Cases reported "Cholelithiasis"

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1/141. fascioliasis observed during laparoscopic cholecystectomy.

    fascioliasis is an uncommon zoonotic disease caused by fasciola hepatica, a liver fluke, for which humans act as an accidental host, infected by the ingestion of water or raw aquatic vegetables contaminated with the metacercaria. We report the case of a patient who presented to our clinic with right upper abdominal pain and nausea. physical examination and abdominal ultrasonography revealed cholelithiasis. Peripheral blood eosinophilia was the only positive sign observed during routine laboratory tests. We therefore decided to perform laparoscopic cholecystectomy. During laparoscopy peritoneal implants approximately 0.5-1 cm diameter were detected which gave an impression of peritoneal carcinomatosa. Laparoscopic cholecystectomy was performed, and biopsies were taken from the peritoneal implants which were examined histopathologically, and fascioliasis was determined.
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keywords = upper abdominal pain, abdominal pain, upper
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2/141. Drug-associated cholelithiasis: a case of sulindac stone formation and the incorporation of sulindac metabolites into the gallstones.

    A case of drug-associated cholelithiasis (sulindac chlecystohepatolithiasis) in a 63-yr-old woman is reported. The patient was admitted to our hospital to undergo treatment for rheumatoid arthritis of 20 yr duration. She was treated with nonsteroidal anti-inflammatory drugs (NSAID: sulindac). Two months later, she presented with right upper quadrant pain. Diagnostic studies including ultrasonography (US), computed tomography (CT) and endoscopic retrograde cholangiography (ERC), led to the diagnosis of cholecystohepatolithiasis. She underwent cholecystectomy and choledochotomy with an extraction of intrahepatic stones. The intrahepatic stones were light yellow in color with a claylike appearance. Unexpectedly, an infrared spectroscopic analysis of the stone showed it to consist of sulindac metabolites. In addition, the dilated segment of the intrahepatic bile duct naturally returned to its normal size after the discontinuation of the drug administration. This is the first reported case of sulindac stone formation in the bile duct. No similar problems with other NSAIDs have been reported previously.
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ranking = 0.00068397086459313
keywords = upper
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3/141. pregnancy and laparoscopic surgery.

    We reviewed the English literature regarding laparoscopic surgery during pregnancy and found that of 518 reported procedures, the most common was cholecystectomy (45%), followed by adnexal surgery (34%), appendectomy (15%), and other operations (6%). We add six cases to this list; three cholecystectomies, an adnexal procedure, and two for abdominal pain. Thirty-three percent were performed in the first trimester, 56% in the second, and 11% in the third trimester. This review demonstrates a definite trend, indicating that laparoscopy in pregnancy appears to be safe when performed by experienced practitioners. (J Am Assoc Gynecol Laparosc 6(3):347-351, 1999)
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ranking = 0.020666739047176
keywords = abdominal pain
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4/141. Sequential sonographic changes of the gallbladder in hemobilia: case report of a patient with intrahepatic duct stones.

    The sonographic features of hemobilia in the gallbladder have been reported with variation, including an echogenic mass, hypoechoic mass, and scattered intraluminal echoes. The sequential sonographic changes of hemobilia in the gallbladder were observed in a 59-year-old male patient with bilateral intrahepatic duct stones. The sonograms of hemobilia in the distended gallbladder initially showed a hyperechoic, homogeneous, movable mass-like lesion, 36 hours before the onset of upper gastrointestinal (UGI) bleeding. A hypoechoic mass-like lesion with a hyperechoic ring was found 5 days after the onset of UGI bleeding. A faint hypoechoic mass-like lesion was found 7 days after the onset of UGI bleeding (the day of no further bleeding). Scattered echoic densities were found 9 days after the onset of UGI bleeding, then disappearance of the lesion was noted 12 days after the onset of UGI bleeding. The sonographic patterns of hemobilia in the gallbladder vary depending on the timing of lysis of the blood clot. It should be differentiated from gallbladder cancer, a stone, a polyp, sludge, acute gangrenous cholecystitis, and gallbladder empyema.
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ranking = 0.00068397086459313
keywords = upper
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5/141. Massive intraperitoneal hemorrhage from a pancreatic pseudocyst.

    Massive bleeding from a pancreatic pseudocyst is a rare condition that poses a diagnostic and therapeutic challenge. A 36-yr-old woman presented with acute pancreatitis due to gallstones. Twenty-two days later, she developed severe abdominal pain and hypotension. CT scan revealed hemorrhage into a pancreatic pseudocyst and a large amount of free blood in the peritoneal cavity. At laparotomy, 8 L of blood was evacuated from the peritoneal cavity and 14 units of blood were transfused. The gastroduodenal artery was found to be the cause of the bleeding and was undersewn. A pancreatic necrosectomy was performed and the cavity was packed. The packs were removed the following day. Postoperatively, pancreatic collections were aspirated under ultrasound guidance on three occasions. She was discharged 50 days after admission and had an open cholecystectomy 1 month later. She remains well 1 yr after surgery.
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ranking = 0.020666739047176
keywords = abdominal pain
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6/141. Gallstone ileus: endoscopic removal of a gallstone obstructing the upper jejunum.

