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cholangitic abscess

Varsha Barai, Jagadish Hedawoo, Sanjay Changole
INTRODUCTION: Choledocholithiasis is presence of stone in Common bile duct (CBD) which can be treated by endoscopy or surgery [1]. Retained foreign bodies like stents forms a nidus for stone formation resulting in pain, fever, jaundice. CASE PRESENTATION: 60 years female patient admitted in surgery ward with features of cholangitis with computed tomography showing cholangitic abscess with dilated common bile duct and sludge around stent in situ. Stone was found at proximal end of stent during surgery...
2017: International Journal of Surgery Case Reports
Ujjwal Gorsi, Pankaj Gupta, Naveen Kalra, Mandeep Kang, Rajinder Singh, Rajesh Gupta, Vikas Gupta, Niranjan Khandelwal
OBJECTIVE: To evaluate the role of multidetector computed tomography (CT) and CT angiography (CTA) in post cholecystectomy complications. METHODS: A retrospective analysis of data from December 2012 to August 2014 was performed. Eight hundred sixty consecutive patients with history of cholecystectomy (laparoscopic or open) were evaluated. After exclusion of 645 patients with normal imaging, analysis for post cholecystectomy complications was performed in 215 patients...
October 2015: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
Sushrut Trakroo, Kamran Qureshi
Hepatic arterial flow is paramount in preserving biliary integrity. We present an interesting clinical scenario of a liver transplant recipient with biliary anastomotic stricture who developed biliary abscess and sepsis after Endoscopic Retrograde Cholangiopancreatography. The abscess did not respond to maximal medical management, percutaneous drainage, and adequate endoscopic biliary drainage. Clinically, patient continued to deteriorate and imaging identified hepatic artery stenosis which was treated with percutaneous intra-arterial stenting...
2016: Case Reports in Transplantation
Ankur Goyal, Kumble S Madhusudhan, Shivanand Gamanagatti, Bhaskar Baruah, Shalimar, Raju Sharma
Hepatic artery pseudoaneurysms (HAP) are uncommon, occurring mostly as a complication of trauma (accidental or iatrogenic). Liver abscess rarely causes HAP and multiple HAP associated with cholangitic abscesses have not been reported in the literature. We present a patient of acute necrotizing pancreatitis with stent block cholangitis and multiple cholangitic abscesses who developed hemorrhagic output through drainage catheter in the liver abscess. A multiphasic CT angiography demonstrated three HAP, which were treated with a combination of endovascular coil embolization and percutaneous thrombin injection...
January 2016: Indian Journal of Radiology & Imaging
Mohammed S Alqahtani, Shadi A Alshammary, Enas M Alqahtani, Shoukat A Bojal, Amal Alaidh, Gelu Osian
INTRODUCTION: Rapid weight loss following bariatric surgery is associated with high incidence of gallstones and complications that may need bilioenteric diversion. This presents a specific challenge in the management of this group of patients. CASE PRESENTATION: A 37 years old female underwent a Roux-en-Y gastric bypass (RYGB) in 2008 for morbid obesity. In 2009 she presented with obstructive jaundice and was diagnosed with choledocholithiasis successfully managed by open cholecystectomy and choledochoduodenostomy...
2016: International Journal of Surgery Case Reports
Silke Leonhardt, Wilfried Veltzke-Schlieker, Andreas Adler, Eckart Schott, Dennis Eurich, Wladimir Faber, Peter Neuhaus, Daniel Seehofer
Secondary sclerosing cholangitis in critically ill patients (SSC-CIP) is an important differential diagnosis in patients presenting with cholestasis and PSC-like cholangiographic changes in endoscopic retrograde cholangiography (ERC). As a relatively newly described entity, SSC-CIP is still underdiagnosed, and the diagnosis is often delayed. The present study aims to improve the early detection of SSC-CIP and the identification of its complications.A total of 2633 records of patients who underwent or were listed for orthotopic liver transplantation at the University Hospital Charité, Berlin, were analyzed retrospectively...
