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Pregnancy cholecystitis

Agnès Ditisheim, Baha M Sibai
Subcapsular liver hematoma is a rare but potentially life-threatening complication of preeclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome. It may present with nonspecific signs and symptoms, none of which are diagnostic, and can mimic pulmonary embolism of cholecystitis. There is no consensus on the management of subcapsular liver hematoma. Unruptured liver hematoma can be conservatively managed. When rupture occurs, surgical, endovascular approaches and, rarely, liver transplantation, may be required...
March 2017: Clinical Obstetrics and Gynecology
Hina Iftikhar, Shareen Idu, Abdel Omer
An acute abdomen assessment in pregnancy is complicated. Pain can have obstetric and nonobstetric causes. Cholecystitis is a common cause of pain in pregnancy with significant morbidity if not managed promptly. We report a case of a ruptured, torted, right ovarian teratodermoid erroneously diagnosed as cholecystitis in pregnancy.
May 2016: Clinical Case Reports
Carin E Reust, Amy Williams
Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception...
May 15, 2016: American Family Physician
Thais O Polanco, Sara Alothman, Hector Depaz, Alexius Ramcharan
Listeria monocytogenes (LM) is an aerobic, motile, intracellular gram-positive bacterium. Most invasive systemic infections caused by LM are commonly seen in patients at both extremes of age, during pregnancy or in immunocompromised hosts. Common clinical manifestations of LM infection in immunocompromised adults are bacteremia, infections of central nervous system, such as meningitis, and self-limiting febrile gastroenteritis. Focal infections of listeria are rare, especially cholecystitis, with only few cases reported in the last 33 years...
2016: Journal of Surgical Case Reports
Frank Lammert, Kurinchi Gurusamy, Cynthia W Ko, Juan-Francisco Miquel, Nahum Méndez-Sánchez, Piero Portincasa, Karel J van Erpecum, Cees J van Laarhoven, David Q-H Wang
Gallstones grow inside the gallbladder or biliary tract. These stones can be asymptomatic or symptomatic; only gallstones with symptoms or complications are defined as gallstone disease. Based on their composition, gallstones are classified into cholesterol gallstones, which represent the predominant entity, and bilirubin ('pigment') stones. Black pigment stones can be caused by chronic haemolysis; brown pigment stones typically develop in obstructed and infected bile ducts. For treatment, localization of the gallstones in the biliary tract is more relevant than composition...
April 28, 2016: Nature Reviews. Disease Primers
Asger Eller, Susy Shim, Louise Sigvardt, Peter Rask, Michael Festersen Nielsen
This case report describes a 35-year-old female with acute cholecystitis 36 weeks into her pregnancy. Laparoscopic cholecystectomy was assessed not to be possible. An ultrasonic guided percutaneous transhepatic gall bladder drainage was performed resulting in immediate pain relief. The patient was discharged two days later, and the drain sat in place until a caesarian section was per--formed. A post-surgery cholangiography demonstrated stones in the gall bladder but no stones in the common bile duct. An uneventful laparoscopic cholecystectomy was carried out three months after surgery...
April 18, 2016: Ugeskrift for Laeger
Christophoros Kosmidis, Georgios Anthimidis, Nikolaos Varsamis, Fotini Makedou, Eleni Georgakoudi, Christophoros Efthimiadis
BACKGROUND: Differential diagnosis of acute abdomen in pregnant patients is one of the greatest challenges for the clinician. Occurrence of Familial Mediterranean Fever (FMF) paroxysm of peritonitis and acute cholecystitis during pregnancy is a unique clinical entity that leads to serious diagnostic and therapeutic dilemmas. CASE REPORT: We present the case of a 33-year-old Armenian patient at 16 weeks' gestational age with a history of FMF, who was admitted twice within 1 month with acute abdomen...
February 24, 2016: American Journal of Case Reports
María López-Collada Estrada, Rosalba Olvera Martínez
BACKGROUND: Laparoscopic surgery is well accepted as a safe technique when performed on a third trimester pregnant woman. OBJECTIVE: The aim is to describe the anaesthetic management of a group of patients undergoing this type of surgery. MATERIAL AND METHODS: An analysis was made of records of 6 patients in their third trimester of pregnancy and who underwent urgent laparoscopic surgery from 2011 to 2013. CLINICAL CASES: The study included 6 patients, with a diagnosis of acute cholecystitis in 4 of them...
September 2016: Cirugia y Cirujanos
J Bouyou, S Gaujoux, L Marcellin, M Leconte, F Goffinet, C Chapron, B Dousset
Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity...
December 2015: Journal of Visceral Surgery
T C Cox, C R Huntington, L J Blair, T Prasad, A E Lincourt, V A Augenstein, B T Heniford
BACKGROUND: When pregnant patients require surgery, whether to perform an operation open or laparoscopic is often debated. We evaluated the impact of laparoscopy for common general surgical problems in pregnancy to determine safety and trends in operative approach over time. METHODS: Pregnant patients undergoing appendectomy or cholecystectomy were identified using the National Surgical Quality Improvement Program (NSQIP) database. We analyzed demographics, operative characteristics, and outcomes...
February 2016: Surgical Endoscopy
Jae Joon Lee, Sung Koo Lee, Sang Hyung Kim, Ga Hee Kim, Do Hyun Park, Sangsoo Lee, Dongwan Seo, Myung-Hwan Kim
BACKGROUND/AIMS: Endoscopic therapy with endoscopic retrograde cholangiopancreatography (ERCP) has been suggested as an effective diagnostic and therapeutic tool for biliary and pancreatic disorders during pregnancy. In this report, we describe our experiences with pancreatobiliary endoscopic procedures during pregnancy. METHODS: We reviewed ERCP and endoscopic ultrasonography (EUS) procedures that were performed at a single tertiary care referral center between January 2002 and October 2013...
