Cases reported "Gallstones"

Filter by keywords:



Filtering documents. Please wait...

1/59. Hydatid liver disease as a cause of recurrent pancreatitis.

    Intrabiliary rupture of a hydatid liver cyst is infrequently reported, but may present with symptoms of choledocholethiasis or cholangitis. We report a case of hydatid liver disease presenting as recurrent pancreatitis, and discuss its clinical, radiological and surgical treatments. Hydatid liver disease has a diverse clinical spectrum, and a diagnosis of acute pancreatitis should be considered in patients with hydatid liver disease presenting with unexplained abdominal pain.
- - - - - - - - - -
ranking = 1
keywords = abdominal pain
(Clic here for more details about this article)

2/59. Massive postoperative hemorrhage from hepatic artery erosion.

    A 66-year-old male patient who had undergone repeated operations for peptic ulcer disease involving the right upper abdominal quadrant, developed cholecystitis with calculous obstruction of the common bile duct. The gallbladder was removed. Later, an operation was performed for removal of a residual stone from the common duct. At this time an anomalous arterial structure was noted about the duct. Hemorrhage occurred ten days postoperatively, and the anomalous hepatic artery was found to be eroded. The bleeding was controlled. During the succeeding two weeks there were four episodes of bleeding (involving erosion of the hepatic artery and adjacent tissues), three of which were controlled. The fourth episode ended in the death of the patient from exsanguination secondary to bleeding from stress ulcers in the gastric remnant. At no time did the laboratory data unequivocally indicate an abnormality of blood coagulation. Erosion of the anomalous cystic artery apparently precipitated the fatal chain of events.
- - - - - - - - - -
ranking = 0.030731527107673
keywords = upper
(Clic here for more details about this article)

3/59. Choledochoduodenostomy: simple side-to-side anastomosis.

    Choledochoduodenostomy, using a simple side-to-side anastomosis technique, was performed in a 74-year-old woman with common bile duct stones. She had chronic heart failure and chronic obstructive lung disease. The choledochoduodenostomy was performed with a cholecystectomy. A 2-cm-longitudinal incision was made in the common bile duct, and an adjacent longitudinal incision was made in the first portion of the duodenum. The first sutures to be placed were the two corner sutures of the posterior anastomotic wall. Then the two sides were sutured, one from the hepatic side corner of the common duct to the anal side corner of the duodenum, and the other from the duodenal side corner of the common duct to the oral side corner of the duodenum. This anastomosis was performed with one layer of interrupted 4-0 adsorbable sutures. The anterior wall of the anastomosis was constructed in a similar manner. The patient recovered uneventfully, and had no complaints of abdominal pain or fever. This procedure, our original method, is technically simple and safe, and results in minimal tension of the anastomosis.
- - - - - - - - - -
ranking = 1
keywords = abdominal pain
(Clic here for more details about this article)

4/59. Choledochal stenosis and lithiasis caused by penetration and migration of surgical metal clips.

    A 71-year-old woman, who had undergone laparoscopic cholecystectomy 1 year previously at our hospital, presented with abdominal pain, high fever, and jaundice. She was diagnosed with choledochal stenosis caused by migration of the clips that were used at the previous operation. At reoperation, the common bile duct was successfully dissected, including the stenotic site, where a metal clip was found to be penetrating the duct wall. The stenotic site was sufficiently resected, when a black-brown gallstone was found proximally to the stenosis. Interestingly, the stone was found to contain two metal clips, which were considered to have migrated into the bile duct and to have acted as a nidus for stone formation. The common bile duct was reconstructed by direct end-to-end anastomosis. Surgeons must exercise caution in the use of metal clips, keeping in mind the potential risk of clip migration.
- - - - - - - - - -
ranking = 1
keywords = abdominal pain
(Clic here for more details about this article)

5/59. Surgical clips as a nidus for stone formation in the common bile duct.

    We report the case of a 40-year-old woman who presented with symptomatic gallbladder stones. A laparoscopic cholecystectomy was performed using metallic clips. Three years later, she underwent a endoscopic retrograde cholangiopancreatography (ERCP) for interscapular and right upper quadrant pain, jaundice, and fever. This examination revealed a stone and clips in the common bile duct (CBD). A sphinteroctomy was undertaken, but the stone could not be extracted despite multiple attempts. Ultimately, a Kocher incision was required to achieve choledocotomy and extraction of the stone and the clips.
- - - - - - - - - -
ranking = 0.030731527107673
keywords = upper
(Clic here for more details about this article)

6/59. Transhepatic balloon sphincteroplasty for bile duct stones after total gastrectomy.