December 2015: Medicine (Baltimore)
Khurram Bari, Harry R Aslanian, Jeffrey Pollak, Eric Reiner, Ronald R Salem, Tamar H Taddei, Sukru H Emre, Priya A Jamidar
A 48-year-old female developed acute emphysematous cholecystitis after an endoscopic retrograde cholangiopancreatography (ERCP) for evaluation of sphincter of Oddi dysfunction. Cholecystectomy was performed 2 days later. Cultures grew Clostridium perfringens. The patient received broad-spectrum antibiotics but developed recurrent cholangitic abscesses and intra- and extra-hepatic biliary necrosis. She was managed by percutaneous transhepatic biliary drains. For next 3 years, patient had recurrent episodes of biliary obstruction, cholangitis, and sepsis, resulting in secondary biliary cirrhosis requiring a liver transplantation...
October 2013: ACG Case Reports Journal
Sandesh V Parelkar, Sanjay N Oak, Amit Maydeo, Beejal V Sanghvi, Prashant B Joshi, Nitin Chaubal, Rajasekhara T Patil, Subrat K Sahoo, Patel Jiwan Lal, Nandita Sampath, Avani Koticha
A 9-year-old boy presented with right upper abdominal pain and fever. The radiologic investigations revealed multiple cholangitic abscesses with cholangitis and worms in common bile duct. Endoscopic retrograde cholangio pancreatographic (ERCP) sphincterotomy, basketing, ballooning and extraction of Fasciola hepatica worms from the common bile duct were done.
January 2013: Journal of Indian Association of Pediatric Surgeons
A J Lawson, S J Beningfield, J E J Krige, P Rischbieter, S Burmeister
BACKGROUND: Malignant biliary obstruction is often inoperable at presentation and has a poor prognosis. Percutaneously placed self-expanding metal stents (SEMS) have been widely used for palliation of malignant biliary obstruction as an alternative to major bypass surgery or when endoscopic drainage is not technically feasible. The success rate, procedural complications and outcomes in patients who underwent placement of SEMS in a tertiary referral centre are presented. METHODS: All patients who had percutaneous transhepatic cholangiography (PTC) and SEMS for palliation of malignant biliary obstruction between May 2008 and July 2010 at Groote Schuur Hospital, Cape Town, were reviewed...
July 11, 2012: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
A Cosme, E Ojeda, I Zamarreño, L Bujanda, G Garmendia, M J Echeverría, J Benavente
OBJECTIVE: To compare the clinical and epidemiological characteristics of patients with pyogenic liver abscess (PLA) and with amebic liver abscess (AHA) in order to determine the potential factors that may help improve diagnosis and treatment for this disease. MATERIAL AND METHOD: A retrospective study of clinical histories of 45 patients with PLA and 13 with ALA, diagnosed between 1985 and 2005 in Donostia Hospital in San Sebastián. RESULTS: Among the 45 patients with PLA (30 men and 15 women, with a mean age of 61 years and 11 months), more than a half were cholangitic (13 cases) or were of unknown origin (15 cases)...
February 2010: Revista Española de Enfermedades Digestivas
G N Khabas
Rare cases of lethal outcomes after surgical operations on the liver were analyzed which were caused by invasion of helminth Opisthorchis felineus. It was shown that prolonged and massive invasion, in the absence of specific treatment, can result in failure of the compensatory potencies of the liver. It occurs mainly due to activation of the pathogenic flora in the bile tree against the background of the intraductal hypertension characteristic of opisthorchiasis. Destructive purulent cholangitis, cholangitic abscesses in the liver and suppuration of opisthorchiasis cysts can develop...
2003: Vestnik Khirurgii Imeni I. I. Grekova
A Chaudhary, S S Negi, S K Puri, P Narang
BACKGROUND: Percutaneous transhepatic cholangiography (PTC) has been the preferred investigation to delineate the anatomy of the biliary tract in a patient with a bile duct stricture after cholecystectomy. Recently magnetic resonance cholangiography (MRC) has been described to evaluate the obstructed biliary tract. This paper reports a comparison of MRC with PTC in evaluating patients with an iatrogenic bile duct stricture. METHODS: This was a prospective study of 26 patients who had surgery for a bile duct stricture after cholecystectomy...
April 2002: British Journal of Surgery
M Sato, Y Watanabe, K Tokui, A Yashima, M Murakami, M Hirose, K Kawachi
A systematic approach is required to treat complex hepatolithiasis. A 45 year-old female patient with hepatolithiasis had bilateral intrahepatic stones, biliary strictures at the right hepatic duct and segment IV duct, cholangitic abscess, and shrinkage of the right hepatic lobe. Six sessions of lithotomy were carried out under the guidance of percutaneous transhepatic choledochoscopy using a dye-laser lithotriptor through the segment III duct. Although stones were eradicated from the common bile duct and segment III duct, stones remained in other segments where cholangioscopic access was not feasible...
