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Candida famata-induced fulminating cholecystitis

Araujo,Paulo Sergio Ramos de; Medeiros,Zulma; Melo,Fabio Lopes de; Maciel,Maria Amelia; Melo,Heloisa Ramos Lacerda de
Fonte: Sociedade Brasileira de Medicina Tropical - SBMT Publicador: Sociedade Brasileira de Medicina Tropical - SBMT
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 EN
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37.17%
Lithiasic cholecystitis is classically associated with the presence of enterobacteria, such as Escherichia coli, Enterococcus, Klebsiella, and Enterobacter, in the gallbladder. Cholecystitis associated with fungal infections is a rare event related to underlying conditions such as diabetes mellitus, steroid use, and broad-spectrum antibiotic use for prolonged periods, as well as pancreatitis and surgery of the digestive tract. Here, we present the first reported case of a gallbladder infection caused by Candida famata.

Emphysematous cholecystitis

Lupinacci,Renato Micelli; Chafai,Najim; Tiret,Emmanuel
Fonte: Colégio Brasileiro de Cirurgia Digestiva Publicador: Colégio Brasileiro de Cirurgia Digestiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2009 EN
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BACKGROUND: Emphysematous cholecystitis is life-threatening condition characterized by gas-forming infection of the gallbladder. It is mostly seems in old male patients with systemic, specially diabetes and vascular diseases. CASE REPORT: - A 30-year-old man without previous diseases was admitted because of right upper quadrant pain and nausea. On admission the patient was febrile (38.7o) with normal bilirubin levels. The white blood count was 26700/µl and reactive protein C was 470. Axial sections of single slice computed tomography imaging (section thickness 5 mm), revealed gallbladder wall enhancement after i.v. contrast, as well as dilatation of the gallbladder with intraluminal air. The patient underwent open cholecystectomy. The culture of the bile showed clostridium perfringes. The postoperative course of the patient was uneventful. CONCLUSION: This is a rare form of cholecystitis that carries a high mortality and usually present insidious clinical signs. CT is the most accurate imaging technique. Antibiotic therapy should begin quickly and include coverage of common pathogens, particularly Clostridia. Surgical intervention should take place as early as possible.

Microflora of bile aspirates in patients with acute cholecystitis With or without cholelithiasis: a tropical experience

Capoor,Malini R.; Nair,Deepthi; Rajni,; Khanna,Geetika; Krishna,S.V.; Chintamani,M.S.; Aggarwal,Pushpa
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2008 EN
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The current study determined the spectrum of biliary microflora with special emphasis on enteric fever organisms in patients with acute cholangitis with and without cholelithiasis or other biliary diseases. The patients were divided into three groups: Group A consisted of patients with acute cholecystitis with cholelithiasis; Group B consisted of patients with acute cholecystitis with gastrointestinal ailments requiring biliary drainage and group C consisted of patients with gallbladder carcinoma. Gallbladder, bile and gallstones were subjected to complete microbiological and histopathological examination. Antimicrobial susceptibility of the isolates was performed as per CLSI guidelines. Bacteria were recovered from 17 samples (32%) in Group A, 17 (51.4%) in Group B and 1 (1.6%) in Group C. The most common organisms isolated were Escherichia coli (11, 29.7%), Klebsiella pneumoniae (10, 27%), Citrobacter freundii (3, 8.1%), Salmonella enterica serovar Typhi (3, 8.1%), etc. The majority of Enterobacteriaceae isolates were susceptible to piperacillin-tazobactam and meropenem. As regards Salmonella spp., S. Typhi was isolated from 2 (3.8%) patients in Group A and 1 (16%) in Group C. Antimicrobial susceptibility of potential causative organisms...

Percutaneous cholecystostomy: a nonsurgical therapeutic option for acute cholecystitis in high-risk and critically ill patients

Dabus,Guilherme de Castro; Dertkigil,Sérgio San Juan; Baracat,Jamal
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2003 EN
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Percutaneous cholecystostomy offers a potentially important type of therapy for critically ill patients with acute cholecystitis who present high risk when undergoing laparotomy or laparoscopy under general anesthesia. It offers a distinct advantage for these kinds of patients by avoiding the risks of the surgical intervention. Percutaneous cholecystostomy is a safe and effective minimally invasive procedure with a high success rate and low procedure-related complications. It should be considered not only in temporary management of calculous cholecystitis, but also in definitive treatment in cases of acalculous cholecystitis.

