11/98. The radiology corner. Porcelain gallbladder.Porcelain gallbladder is an uncommon manifestation of chronic cholecystitis. diagnosis is suggested on the plain abdominal roentgenogram by identifying thin curvilinear calcifications in the right upper quadrant. Because porcelain gallbladders fail to visualize on oral or intravenous studies, cholecystosonography may be used to confirm the location of the calcifications within the gallbladder wall.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
12/98. Hemorrhagic cholecystitis as a likely cause of nontraumatic hemobilia in metachromatic leukodystrophy: report of a case.A 17-years-old man with the juvenile form of MLD developed massive hemobilia. CT and US scans showed blood and clots filling the gallbladder and the biliary ways, with no bleeding source seen at selective angiography. Explorative laparotomy evidenced bleeding from a papillomatous gallbladder mucosa, resolved with cholecystectomy. Histologic examination with specific colorations diagnosed hemorrhagic cholecystitis from metachromatic leukodystrophy of the gallbladder. This is, to our knowing, the third case reported in literature, and thus hemorrhagic cholecystitis may be considered a life-threatening complication of MLD to be prevented with cholecystectomy as soon as signs of gallbladder pathology (papillomatosis/polyposis, jaundice, abdominal pain) are suspected.- - - - - - - - - - ranking = 55.872464963627keywords = abdominal pain, pain (Clic here for more details about this article) |
13/98. Successful major surgical recovery of a patient following haploidentical stem cell transplantation for chronic myeloid leukemia in blast crisis and aspergillosis.A 44-year-old woman who underwent haploidentical stem cell transplantation (haplo SCT) for chronic myeloid leukemia in blast crisis and aspergillosis was admitted to the emergency room 7 months later because of severe right upper quadrant abdominal pain, fever, leukocytosis and peritoneal signs. Computer tomography disclosed cholecystitis and gallbladder perforation. Within hours, she underwent urgent open laparatomy and cholecystectomy. The postoperative period was uneventful and she was discharged 10 days later without any complications. Currently, she is 2(1/2) years posttransplantation in full hematological, cytogenetic and molecular remission with 100% karnofsky performance status. Most notably, normal and fast recovery was observed following major surgery 7 months post-haplo SCT which is usually considered to result in long-lasting immunosuppression and malfunction of the immune system.- - - - - - - - - - ranking = 56.872464963627keywords = abdominal pain, pain, upper (Clic here for more details about this article) |
14/98. Successful elimination of ascaris lumbricoides from the gallbladder by conservative medical therapy.Migration of ascaris lumbricoides into the gallbladder is rare, unlike ascariasis of the bile duct, and, when it does occur, treatment is generally by endoscopic or surgical extraction. We describe a case of the successful treatment of gallbladder ascariasis with conservative therapy. A 44-year-old Korean man was admitted because of nausea and right upper quadrant pain that did not respond to medical control and had worsened 1 day before admission. Abdominal ultrasonography showed a long, linear, moving echogenic structure in the distended lumen of the gallbladder, but no abnormal dilation of the bile duct. Computerized tomography showed a linear soft-tissue density in the dependent portion of the gallbladder. The patient presented with eosinophilia, and abnormal liver function results, but no fever or hepatomegaly. Based on these findings, and presuming a diagnosis of gallbladder ascariasis, we administered antiparasitic medication (albendazole 400 mg/day for 1 day). Seven days later, we obtained one adult female A. lumbricoides from the feces. The symptoms were fully resolved, and no moving structure could be visualized in the gallbladder by ultrasonography. We recommend that initial therapy for gallbladder ascariasis should involve conservative treatment, unless an associated disease is present or a complication arises.- - - - - - - - - - ranking = 5.7754237759154keywords = pain, upper (Clic here for more details about this article) |
15/98. Porcelain gallbladder.OBJECTIVE: To discuss the case of a porcelain gallbladder found incidentally in a patient with low back and heel pain. Clinical Features: A 70-year-old woman had low back pain, numbness in the left lower leg, and sharp pain in her left heel. Plain films of the lumbar spine necessitated diagnostic abdominal ultrasound, the findings of which were consistent with porcelain gallbladder. Intervention and Outcome: The patient has been recommended for prophylactic cholecystectomy and is concurrently being treated for mechanical low back and heel pain. CONCLUSIONS: Porcelain gallbladder is an uncommon finding; however, due to the greatly increased chance of malignancy, it must be considered in patients who have cystic type calcification in the right upper abdominal quadrant.- - - - - - - - - - ranking = 20.101695103662keywords = pain, upper (Clic here for more details about this article) |
