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Septic Shock cholangitis

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https://www.readbyqxmd.com/read/30539515/management-of-acute-gallstone-cholangitis-after-roux-en-y-gastric-bypass-with-laparoscopic-transgastric-endoscopic-retrograde-cholangiopancreatography
#1
Frédéric Borel, Julien Branche, Grégory Baud, Romain Gérard, François Pattou, Robert Caiazzo
BACKGROUND: The incidence of biliary lithiasis is increased after bariatric surgery due to rapid weight loss [1]. Trans-oral endoscopic management in cases of common bile duct gallstone complication is not possible in patients with Roux-en-Y gastric bypass (RYGB) due to the modified anatomy. Access to the biliary tree after RYGB with a classical direct surgical approach of common bile duct and choledocoscopy can be used, but may be complicated in situations of acute cholangitis because of the fragility of common duct, or in cases of previous cholecystectomy...
December 11, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29682365/bedside-endoscopic-retrograde-cholangiopancreatography-using-portable-x-ray-in-acute-severe-cholangitis
#2
Rushikesh Shah, Emad Qayed
Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP) in the endoscopy unit. Fluoroscopic guidance is required to confirm deep biliary cannulation during ERCP. There are a few reported cases of bedside ERCP using portable C-arm fluoroscopy unit or ultrasound guided cannulation...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29480416/procalcitonin-as-a-decision-supporting-marker-of-urgent-biliary-decompression-in-acute-cholangitis
#3
Yoon Suk Lee, Kwang Bum Cho, Kyung Sik Park, Ju Yup Lee, Yoo Jin Lee
BACKGROUND AND AIM: This study aimed to evaluate the association of serum procalcitonin (PCT) at hospital presentation with disease severity and clinical deterioration to septic shock in acute cholangitis. METHODS: This study included consecutive patients with a diagnosis of acute cholangitis who presented to the emergency department and underwent biliary drainage. PCT and blood culture tests were conducted at the time of initial presentation. Patients were categorized into three groups based on disease severity...
September 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28876571/duodenectomy-managing-the-fistula
#4
M Govender, O Matsevych, F Ghoor, N Singh, C Molenaar
BACKGROUND: Duodenectomy is rarely indicated, however, in certain circumstances may have be performed. Enterocutaneous fistula (ECF) is the main cause of serious adverse outcomes. Its management remains challenging. METHOD: Two cases of emergency duodenectomy are presented. The management of ECF is described and discussed. RESULTS: Case 1: A 22-year-old male presented in septic shock with perforated duodenal ulcer, suffered two cardiac arrests before index surgery...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28584805/primary-sclerosing-cholangitis-associated-with-severe-ulcerative-colitis-in-a-young-man
#5
José Cândido Caldeira Xavier, Kunie Iabuki Rabello Coelho, Ligia Yukie Sassaki, Fabio da Silva Yamashiro, Kelly Cristhian Lima Oliveira, Maria Aparecida Marchesan Rodrigues
Primary sclerosing cholangitis, a chronic progressive cholestatic liver disease, is the most serious hepatobiliary complication of ulcerative colitis (UC). The authors present the case of a severe and intractable form of UC associated with primary sclerosing cholangitis, in which the diagnosis of this hepatobiliary complication was made during the postmortem examination. A 19-year-old man, with an 8-month diagnosis of UC, was non-responsive to any therapeutic approach. He presented at the emergency care unit severely ill and with cachexia, and subsequently died of septic shock...
October 2013: Autopsy & Case Reports
https://www.readbyqxmd.com/read/28535517/coupled-plasma-filtration-adsorption-application-for-liver-and-thyroid-toxins
#6
Gabriele Donati, Irene Capelli, Anna Laura Croci Chiocchini, Nicolò Natali, Anna Scrivo, Gaetano La Manna
Coupled plasma filtration and adsorption (CPFA) is a detoxification system that combines a plasma adsorption circuit and a continuous renal replacement therapy circuit. Its main application is for sepsis and septic shock with or without acute renal failure. Several recent studies have suggested that CPFA can reduce the mortality when the volume of plasma absorbed on the styrenic resin is at least >0.18 L/kg/day. At present, new applications for CPFA are under investigation, also in patients without significant kidney failure...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28316845/spinal-cord-infarction-in-the-course-of-a-septic-shock-about-one-case-and-review-of-the-literature
#7
P Henin, A Molderez, V Huberlant, H Trine
We report the case of a patient admitted to our intensive care unit in the course of a septic shock, secondary to cholangitis. After rapid hemodynamic stabilization, antibiotherapy, and endoscopic extraction of bile ducts stones, she appeared to have developed flaccid paraplegia. The suspected diagnosis of medullar ischemia was confirmed by typical MRI findings. This case stresses the potential pathogenic role of hypotension in medullar ischemia and the place of magnetic resonance imaging (MRI) as a reliable diagnostic tool...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28254686/impact-of-inadequate-initial-antimicrobial-therapy-on-mortality-in-patients-with-bacteraemic-cholangitis-a-retrospective-cohort-study
#8
Y Tagashira, N Sakamoto, T Isogai, M Hikone, A Kosaka, R Chino, M Higuchi, Y Uehara, H Honda
OBJECTIVES: Acute cholangitis is a common cause of bacteraemia resulting in severe sepsis or septic shock. The impact of the appropriate initial antimicrobial therapy on short-term mortality in bacteraemic cholangitis has not been well investigated. METHODS: We conducted a retrospective cohort study of patients with bacteraemic cholangitis at two large tertiary care centres in Tokyo, Japan between 2009 and 2015. We determined the factors associated with 30-day all-cause mortality from the date of drawing the first positive blood culture, using a multivariate logistic regression analysis...