Morphine cholescintigraphy in the evaluation of hospitalized patients with suspected acute cholecystitis.

Flancbaum, L; Choban, P S; Sinha, R; Jonasson, O
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /07/1994 EN
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27.48%
OBJECTIVE: The authors determined if the diagnosis of acute cholecystitis can be accurately made or reliably eliminated by the use of morphine-augmented radionuclide cholescintigraphy (morphine cholescintigraphy [MC]) in hospitalized patients in whom the diagnosis is in doubt. SUMMARY/BACKGROUND DATA: Diagnosis of acute cholecystitis, calculous or acalculous, may be difficult in patients hospitalized for abdominal pain or other illnesses. Clinical signs often are obscure, and routine imaging studies are nonspecific or associated with a high incidence of false-positive tests. The authors report the use of MC in the evaluation of 163 hospitalized patients for acute cholecystitis over an 8-year period. METHODS: All patients suspected to have acute cholecystitis initially had standard cholescintigraphy performed, which showed nonvisualization of the gallbladder, and then were given morphine sulfate (0.05-0.1 mg/kg, intravenously). Patients were divided into the following three groups: I--acute abdominal pain (N = 53); II--hospitalized for associated illness (N = 49); and III--critically ill (N = 61). RESULTS: Overall, MC confirmed the diagnosis of acute cholecystitis in 75 patients (46%), including 23 cases of acalculous cholecystitis. Visualization of the gallbladder occurred within 60 minutes of intravenous administration of morphine sulfate in all patients. Cystic duct obstruction and...

Factors associated with successful laparoscopic cholecystectomy for acute cholecystitis.

Rattner, D W; Ferguson, C; Warshaw, A L
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /03/1993 EN
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OBJECTIVE: This article determined which preoperative data correlated with successful completion of a laparoscopic cholecystectomy in patients with acute cholecystitis. SUMMARY BACKGROUND DATA: Although laparoscopic cholecystectomy is the procedure of choice in chronic cholecystitis, its use in acute cholecystitis may be associated with higher costs and complication rates. It is not known which patients with acute cholecystitis are likely to require conversion to open cholecystectomy based on preoperative data or if a cooling-off period with medical therapy can diminish inflammation and increase the chance of successful laparoscopic cholecystectomy. METHODS: All laparoscopic cholecystectomies done by the authors between 10/90 and 2/92 were reviewed. Data on cases of acute cholecystitis were prospectively collected on standardized data forms. RESULTS: Twenty of 281 laparoscopic cholecystectomies were done for acute cholecystitis; 7/20 patients with acute cholecystitis required conversion to open cholecystectomy compared with 6/281 patients undergoing elective operation for chronic cholecystitis. In patients with acute cholecystitis the interval from admission to cholecystectomy in the successful cases was 0.6 days vs. 5 days in the cases requiring conversion to open cholecystectomy (p = .01). Cases requiring conversion to open cholecystectomy also had higher WBC (14.0 vs. 9.0...

Acute acalculous cholecystitis: challenging the myths1

Shridhar Ganpathi, Iyer; Diddapur, Ravishankar K.; Eugene, Huang; Karim, Masud
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
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Background: Acute acalculous cholecystitis (AAC) is traditionally known to occur in critically ill patients, following cardiac surgery, abdominal vascular surgery, severe trauma, burns, prolonged fasting, total parenteral nutrition, or sepsis, and is believed to have a worse prognosis as compared with acute cholecystitis associated with stones. Our observation of de novo presentation of AAC in several outpatients in the absence of critical illness or predisposing factors prompted us to undertake this study. The aims of the present study were to examine the prevalence of AAC patients in the outpatient setting in our hospital, to identify associated risk factors and to assess the clinical course and outcome of these patients. Patients and methods: All patients who had a cholecystectomy (laparoscopic or open surgery) for acute cholecystitis at National University Hospital from January 2001 to May 2005 were reviewed from a prospectively maintained database. The demographic characteristics, clinicopathologic features, operative parameters, postoperative course, and histopathology of the patients were reviewed. Results: Eleven of 133 patients with acute cholecystitis fulfilled the criteria for the diagnosis of AAC. Patients’ ages ranged from 30 to 69 years (mean 52.39 years). All these patients presented as outpatients. None of the patients had any critical illness predisposing to AAC. The mean age was slightly less in the AAC group as compared with the remaining patients with acute cholecystitis (52.39 years vs 55.22 years...

Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines

Yamashita, Yuichi; Takada, Tadahiro; Kawarada, Yoshifumi; Nimura, Yuji; Hirota, Masahiko; Miura, Fumihiko; Mayumi, Toshihiko; Yoshida, Masahiro; Strasberg, Steven; Pitt, Henry A.; de Santibanes, Eduardo; Belghiti, Jacques; Büchler, Markus W.; Gouma, Dirk
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
EN
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Cholecystectomy has been widely performed in the treatment of acute cholecystitis, and laparoscopic cholecystectomy has been increasingly adopted as the method of surgery over the past 15 years. Despite the success of laparoscopic cholecystectomy as an elective treatment for symptomatic gallstones, acute cholecystitis was initially considered a contraindication for laparoscopic cholecystectomy. The reasons for it being considered a contraindication were the technical difficulty of performing it in acute cholecystitis and the development of complications, including bile duct injury, bowel injury, and hepatic injury. However, laparoscopic cholecystectomy is now accepted as being safe for acute cholecystitis, when surgeons who are expert at the laparoscopic technique perform it. Laparoscopic cholecystectomy has been found to be superior to open cholecystectomy as a treatment for acute cholecystitis because of a lower incidence of complications, shorter length of postoperative hospital stay, quicker recuperation, and earlier return to work. However, laparoscopic cholecystectomy for acute cholecystitis has not become routine, because the timing and approach to the surgical management in patients with acute cholecystitis is still a matter of controversy. These Guidelines describe the timing of and the optimal surgical treatment of acute cholecystitis in a question-and-answer format.

Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines

Hirota, Masahiko; Takada, Tadahiro; Kawarada, Yoshifumi; Nimura, Yuji; Miura, Fumihiko; Hirata, Koichi; Mayumi, Toshihiko; Yoshida, Masahiro; Strasberg, Steven; Pitt, Henry; Gadacz, Thomas R; de Santibanes, Eduardo; Gouma, Dirk J.; Solomkin, Joseph S.; Be
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
EN
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The aim of this article is to propose new criteria for the diagnosis and severity assessment of acute cholecystitis, based on a systematic review of the literature and a consensus of experts. A working group reviewed articles with regard to the diagnosis and treatment of acute cholecystitis and extracted the best current available evidence. In addition to the evidence and face-to-face discussions, domestic consensus meetings were held by the experts in order to assess the results. A provisional outcome statement regarding the diagnostic criteria and criteria for severity assessment was discussed and finalized during an International Consensus Meeting held in Tokyo 2006. Patients exhibiting one of the local signs of inflammation, such as Murphy’s sign, or a mass, pain or tenderness in the right upper quadrant, as well as one of the systemic signs of inflammation, such as fever, elevated white blood cell count, and elevated C-reactive protein level, are diagnosed as having acute cholecystitis. Patients in whom suspected clinical findings are confirmed by diagnostic imaging are also diagnosed with acute cholecystitis. The severity of acute cholecystitis is classified into three grades, mild (grade I), moderate (grade II), and severe (grade III). Grade I (mild acute cholecystitis) is defined as acute cholecystitis in a patient with no organ dysfunction and limited disease in the gallbladder...