    In a 91-year-old female patient admitted with an ileus, ultrasound and computed tomography demonstrated the obstruction of the upper jejunum by a large gallstone. Due to concurrent diseases the patient was unfit for surgery. An attempt was made to remove the impacted stone endoscopically. After successful mobilization and fragmentation by mechanical lithotripsy the obstruction was cleared away. Since the patient improved considerably after this procedure, the gallbladder and the cholecystoduodenal fistula were left in place.
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ranking = 0.0034198543229656
keywords = upper
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7/141. Hepaticojejunostomy after excision of choledochal cyst in two children with previous biliary surgery.

    Hepaticojejunostomy Roux-en-Y after excision of choledochal cyst is the treatment of choice for children with choledochal cyst, to prevent the risk of postoperative cholangitis, stone formation and malignancy. The author reports two children with previous biliary surgery for choledochal cyst, one with cystojejunostomy without cholecystectomy and the other with cholecystectomy alone. Two children were admitted to the Pediatric Surgical Unit, Ratchaburi Hospital, with the complaint of chronic abdominal pain. After investigation the two children had cyst excision and hepaticojejunostomy Roux-en-Y. After six and one year follow-up the patients remain asymptomatic. The aim of this report was to show the complication of two previous biliary surgeries for choledochal cyst and support total cyst excision combined with hepaticojejunostomy Roux-en-Y being the treatment of choice for choledochal cyst.
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ranking = 0.020666739047176
keywords = abdominal pain
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8/141. Jejunal limb obstruction caused by a cholesterol stone 15 years after a total gastrectomy and 20 years after a cholecystectomy: report of a case.

    We present herein the rare case of a 74-year-old woman found to have jejunal limb obstruction caused by a cholesterol stone 15 years after a total gastrectomy with Roux-en-Y anastomosis, and 20 years after a cholecystectomy. The patient complained of repeated episodes of upper abdominal distress on three separate occasions over a period of 20 months, and jejunal limb obstruction was diagnosed by abdominal computed tomography scanning and (99m)Tc scintigraphy. Surgery revealed a stone incarcerated in the jejunal limb, where the anastomosis had become slightly stenotic. The removed stone was 3.5 cm in diameter and was subsequently demonstrated to be a cholesterol stone by chemical analysis. This report is thought to be the first to describe jejunal limb obstruction caused by a gallstone incarcerated in the jejunal limb after a total gastrectomy in a patient with a history of cholecystectomy.
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ranking = 0.00068397086459313
keywords = upper
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9/141. Electrohydraulic lithotripsy treatment of gallstone after disimpaction of the stone from the duodenal bulb (Bouveret's syndrome).

    A 75-year-old man with right upper quadrant abdominal pain was diagnosed by gastroscopy to have an impacted gallstone in the duodenal bulb. Using the polypectomy loop, the stone was extracted from the bulbus and mobilized into the stomach. After failure to remove the stone from the stomach as well as fragmentation by mechanical lithotripsy, electrohydraulic lithotripsy was used to break up the stone, parts of which passed spontaneously through the bowel. Thus, it was unnecessary to proceed with surgical enterolithotomy to remove, from the duodenal bulb, the impacted gallstone responsible for the gastric outlet obstruction.
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ranking = 0.021350709911769
keywords = abdominal pain, upper
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10/141. Haemorrhage into non-functioning adrenal cysts--report of two cases and review of the literature.

    Adrenal cysts are a rare condition and are usually non-functioning and asymptomatic. Most of the reported cases were incidental findings or discovered at autopsy. However, large cysts have a tendency to develop complications such as intracystic haemorrhage and rupture, which can present as an acute surgical emergency. We report two cases of adrenal cysts with intracystic haemorrhage. One patient presented with persistent non-specific upper abdominal pain, investigations with ultrasound (US) scan and computed tomographic (CT) scan revealed a left adrenal cyst and gallstones. Simultaneous cholecystectomy and adrenalectomy was performed with resultant relief of symptoms. The second patient presented with acute abdominal pain simulating acute surgical abdomen. Preoperative CT scan showed a large cystic lesion in the region of the tail of the pancreas with radiological evidence of haemorrhage but was unable to confirm its origin. The cyst was found to have arisen from the left adrenal gland at laparotomy; left adrenalectomy with complete excision of the cyst was done. histology showed pseudocyst with haemorrhage in both cases. Pseudocyst is the commonest histological type encountered clinically. We believe the second case is related to pregnancy and childbirth as the patient presented during puerperium and the cyst, even though very large in size (25 x 15 x 15 cm), was not noted during antenatal screening with US scan.
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ranking = 1.0206667390472
keywords = upper abdominal pain, abdominal pain, upper
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