1/6. Double gallbladder-a laparoscopic management.A rare case of gallbladder duplication, an unusual biliary anomaly is reported in a young female patient presenting with acute cholecystitis. After a confirmed diagnosis of double gallbladder was made by sonography, endoscopic retrograde cholangio-pancreaticography (ERCP), and magnetic retrograde cholangio-pancreaticography(MRCP), both gallbladders were removed laparoscopically. On histology both gallbladders showed cholesterolosis. Detailed preoperative investigations are required for an accurate preoperative diagnosis before considering laparoscopic cholecystectomy to avoid inadvertent damage to biliary ductal system and overlooking of second gallbladder during surgery.- - - - - - - - - - ranking = 1keywords = duct (Clic here for more details about this article) |
2/6. Acute cholecystitis and severe ischemic cardiac disease: is laparoscopy indicated?BACKGROUND AND OBJECTIVES: laparoscopy in patients with poor cardiac function has been the subject of controversy and is considered by many surgeons a relative contraindication. methods: We report the case of a patient who presented with acute cholecystitis and choledocholithiasis concurrent with unstable angina. Our experience in laparoscopic management of patients with calculous biliary disease and severe coronary artery disease is examined. RESULTS: The patient was managed by coronary angioplasty and stenting immediately followed by laparoscopic cholecystectomy and common bile duct exploration under close invasive hemodynamic monitoring and low-pressure pneumoperitoneum. Between 1996 and 2001, 39 patients with coronary artery disease and an ASA class of III or IV underwent laparoscopic cholecystectomy. Eight of these patients (20.5%) had common bile duct stones necessitating laparoscopic common bile duct exploration. No conversions were necessary, and no major morbidity or mortalities occurred. CONCLUSIONS: Laparoscopic cholecystectomy and common bile duct exploration can be safely performed in patients with severe ischemic cardiac disease under close hemodynamic monitoring and a low-pressure pneumoperitoneum (10 to 12 mm Hg).- - - - - - - - - - ranking = 26.273418258993keywords = bile duct, bile, duct (Clic here for more details about this article) |
3/6. Cytologic diagnosis of suppurative cholecystitis due to candida albicans and actinomyces. A report of 2 cases.BACKGROUND: Cholecystitis is a common inflammatory disease of the gallbladder. actinomycosis and candidiasis of the gallbladder are uncommon causes of acute cholecystitis. There has been no previous report on the cytologic diagnosis of actinomycosis and candidiasis from aspirated gallbladder bile intraoperatively. CASES: Purulent bile was intraoperatively aspirated from the gallbladder of 71-year-old Indian and a 30-year-old Australian woman. The specimens were sent for cytologic examination. The first case revealed sulphur granules characteristic of actinomyces spp. The second case showed budding spores and pseudohyphae of Candida spp. Pure colonies of candida albicans grew from the bile culture. CONCLUSION: actinomycosis and candidiasis rarely cause acute suppurative cholecystitis. Initial diagnosis can be made by cytologic examination of the aspirated purulent bile intraoperatively.- - - - - - - - - - ranking = 6.9992928418304keywords = bile (Clic here for more details about this article) |
4/6. Multiseptate gallbladder with acute acalculous cholecystitis.Multiseptate gallbladder is a rare congenital malformation of the gallbladder. In some cases, right upper quadrant pain, recurrent abdominal pain, and gallstones were present. We present the sonographic findings in a case of multiseptate gallbladder with acute cholecystitis, which (to our knowledge) has not been reported before. We hypothesize that bile sludge accumulated and subsequent cholecystitis developed as a result of bile stasis in our case because the classic predisposing factors that have been described were absent.- - - - - - - - - - ranking = 3.4996464209152keywords = bile (Clic here for more details about this article) |
5/6. Rim sign in Tc-99m sulfur colloid hepatic scintigraphy.A case of pericholecystic hyperperfusion on Tc-99m sulfur colloid (SC) flow images with a pericholecystic rim of increased activity (PCHA) on delayed planar and single-photon emission computed tomography images of the liver was seen in a patient with a history of multiple renal transplants admitted with cramping right lower quadrant abdominal pain. laparotomy performed 5 days after the scan revealed an acutely perforated gangrenous gallbladder and occluded cystic duct. The secondary findings of gallbladder hyperperfusion and PCHA or "rim sign" have been frequently reported with Tc-99m IDA hepatobiliary imaging. These secondary findings in conjunction with a nonvisualized gallbladder on an IDA scan suggest a complicated or advanced stage of acute cholecystitis and usually require urgent surgical intervention. The rim sign on Tc-99m SC scintigraphy also likely indicates the same grave diagnosis.- - - - - - - - - - ranking = 1keywords = duct (Clic here for more details about this article) |
6/6. Two reports of acute neonatal acalculous cholecystitis (necrotizing cholecystitis) in a 2-week-old premature infant and a term neonate.We present 2 cases of acute acalculous cholecystitis, an extremely rare entity in newborns. A number of risk factors have been identified, such as inspissated bile, prematurity, sepsis, dehydration, total parenteral nutrition, medications, and escherichia coli lipopolysaccharide endotoxin. In our cases, gallbladder bile had positive bacterial cultures for E coli. We present the cases of a premature infant and a term neonate who developed acute acalculous cholecystitis: one with several risk factors and the second with a very atypical presentation.- - - - - - - - - - ranking = 3.4996464209152keywords = bile (Clic here for more details about this article) |