Deficiencies of Circulating Mucosal-associated Invariant T Cells and Natural Killer T Cells in Patients with Acute Cholecystitis

Kim, Jung-Chul; Jin, Hye-Mi; Cho, Young-Nan; Kwon, Yong-Soo; Kee, Seung-Jung; Park, Yong-Wook
Fonte: The Korean Academy of Medical Sciences Publicador: The Korean Academy of Medical Sciences
Tipo: Artigo de Revista Científica
EN
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Mucosal-associated invariant T (MAIT) cells and natural killer T (NKT) cells are known to play crucial roles in a variety of diseases, including autoimmunity, infectious diseases, and cancers. However, little is known about the roles of these invariant T cells in acute cholecystitis. The purposes of this study were to examine the levels of MAIT cells and NKT cells in patients with acute cholecystitis and to investigate potential relationships between clinical parameters and these cell levels. Thirty patients with pathologically proven acute cholecystitis and 47 age- and sex-matched healthy controls were enrolled. Disease grades were classified according to the revised Tokyo guidelines (TG13) for the severity assessment for acute cholecystitis. Levels of MAIT and NKT cells in peripheral blood were measured by flow cytometry. Circulating MAIT and NKT cell numbers were significantly lower in acute cholecystitis patients than in healthy controls, and these deficiencies in MAIT cells and NKT cell numbers were associated with aging in acute cholecystitis patients. Notably, a reduction in NKT cell numbers was found to be associated with severe TG13 grade, death, and high blood urea nitrogen levels. The study shows numerical deficiencies of circulating MAIT and NKT cells and age-related decline of these invariant T cells. In addition...

The outcome of early laparoscopic surgery to treat acute cholecystitis: a single-center experience

Ciftci, Fatih; Abdurrahman, Ibrahim; Girgin, Sadullah
Fonte: e-Century Publishing Corporation Publicador: e-Century Publishing Corporation
Tipo: Artigo de Revista Científica
Publicado em 15/03/2015 EN
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27.45%
Aim: The aim of this study was to prospectively assess the outcome of early laparoscopic cholecystectomy (LC) in patients with acute cholecystitis. Materials and methods: Between July 2005 and December 2012, of 623 patients who had symptoms of acute cholecystitis during the first 72 h of hospital admission and who did not respond to non-operative treatment, 302 underwent surgical treatment. After initial treatment, all patients were followed up for 21 months on average (range: 5-27 months). The clinical, biochemical, radiological, and operative data of the 302 consecutive patients with acute cholecystitis were recorded and analyzed prospectively. Results: Of the 302 patients who underwent LC for acute cholecystitis, 169 were females and 133 males. Their mean ages were 47.8 years (range: 17-79 years) and 53.3 years (range: 27-90 years) respectively. Conversion to open surgery was required in 32 patients (10.5%). The mean postoperative length of hospital stay was 2 days (range: 1-3 days) in the LC group and 3 days (range: 2-6 days) in the conversion group. Significant differences between the successful LC group and the conversion group were evident terms of the length of postoperative hospitalization and gallbladder wall thickness (P=0.023). Factors associated with conversion were male gender...

The appearance of myofibroblasts and the disappearance of CD34-positive stromal cells in the area adjacent to xanthogranulomatous foci of chronic cholecystitis

Kuroda, Naoto; Guo, L.; Miyazaki, E.; Hamauzu, T.; Toi, M.; Hiroi, Makoto; Enzan, H.
Fonte: Murcia : F. Hernández Publicador: Murcia : F. Hernández
Tipo: Artigo de Revista Científica Formato: application/pdf
ENG
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We investigated the distribution of myofibroblasts and CD34-positive stromal cells in normal gallbladder and its pathological conditions (cholecystitis, n=25) using immunohistochemistry and in situ hybridization. In the wall of normal gallbladder, myofibroblasts were generally absent from all layers, but many CD34-positive stromal cells were observed in the connective tissue layer. In chronic cholecystitis with mild perimuscular fibrosis, a small to moderate number of myofibroblasts appeared in the mucosal layer. In chronic cholecystitis with marked perimuscular fibrosis, a small to large number of myofibroblasts appeared predominantly in the connective tissue layer, whereas the number of CD34-positive stromal cells decreased at the same location, although the number of myofibroblasts increased. In chronic cholecystitis with xanthogranulomatous foci, a small to large number of myofibroblasts were observed in the periphery of the xanthogranulomatous reaction and adjacent area. In contrast, CD34-positive stromal cells were completely absent or were limited to the area just around the xanthogranulomatous reaction. Induction of collagen type I and III mRNA was predominantly observed in the cytoplasm of myofibroblasts associated with the marked fibrosis...