    Previous upper gastrointestinal surgery with the construction of a Roux-en-Y jejunal loop may prevent endoscopic access to the second part of the duodenum. We report a technique of percutaneous transhepatic balloon sphincteroplasty to facilitate the removal of common bile duct (CBD) stones. A 67-year-old woman presented with a 1-week history of right upper quadrant abdominal pain and fever, deranged liver function tests, and dilated intrahepatic ducts. The patient had previously had a total gastrectomy with Roux-en-Y reconstruction for a high-grade B-cell lymphoma of the stomach. Peroral endoscopic access to the biliary tree was unsuccessful. Percutaneous transhepatic cholangiography confirmed the presence of CBD stones. Over a period of 8 weeks, sequential dilatation of the percutaneous tract was undertaken. After a further 2 weeks, percutaneous choledochoscopy was performed. Several large stones were visualized and then fragmented. The choledochoscope would not pass through to the duodenum due to postinflammatory stenosis of the papilla, so the papilla was dilated with an endoscopic balloon. The remaining fragments were pushed through, and the duct was thoroughly irrigated with saline. Repeat cholangiography confirmed a clear CBD. Balloon catheter sphincteroplasty and biliary stone extrusion into the duodenum is a novel technique that enabled clearance of the CBD in an elderly patient who may otherwise have required open surgical exploration.
- - - - - - - - - -
ranking = 1.0614630542153
keywords = abdominal pain, upper
(Clic here for more details about this article)

7/59. Clip migration causes choledocholithiasis after laparoscopic cholecystectomy.

    The migration of surgical clips after laparoscopic procedures was first reported in 1992, but such instances are extremely rare. We herein demonstrate a case of a migrated metal clip, which had been applied originally to the cystic duct, but thereafter had moved to the common bile duct. This clip caused choledocholithiasis in a patient 1 year after a laparoscopic cholecystectomy. A 63-year-old man underwent a laparoscopic cholecystectomy. During the operation, the inflamed cystic duct was divided accidentally, and three clips were applied immediately. The patient complained of upper abdominal pain from postoperative day 8. Endoscopic retrograde cholangiography demonstrated bile leakage from the cystic duct, but showed no clips or choledochal stones. The patient complained of severe upper abdominal and back pain 1 year after the operation. Endoscopic retrograde cholangiography showed a metal clip in the common bile duct and choledochal stones above the clip. The clip and the cholesterol stones were removed using a basket catheter. Three clips applied to the cystic duct should have been removed because of the necrosis in the remaining cystic duct. Thereafter, the clip may have migrated through the stump of the cystic duct into the lower part of the common bile duct. This clip seems to have later caused choledocholithiasis resulting from stagnation of the bile flow. Bile leakage after an operation seems to increase the risk of clip migration. Regardless of the primary lesion, a careful follow-up evaluation is necessary for patients demonstrating complications.
- - - - - - - - - -
ranking = 40.876122478242
keywords = upper abdominal pain, abdominal pain, upper, back
(Clic here for more details about this article)

8/59. Liver hematoma following endoscopic retrograde cholangiopancreatography (ERCP).

    We report the case of an 81-year-old man who presented with abdominal pain following endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis. A diagnosis of infected hematoma was made. A CT-guided puncture produced bloody matter that grew citrobacter freundii. A catheter was left in place for 3 weeks before the patient could be discharged from hospital. We hypothesize that the hepatic parenchyma had been torn by the guide used during the ERCP. This case represents the first report of this type of iatrogenic injury.
- - - - - - - - - -
ranking = 1
keywords = abdominal pain
(Clic here for more details about this article)

9/59. Biliary metal stent as a nidus for bile duct stone.

    Several cases of recurrent stone formation caused by a surgical material as a nidus have been reported. Recently, we experienced one case in which a migrated metal stent might have been served as a nidus for common duct stone formation. The diagnosis was confirmed by ERCP, the stone was successfully removed with endoscopic therapy. Six years ago, she had undergone a lithotripsy using a percutaneous cholangioscopy (PTCS) because of intrahepatic bile duct stones. Six years later, she developed abdominal pain in the right upper quadrant. ERCP revealed the dilated extrahepatic bile duct and left intrahepatic bile duct and the presence of a large elongated freely mobile filling defect suggestive of common bile duct stone containing metal mesh in the distal common bile duct. The removed stone with endoscopic sphincterotomy was soft and dark brown in color with metal stent.
- - - - - - - - - -
ranking = 1.0307315271077
keywords = abdominal pain, upper
(Clic here for more details about this article)

10/59. Esophageal intubation with duodenoscope in the presence of pharyngeal pouch by a guidewire and catheter-guided technique.

    esophageal perforation can occur during blind intubation with a side-viewing duodenoscope during endoscopic retrograde cholangiopancreatogram (ERCP) in patients with pharyngeal or esophageal anomalies. We describe a case of difficult intubation during an ERCP due to an asymptomatic and unsuspected pharyngeal pouch (Zenker's diverticulum). The side-viewing duodenoscope was withdrawn once resistance was encountered during intubation, and a forward-viewing gastroscope was inserted carefully under direct vision to evaluate the upper esophagus. After the diagnosis was made, intubation of the duodenoscope was performed by exchanging scopes over a guidewire. Subsequent ERCP with sphincterectomy and stone removal was uneventful. We caution that a side-viewing duodenoscope should be withdrawn once resistance is encountered during blind intubation during ERCP. Our technique minimizes patient discomfort and is rapid and easy to perform. In addition, no extra device such as an overtube is required.
- - - - - - - - - -
ranking = 0.030731527107673
keywords = upper
(Clic here for more details about this article)
| Next ->


Leave a message about 'Gallstones'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.