enterolith ileus. If there are signs of bowel ischemia, other (unborn) enteroliths, inflammation of the bowel or if there are signs of a (sealed) perforation, the case is considered a complicated enterolith ileus. If none of these signs are present, uncomplicated enterolith ileus is present. In uncomplicated enterolith ileus (21 patients), more often milking and crushing or enterotomy was performed. In complicated enterolith ileus (13 patients), more often a segmental resection of the involved jejunum was performed (p < 0.01). CONCLUSION: Small bowel obstruction due to enteroliths expelled from jejunal diverticula is a rare condition. Relevant literature is only available in the form of case reports. On the basis of the presented patients and patients reported in the literature, a justifiable therapeutic strategy is presented. The least invasive step in the therapeutic approach is to crush and milk the obstructing enterolith down to the colon. Laparoscopic crushing and milking of the enterolith is described. If this fails an enterotomy could be tried, if possible proximal or distal from the obstruction site, in order to make an incision in a less edematous area. If the first two strategies fail, or if complicated enterolith ileus is present, resection of the involved jejunal segment could be considered.- - - - - - - - - - ranking = 0.37598210368107keywords = obstruction (Clic here for more details about this article) |
18/129. Endoscopic intervention for hepatolithiasis associated with sharp angulation of right intrahepatic ducts.BACKGROUND: Hepatolithiasis (intrahepatic stones) is common in Asian patients. Hepatolithiasis with intrahepatic strictures and sharp ductal angulation poses a particularly difficult management problem. methods: Cases of hepatolithiasis with sharp angulation of right intrahepatic ducts were retrospectively reviewed. OBSERVATIONS: Five patients with hepatolithiasis and right sharp intrahepatic ductal angulation were treated endoscopically via ERCP. Two patients died soon after the procedure. In the remaining 3 patients, treatment by dilation of the intrahepatic strictures and stent placement was only partially successful. Attempts to access the sharply angulated intrahepatic duct were unsuccessful. CONCLUSIONS: Endoscopic management of hepatolithiasis associated with sharp angulation of a right intrahepatic duct is difficult and is generally managed best with percutaneous treatment modalities or surgery, where possible.- - - - - - - - - - ranking = 0.87467263210631keywords = duct (Clic here for more details about this article) |
19/129. Intraoperative endoscopic electrohydraulic lithotripsy of pancreatic stones.Two male patients with complications associated with chronic pancreatitis are described. In each patient, preoperative examinations revealed a large stone obstructing the main duct in the head of the pancreas. Lateral pancreaticojejunostomy was performed to relieve pain and prevent further attacks of pancreatitis. During each operation, the stone was fragmented under direct visual control with the use of a flexible choledochoscope and a contact electrohydraulic lithotriptor. The stone was removed and ductal flow through the head of the pancreas was reestablished. Our experience shows that endoscopic electrohydraulic lithotripsy facilitates operative removal of pancreatic stones deeply located in the head of the pancreas.- - - - - - - - - - ranking = 0.19437169602362keywords = duct (Clic here for more details about this article) |
20/129. Effective extracorporeal shock wave lithotripsy for pancreatic duct stone.A 55-year-old man with alcoholic chronic pancreatitis was hospitalized for further treatment of intractable repeated upper abdominal pain. A laboratory data showed normal hepatobiliary enzymes and glucose tolerance test, but abnormal pancreatic enzymes including amylase, lipase, trypsin and elastase I. Pancreatic function diagnostant test was 71%. Abdominal ultrasound examination and computed tomography showed an approximately 4 mm main pancreatic duct stone and multiple small stones in the surrounding parenchyma, and the findings being compatible with chronic pancreatitis. Endoscopic retrograde cholangiopancreatrography revealed that there was a main pancreatic duct stone in the pancreas head, and that the caudal pancreatic duct could not be visualized due to the impacted stone. In addition, intrapancreatic bile duct showed no malignant irregularity, but pancreatitis-induced smooth narrowing. The patient underwent extracorporeal shock wave lithotripsy (ESWL) alone, because endoscopic manipulation for pancreatic stone removal was impossible due to tightly impacted stone with stenosis. Successful ESWL was achieved with the stone disappearance and without any complication.- - - - - - - - - - ranking = 0.84096932276601keywords = duct, bile duct, bile (Clic here for more details about this article) |
| <- Previous || Next -> |