November 1999: Hepato-gastroenterology
M F Chen, Y Y Jan, C S Wang, T L Hwang, L B Jeng, S C Chen, T C Chao
BACKGROUND: Hepatic resection is the treatment of choice for unilateral intrahepatic stones. The availability of the flexible choledochoscope has greatly changed the management of intrahepatic stones. Little has been reported regarding hepatic resection for bilateral intrahepatic stones. METHODS: Fifty-nine (15.1 per cent) of 392 patients with bilateral intrahepatic stones underwent hepatic resection. The indications and results were reported. Surgical outcome and long-term follow-up were analysed, and results were compared with those in patients not undergoing hepatectomy...
September 1997: British Journal of Surgery
M V Ha
The most frequent hepatobiliary diseases in Vietnam are chronic hepatitis and cirrhosis, liver abscess, hepatobiliary ascaridiasis, angiocholitis, biliary lithiasis and primary liver cancer. The principal causes of chronic hepatitis and cirrhosis are HBV and HCV infections. Alcohol and chemicals (drugs, agricultural, industrial, war herbicides) also play an important role. Malaria causes hepatitis and fibrosis lesions, however no cirrhotic lesions were observed. There are two categories of liver abscess, amoebic and cholangitic, often caused by ascaridiasis...
May 1997: Journal of Gastroenterology and Hepatology
C J Hung, P W Lin
BACKGROUND: The role of right hepatic lobectomy is evaluated in the treatment of selected patients with isolated right-sided hepatolithiasis. METHODS: During the past 7 years right hepatic lobectomy was performed in five patients who had isolated right-sided hepatolithiasis. The rationale and indications of this procedure are discussed. The efficacy of preoperative evaluations, the operative findings, and the operative results are analyzed. RESULTS: All the patients were female with a mean age of 49...
February 1997: Surgery
S T Fan, E C Lai, J Wong
OBJECTIVE: To analyze the results of hepatic resection for hepatolithiasis. DESIGN: A retrospective study of case records of patients with hepatolithiasis undergoing hepatic resection. These patients had been followed up for 3 to 38 months. They were referred to Queen Mary Hospital, a tertiary referral center in Hong Kong. PATIENTS: Of 172 patients with hepatolithiasis seen between January 1984 and December 1981, 63 patients underwent hepatic resection because the affected liver segments were destroyed by repeated infection (n = 51), multiple cholangitic liver abscesses were found in the affected liver segments (n = 9), or concomitant intrahepatic cholangiocarcinoma was diagnosed (n = 3)...
September 1993: Archives of Surgery
L A Zubareva, N F Kuzovlev, E I Gal'perin
The article generalizes experience (1986-1991) in the treatment of 246 patients with choledocholithiasis with the performance of endoscopic papillosphincterotomy. Most patients (61%) were over 60 years of age, many had serious concomitant diseases. Among patients with occlusion of the bile ducts, 53.6% had obstructive purulent cholangitis, 53.6% had acute biliary pancreatitis, and 30.9% had acute cholecystitis. Typical as well as atypical cannulation EPST was applied. To exclude an X-ray load on the patient and doctor, the orifices of the terminal part of the common bile duct and of the main pancreatic duct were identified in most patients by an elaborated method of cannulation with aspiration control without preliminary contrast X-ray examination...
December 1994: Khirurgiia
A Uccheddu, G Faa, A Cois, R Ambu
Two cases of inflammatory pseudotumor (IPT) of the liver are reported. Clinical presentation was vague and aspecific. Laboratory tests and data from imaging techniques provided no specific information on the actual nature of the lesions and were misleading, suggesting a malignant lesion in one patient and a complicated hydatid cyst in the other. On gross examination, the tumors appeared yellowish ore grey-yellow in color, with a firm cut surface and well circumscribed from the surrounding parenchyma, although a true capsule was not evident...
March 1995: Tumori
S A Shalimov, I R Rustamov, V S Zemskov
No abstract text is available yet for this article.
June 1980: Khirurgiia
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