16/98. Secondary hemocholecyst after radiofrequency ablation therapy for hepatocellular carcinoma.A 65-year-old Japanese man underwent radiofrequency ablation (RFA) therapy of a hepatocellular carcinoma. hemobilia from the intrahepatic bile ducts adjacent to the tumor developed on the fifth day after the RFA therapy. Ultrasonograms and computed tomograms showed swelling of the gallbladder, which was filled with a clot, suggesting the diagnosis of hemocholecyst. The hemobilia resolved with conservative therapy, but a cholecystectomy was performed to manage postprandial abdominal pain. The resected gallbladder was filled with a clot, but injury or ulceration of the gallbladder was absent, suggesting that the hemocholecyst developed secondary to the hemobilia. Secondary hemocholecyst is a rare complication of RFA therapy. The number of cases of secondary hemocholecyst is likely to increase as hepatocentestic therapy becomes more common. cholecystectomy is indicated for hemocholecyst because spontaneous liquefication and drainage of a clot in the gallbladder usually does not occur.- - - - - - - - - - ranking = 55.872464963627keywords = abdominal pain, pain (Clic here for more details about this article) |
17/98. Large choledochal cyst present through 2 pregnancies. A case report.BACKGROUND: choledochal cyst is rarely diagnosed during pregnancy, and it is very difficult to make a diagnosis of it clinically or radiologically. CASE: A woman was diagnosed as having an ovarian cyst and gallbladder mucocele on ultrasonography in both her first and second pregnancies. She was asymptomatic, and conservative management was adopted. Three days after delivery of her second child, the patient had a sudden onset of right upper quadrant pain associated with deranged liver function. Emergency laparotomy revealed a type I choledochal cyst with evidence of infection. Excision of the cyst, cholecystectomy and bilateral hepatojejunostomy in the Roux-en-Y fashion were performed. CONCLUSION: A choledochal cyst in pregnancy is difficult to diagnose and poses a threat to mother and fetus.- - - - - - - - - - ranking = 5.7754237759154keywords = pain, upper (Clic here for more details about this article) |
18/98. Primary benign ulcer of the gall bladder.It is sometimes impossible to come to a final diagnosis in patients with dyspepsia and upper abdominal pain in spite of extensive investigation. Such patients are usually given vague diagnoses like "non-ulcer dyspepsia" and they represent an important diagnostic challenge.- - - - - - - - - - ranking = 56.872464963627keywords = abdominal pain, pain, upper (Clic here for more details about this article) |
19/98. Acute hydrops of the gallbladder in childhood.Acute hydrops of the gallbladder (AHGB) is a rare paediatric disease being diagnosed with increased frequency due to its association with other illnesses and the availability of ultrasonography. The symptoms and signs of AHGB include abdominal pain, vomiting, abdominal mass and/or tenderness. As these clinical features mimic the more common surgical conditions such as acute appendicitis, intussusception and volvulus, some cases are still diagnosed only at laparotomy. diagnosis is established by ultrasonography of the abdomen demonstrating normal biliary ducts and a distended gallbladder without calculi or congenital malformation. The aetiology of acute hydrops of the gallbladder is unknown but may be multifactorial. Treatment varies from non-operative management to surgical intervention.- - - - - - - - - - ranking = 55.872464963627keywords = abdominal pain, pain (Clic here for more details about this article) |
20/98. Intracholecystic hemorrhage: an atypical complication after liver needle biopsy.The authors report an unusual case of intracholecystic hemorrhage related to liver biopsy in a 23-year-old man. Echography and computed tomography evidenced changes in density within the gallbladder which were probably caused by hemorrhagic discharge. Although the mechanism by which liver biopsy induced intracholecystic hemorrhage is unclear, the authors believe that this iatrogenic complication was probably the result of microlesions of the gallbladder wall caused by needle puncture: the lesions extended into the submucosa and provoked slow hematic leakage. The pain syndrome began 48 hours after biopsy. The peculiarity of this case report was confirmed by the fact that no bile was aspirated, no choleperitoneum was found, and no gallbladder tissue was detected in the sample. The authors conclude by recommending clinical and echographic control following liver biopsy.- - - - - - - - - - ranking = 4.7754237759154keywords = pain (Clic here for more details about this article) |
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