October 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27924081/liver-guardian-modifier-and-target-of-sepsis
#9
REVIEW
Pavel Strnad, Frank Tacke, Alexander Koch, Christian Trautwein
Sepsis and septic shock are characterized by life-threatening organ dysfunction caused by a dysregulated host response to infection. The liver has a central role during sepsis, and is essential to the regulation of immune defence during systemic infections by mechanisms such as bacterial clearance, acute-phase protein or cytokine production and metabolic adaptation to inflammation. However, the liver is also a target for sepsis-related injury, including hypoxic hepatitis due to ischaemia and shock, cholestasis due to altered bile metabolism, hepatocellular injury due to drug toxicity or overwhelming inflammation, as well as distinct pathologies such as secondary sclerosing cholangitis in critically ill patients...
January 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27761292/pediatric-fulminant-leptospirosis-complicated-by-pericardial-tamponade-macrophage-activation-syndrome-and-sclerosing-cholangitis
#10
Osman Yeşilbaş, Hasan Serdar Kıhtır, Hamdi Murat Yıldırım, Nevin Hatipoğlu, Esra Şevketoğlu
BACKGROUND: Leptospirosis is a zoonotic infectious disease caused by pathogenic spirochetes of the genus Leptospira. Although it is usually asymptomatic and self-limited, severe potentially fatal illness accompanied by multi-organ failure may occur. CASE REPORT: Here we report an unusual case of severe leptospirosis successfully treated with continuous venovenous hemofiltration (CVVHF) and therapeutic plasma exchange (TPE). The patient presented with pericardial tamponade, renal failure and macrophage activation syndrome, and later suffered prolonged jaundice and sclerosing cholangitis during hospitalization in the pediatric intensive care unit (PICU)...
September 2016: Balkan Medical Journal
https://www.readbyqxmd.com/read/27678368/immunohistochemical-evaluation-for-outflow-reconstruction-using-opened-round-ligament-in-living-donor-right-posterior-sector-graft-liver-transplantation-a-case-report
#11
Yukihiro Sanada, Yasunaru Sakuma, Hideki Sasanuma, Atsushi Miki, Takumi Katano, Yuta Hirata, Noriki Okada, Naoya Yamada, Yoshiyuki Ihara, Taizen Urahashi, Naohiro Sata, Yoshikazu Yasuda, Koichi Mizuta
Utilizing the opened round ligament as venous grafts during liver transplantation is useful but controversial, and there are no pathological analyses of this procedure. Herein, we describe the first reported case of a pathological analysis of an opened round ligament used as a venous patch graft in a living donor liver transplantation (LDLT). A 13-year-old female patient with biliary atresia underwent LDLT using a posterior segment graft from her mother. The graft had two hepatic veins (HVs), which included the right HV (RHV; 15 mm) and the inferior RHV (IRHV; 20 mm)...
September 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27506331/the-impact-of-delayed-biliary-decompression-and-anti-microbial-therapy-in-260-patients-with-cholangitis-associated-septic-shock
#12
C J Karvellas, J G Abraldes, S Zepeda-Gomez, D C Moffat, Y Mirzanejad, G Vazquez-Grande, E K Esfahani, A Kumar
BACKGROUND: Cholangitis-associated septic shock carries significant mortality. There is uncertainty regarding the most appropriate time to achieve biliary decompression. AIM: To determine whether the timing of biliary decompression and anti-microbial therapy affect the survival in cholangitis patients with septic shock. METHODS: Nested retrospective cohort study of all cholangitis-associated septic shock patients (hypotension requiring vasopressors) from an international, multi-centre database between 1996 and 2011...
October 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27122677/urgent-endoscopic-ultrasound-guided-choledochoduodenostomy-for-acute-obstructive-suppurative-cholangitis-induced-sepsis
#13
Kosuke Minaga, Masayuki Kitano, Hajime Imai, Kentaro Yamao, Ken Kamata, Takeshi Miyata, Shunsuke Omoto, Kumpei Kadosaka, Tomoe Yoshikawa, Masatoshi Kudo
Acute obstructive suppurative cholangitis (AOSC) due to biliary lithiasis is a life-threatening condition that requires urgent biliary decompression. Although endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is the current gold standard for biliary decompression, it can sometimes be difficult because of failed biliary cannulation. In this retrospective case series, we describe three cases of successful biliary drainage with recovery from septic shock after urgent endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) was performed for AOSC due to biliary lithiasis...