Evaluación de la colecistectomía temprana frente a la colecistectomía diferida como tratamiento de la colecistitis aguda; Evaluation of early cholecystectomy versus delayed cholecystectomy in the treatment of acute cholecystitis

Sánchez Carrasco, Miguel
Fonte: Universidade de Cantabria Publicador: Universidade de Cantabria
Tipo: Tese de Doutorado
SPA
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37.01%
RESUMEN: El tratamiento de la colecistitis aguda contempla dos posibles alternativas quirúrgicas: colecistectomía temprana y colecistectomía diferida. La hipótesis de trabajo es que la colecistectomía temprana es segura en términos de morbi-mortalidad y puede aportar beneficios como menor estancia hospitalaria y menos reingresos. Se ha realizado un estudio retrospectivo comparando ambas opciones de tratamiento. Se analizan: el porcentaje de conversión, el tiempo quirúrgico, la morbilidad global, la morbilidad quirúrgica, la mortalidad, las reintervenciones, los días de estancia en cuidados intensivos, los reingresos hospitalarios, los días de ingreso hospitalario y los costes directos. En cirugía temprana se encuentra: menor morbilidad, a expensas de una menor tasa de infecciones y porcentajes de sangrado y lesión iatrogénica de la vía biliar similares, menor número de reingresos, menos estancias en cuidados intensivos y menos días de estancia hospitalaria. Además la cirugía temprana podría suponer un ahorro en costes directos.; ABSTRACT: Treatment of acute cholecystitis includes two possible surgical alternatives: early cholecystectomy and delayed cholecystectomy. The working hypothesis is that early cholecystectomy is safe in terms of morbidity and mortality and may provide benefits such as a shorter hospital stay and fewer readmissions. We performed a retrospective study comparing the two treatment options and analyzed: conversion risk...

Laparoscopic Cholecystectomy and Open Cholecystectomy in Acute Cholecystitis: Critical Analysis of 520 Cases; Colecistectomia por Laparoscopia e por Laparotomia na Colecistite Aguda: Análise Crítica de 520 Casos

Teixeira, João Araújo; Serviço de Cirurgia. Faculdade de Medicina. Universidade do Porto/Hospital de S. João. Porto. Portugal.; Ribeiro, Carlos; Serviço de Cirurgia. Faculdade de Medicina. Universidade do Porto/Hospital de S. João. Porto. Portugal.;
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf; application/pdf
Publicado em 30/12/2014 POR; ENG
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Introduction: Despite the skepticism with which it was initially seen, laparoscopic cholecystectomy is now the technique of choice for acute cholecystitis. It is, however, important to evaluate the results in comparison with classic cholecystectomy, since the latter is still used by some surgeons in certain situations.Material and Methods: Our research corresponds to the analysis of 520 patients operated on for acute cholecystitis performed in the department of surgery at the São João Hospital in Oporto - 412 (79.2%) laparoscopic cholecystectomies and 108 (20.8%) open cholecystectomies - from 2007 to 2013. We evaluated comorbidities, leukocytosis, time between diagnosis and surgery, ASA, per and postoperative complications, mortality, reoperations, lesion of main bile duct, conversion rate and hospital stay, in order to compare these two techniques. The conversion group was included in laparoscopic cholecystectomy. Statistical analysis was based on descriptive statistic procedures and the evaluation of contrast between groups was based on Fishers’ exact test. Significant values were considered for p < 0.05.Results: Laparoscopic Cholecystectomy versus Open Cholecystectomy: Mortality: 0.7% vs 3,7% (p = 0.0369); Peroperative complications: 3.6% vs 12.9% (p = 0.0006); Surgical postoperative complications: 7.7% vs 17.5% (p = 0.0055); Medical postoperative complications: 4.3% vs 5.5% (p = 0.6077); Lesion of the main bile duct: 0.9% vs 1.8% (p = 0.6091); Reoperation: 2.9% vs 5.5% (p = 0.2315); Hospital stay up to 4 days after surgery: 64.8% vs 18.5% (p < 0.001). The convertion rate was of 10.7%: 8.8% in early surgery (before 4 days after de diagnosis) and 13.7% in the late surgery (after this time but in the same stay) (p = 0.1425). Multiple causes led to convertion: surgical complications (biliary lesions...