April 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/26775071/unique-characteristics-of-pyogenic-liver-abscesses-of-biliary-origin
#14
Shaohua Shi, Weiliang Xia, Haijun Guo, Haishen Kong, Shusen Zheng
BACKGROUND: Pyrogenic liver abscesses (PLA) can be caused by cholangitis associated with hepatolithiasis and cholangitis related to an abnormal bilioenteric communication, such as a hepaticojejunostomy or the presence of indwelling biliary stents. Our aim was to evaluate the clinical characteristics of PLA of biliary origin. METHODS: We compared patients with PLA related to biliary tract disease (PLA-B; n = 125) with patients with PLA not related to biliary tract disease (PLA-NB; n = 444)...
May 2016: Surgery
https://www.readbyqxmd.com/read/26522207/septic-shock-due-to-biliary-stones-in-a-postcholecystectomy-patient
#15
Mohammad Feroz Azfar, Muhammad Faisal Khan, Moazzum Khursheed
Septic shock leading to multi-organ failure is not uncommon. Early diagnosis to confirm the source is the distinctive attribute of sepsis management guidelines. Cholangitis as the source of sepsis can become a diagnostic dilemma in patients who have had cholecystectomy in the past. CT abdomen should be the investigation of choice in this group of patients. This report describes two postcholecystectomy patients who presented with septic shock secondary to biliary stones. The source of septic shock in both patients were biliary stones was confirmed with abdominal CT...
October 2015: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/26468310/acute-bacterial-cholangitis
#16
REVIEW
Vincent Zimmer, Frank Lammert
BACKGROUND: Acute bacterial cholangitis for the most part owing to common bile duct stones is common in gastroenterology practice and represents a potentially life-threatening condition often characterized by fever, abdominal pain, and jaundice (Charcot's triad) as well as confusion and septic shock (Reynolds' pentad). METHODS: This review is based on a systematic literature review in PubMed with the search items 'cholangitis' 'choledocholithiasis' 'gallstone disease' 'biliary infection', and 'biliary sepsis'...
June 2015: Viszeralmedizin
https://www.readbyqxmd.com/read/26181839/erratum-to-endotoxin-adsorption-therapy-using-polymyxin-b-immobilized-fiber-as-a-treatment-for-septic-shock-associated-severe-acute-cholangitis
#17
Yoshihiro Inoue, Yasuhisa Fujino, Makoto Onodera, Satoshi Kikuchi, Masayuki Sato, Gaku Takahashi, Masahiro Kojika, Shigeatsu Endo
No abstract text is available yet for this article.
October 2013: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/26181837/endotoxin-adsorption-therapy-using-polymyxin-b-immobilized-fiber-as-a-treatment-for-septic-shock-associated-severe-acute-cholangitis
#18
Yoshihiro Inoue, Yasuhisa Fujino, Makoto Onodera, Satoshi Kikuchi, Gaku Takahashi, Masahiro Kojika, Shigeatsu Endo
The application of endotoxin adsorption therapy for severe acute cholangitis is controversial. We present a survival case of septic shock and multiple organ failure due to severe acute cholangitis. The patient was treated by endotoxin adsorption therapy using polymyxin B-immobilized fiber because he continued to remain in shock even after successful endoscopic nasobiliary drainage. The patient was an 84-year-old male diagnosed with acute cholangitis and acute pancreatitis who was transferred to our department because of shock and severe dyspnea...
October 2013: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/25375059/biliary-cast-complication-of-cholangitis-and-pancreatitis-in-a-pancreas-divisum-patient
#19
F Graur, H Neagos, A Cavasi, N Al Hajjar
We report a rare cause of biliary cast secondary to cholangitis and pancreatitis, in a 60 year old female patient with pancreas divisum. She was admitted in our hospital with an acute pancreatitis (alcoholic etiology was excluded) complicated with pancreatic abscess and obstructive jaundice. The patient had undergone a complex surgical intervention: cholecystectomy,choledocotomy with extraction of the biliary thrombus,external biliary drainage through a T tube, evacuation of the pancreatic abscess, sequestrectomy, peritoneal lavage and multipledrainages...
September 2014: Chirurgia
https://www.readbyqxmd.com/read/24831869/-changing-the-therapeutic-goal-in-critically-ill-patients-ethical-analysis-of-a-surgical-case
#20
R J Jox, L Ney
We report on a 32-year-old patient, who developed septic shock, toxic shock-like syndrome, and multiple organ failure following nectrotizing fasciitis. Amputations had to be performed on all extremities. Subsequently, she developed secondary sclerosing cholangitis. Treatment goals had to be reassessed, since long-term survival seemed doubtful and, in the best case, burdened with severe handicap. We discuss the evaluation of the treatment goals, utilizing a structured model of goal-setting. In the first step the treatment goal is identified based on the patient's wishes...
May 2014: Der Unfallchirurg
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