Prevalence of Helicobacter spp in chronic cholecystitis and correlation with changes on the histological pattern of the gallbladder

Moricz,André de; Melo,Murilo; Castro,Ana Maria; Campos,Tercio de; Silva,Rodrigo Altenfelder; Pacheco Jr,Adhemar Monteiro
Fonte: Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia Publicador: Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2010 EN
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37.27%
PURPOSE: Establish the prevalence of Helicobacter spp in chronic cholecystitis and its correlation with the gallbladder's histological findings. METHODS: 100 patients were operated for chronic cholecystitis with cholecystolithiasis. In pathological examination of the gallbladder, were evaluated the presence of metaplasia, dysplasia, lymphoid follicles, anaplasia and tumors that might be related to the presence of Helicobacter plus the presence of the bacilli Giemsa? by optical microscopy. From the DNA extracted from the gallbladder's bile, PCR was performed by using specific primers for the identification of Helicobacter spp with amplification of the 400bp segment of rRNA gene16S, with positive control DNA from Helicobacter pylori. All the cases negative for isolation of genetic material were excluded. The cases of PCRΘ and GiemsaΘ were used as negative control group. The histological findings were compared to the presence of bacilli and PCR data using a chi-square and Fisher's Exact test (CI = 95.0%, p <0.05). RESULTS: Of 68 patients, 42 (61.8%) were PCR? for Helicobacter spp and 19 (27.9%) had Giemsa?. There was no correlation between the two findings. The PCR? for Helicobacter spp was not correlated to the histological findings. The presence of lymphoid follicles and metaplasia was related to the Giemsa? (p = 0.025 and p= 0.039). CONCLUSION: There is high prevalence of Helicobacter spp in patients with chronic cholecystitis and cholecystolithiasis without be correlated with the histological patterns studied.

Hemorrhagic cholecystitis and hemobilia: two infrequent complications of systemic lupus erythematosus

García Pérez,Rocío; Ruiz de Angulo,David; López Poveda,María José; Febrero Sánchez,Beatriz; Navas Carrillo,Diana; Parrilla Paricio,Pascual
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/08/2011 ENG
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37.35%
Introduction: the patients affected by systemic lupus erythematosus (SLE) often suffer gastrointestinal symptoms. The differential diagnosis should contemplate pathology of the gall bladder. We present the case of a patient with hemorrhagic lithiasic cholecystitis and hemobilia. Case report: 24 year old female diagnosed with SLE under treatment with Sintrom®, Dacortin® and Dolquine® that presented acute lithiasic cholecystitis and hemobilia with a distal calculus. Cholecystectomy and aperture of the ductus choledochus were performed allowing to confirm the hemobilia and to extract the calculus. Discussion: the treatment of cholecystitis in the patients with SLE is controversial due to the fact that most reviewed cases have been solved with cholecystectomy, or in other cases with conservative treatment with corticosteroids. We believe that the presence of cholelithiasis in a patient with SLE with pain on the right hypochondrium and ultrasound confirming the suspicion of cholecystitis demands a surgical treatment since the cause may be vascular, lithiasic or combined. Besides, the possible complications will not respond to pharmaceutical treatment.

Hemobilia secondary to chronic cholecystitis

Quinta Frutos,R. de; Moles Morenilla,L.; Docobo Durantez,F.; Soto Pradas,J. A.; Iriarte Calvo,J.; Vázquez Medina,A.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/03/2004 POR
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37.01%
The term hemobilia is used to describe the presence of blood in the biliary tract. We report a case of symptomatic hemobilia associated with chronic cholecystitis in a 57-year-old man with jaundice, gastrointestinal hemorrhage, and epigastric pain. We review the etiology of this condition and highlight the role of abdominal ultrasonography in its diagnosis. In our case, abdominal ultrasonography revealed the presence of clots inside the gallbladder. The clinical condition was resolved by means of a cholecystectomy. The patient had an uneventful recovery.

Quality of life (GIQLI) and laparoscopic cholecystectomy usefulness in patients with gallbladder dysfunction or chronic non-lithiasic biliary pain (chronic acalculous cholecystitis)

Planells Roig,M.; Bueno Lledó,J.; Sanahuja Santafé,A.; García Espinosa,R.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/07/2004 ENG
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37.27%
Objective: the aim of this study was to evaluate the incidence, clinical features and role of laparoscopic cholecystectomy (LC) in patients with chronic acalculous cholecystitis (CAC) in comparison with a control group of patients who underwent cholecystectomy for chronic calculous cholecystitis (CCC). Material and methods: prospective evaluation of 34 patients with CAC in contrast with 297 patients with CCC. Outcome measures: clinical presentation, quality of life using the Gastrointestinal Quality of Life Index (GIQLI), usefulness derived from the therapeutic procedure as measured in quality of life units by GIQLI, and clinical efficacy at one year of follow-up. Results: the incidence of complicated biliary disease was higher in CAC (27%), in comparison with CCC (13.8%). The histological study of the excised gallbladder revealed a higher incidence of cholesterolosis associated with chronic cholecystitis in the CAC group (64.9%). GIQLI showed significant differences between preoperative and postoperative measurements in both groups. The associated usefulness of LC was similar in both groups (73 versus 67.3 per cent), confirming an important increase in quality of life for both categories. Conclusions: the incidence of CAC is 11 per cent with a high association with cholesterolosis. Quality of life and LC usefulness are similar to those of patients with CCC. Due to the fact that cholecistogammagraphy is a technique not available in daily clinical practice...

Acute alithiasic cholecystitis: a not so rare disease

Blasco-Alonso,Javier; Santiago-García-Caro,Eloísa; Gil-Gómez,Raquel; Jiménez-Alcántara,Carolina; Sánchez-Yáñez,Pilar; Milano-Manso,Guillermo
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/08/2014 ENG
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37.01%
Introduction: Acute acalculous cholecystitis (AAC) occurs more frequently in critically ill patients, in the immediate postoperative period, after trauma or extensive burns. It has a high rate of morbidity and mortality. Ischemia, infection and vesicular stasis are determinants in its pathogenesis. Material and method: Retrospective study including all cases of AAC diagnosed in our pediatric intensive care unit between January 1997 and December 2012. Results: We included 7 patients, all associated with viral or bacterial infection. All of them suffered from abdominal pain, mainly localized in the right upper quadrant, jaundice and dark urine. Abdominal ultrasound showed thickening and hypervascularity of the gallbladder wall in all cases. The outcome was satisfactory without surgery in all patients. Conclusions: The clinical presentation is oligosymptomatic within severe systemic diseases. The AAC should be suspected in the appearance of any abdominal pain with jaundice/dark urine and hypertransaminasemia in patients suffering from critical or serious infections.

Eosinophilic cholecystitis: an infrequent cause of acute cholecystitis

Moral-Martínez,María del; Barrientos-Delgado,Andrés; Crespo-Lora,Vicente; Cervilla-Sáez-de-Tejada,María Eloísa; Salmerón-Escobar,Javier
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/01/2015 ENG
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Eosinophilic cholecystitis (EC) is a rare disease that is characterised by eosinophilic infiltration of the gallbladder. Its pathogenesis is unknown, although many hypotheses have been made. Clinical and laboratory manifestations do not differ from those of other causes of cholecystitis. Diagnosis is histological and usually performed after analysis of the surgical specimen. We report the case of a woman aged 24 years, with symptoms of fever, vomiting and pain in the right upper quadrant. When imaging tests revealed acalculous cholecystitis, an urgent cholecystectomy was performed. Histological examination of the surgical specimen revealed eosinophilic cholecystitis. No cause of the symptoms was found.