September 23, 2015: Gut and Liver
Grace H Taylor, Steven D Schwaitzberg
INTRODUCTION: Symptoms of severe intestinal dysmotility decrease patients' quality of life and may prevent them from sustaining adequate oral intake. Dronabinol is a synthetic cannabinoid that is labeled for use in AIDS-related anorexia and chemotherapy-associated nausea and vomiting that has additional efficacy in patients with other etiologies of nausea, vomiting, and anorexia. PRESENTATION OF CASE: We present a 58-year-old female with a history of nausea, vomiting, abdominal pain, and inability to maintain oral intake after multiple laparotomies for ectopic pregnancy, recurrent caecal volvulus, and cholecystitis...
2015: International Journal of Surgery Case Reports
Ashvin Paramanathan, Sam Zachary Walsh, Jieyun Zhou, Steven Chan
INTRODUCTION: Biliary tract disease is a common non-obstetric surgical presentation during pregnancy. Although small international series demonstrate favourable outcomes following laparoscopic cholecystectomy (LC) during pregnancy, there is a paucity of Australian data to complement these findings. METHOD: Between 1st January 2003 and 30th June 2013, all patients undergoing planned LC during pregnancy at Western Health were retrospectively identified. RESULTS: Twenty-two patients underwent planned LC with 3 (13%) cases converted to open surgery...
June 2015: International Journal of Surgery
Eran Weiner, Yossi Mizrachi, Ran Keidar, Ram Kerner, Abraham Golan, Ron Sagiv
PURPOSE: The aim of our study was to assess the clinical and obstetric outcomes of laparoscopic surgeries performed during advanced pregnancy compared to those performed in early pregnancy. METHODS: We retrospectively reviewed all cases of patients who underwent laparoscopic surgery during pregnancy in our institution between 1996 and 2013. RESULTS: We reviewed cases of 117 pregnant women who underwent laparoscopic surgery during the study period...
November 2015: Archives of Gynecology and Obstetrics
Bimbo Ayoola Ashaolu, Mopelola Christianah Asaleye, Adebayo Victor Adetiloye, Isaac Olusegun Alatise
AIM AND OBJECTIVE: The purpose of this study was to determine the spectrum of disease on abdominal ultrasound (US) and the diagnostic efficacy of US in adult patients with nontraumatic acute abdomen at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife. MATERIALS AND METHODS: The study population included consecutive 150 adult patients aged 15 years and above presenting with nontraumatic acute abdomen via the adult emergency unit or as inpatients referred to the Radiology Department of OAUTHC, Ile-Ife for abdominal US...
January 2015: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
April M Jorge, Rajesh N Keswani, Anna Veerappan, Nathaniel J Soper, Andrew J Gawron
Symptomatic cholelithiasis (SC) is common in pregnancy. Guidelines recommend laparoscopic cholecystectomy (LC) for SC in pregnancy. Our aim was to evaluate current practice patterns and outcomes for patients undergoing initial non-operative management for uncomplicated SC during pregnancy. We performed a retrospective analysis and telephone survey of all patients presenting in a 42-month period to a tertiary care center for uncomplicated SC during pregnancy. Women with complicated gallstone disease, including cholecystitis, pancreatitis, choledocholithiasis, and cholangitis were excluded...
April 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Karen Holub, Barbara Camune
Acute fatty liver of pregnancy, although rare, is usually a third trimester of pregnancy occurrence that may be life threatening for both the pregnant woman and the fetus. Often, the onset resembles gastroenteritis or cholecystitis and correct diagnosis is delayed. Because it can also present with preeclampsia and eclampsia, it may be mistakenly diagnosed as hemolysis, elevated liver enzymes, low platelet syndrome. This article presents diagnostic differences between liver conditions that can complicate pregnancy and management strategies for treating and maintaining the well-being of pregnant women, fetuses, and infants who are affected by acute fatty liver of pregnancy...
January 2015: Journal of Perinatal & Neonatal Nursing
María Rocío del Avila-Silva, Julio César Zavala-Castillo, Fausto Moisés Coronel-Cruz
BACKGROUND: Cholecystitis is the second cause of abdominal pain during pregnancy. 1-8 of 10,000 requiring surgery, being performed in the first and second quarter laparoscopically. 100% of patients with cholecystitis, about 12% are associated with pancreatitis with high rates of maternal and fetal morbidity and mortality. OBJECTIVE: To evaluate advantages--disadvantages of maternal-fetal pregnancy laparoscopic cholecystectomy and its preventive character avoiding cases of pancreatitis...
August 2014: Ginecología y Obstetricia de México
Ingolf Juhasz-Böss, Erich Solomayer, Martin Strik, Christoph Raspé
BACKGROUND: Abdominal operations are performed during ca. 2% of all pregnancies. They represent an unusual situation not only for the patient, but also for the involved surgeons and anesthesiologists. Appendectomy, followed by cholecystectomy are the two most common types of operation performed during pregnancy. Special questions arise with regard to the peri- and intraoperative management and the optimal surgical approach. METHOD: This review is based on pertinent articles retrieved by a selective search in the PubMed database...
July 7, 2014: Deutsches Ärzteblatt International
Lawrence M Knab, Anne-Marie Boller, David M Mahvi
Acute cholecystitis is defined as inflammation of the gallbladder and is usually caused by obstruction of the cystic duct. Cholescintigraphy is the most sensitive imaging modality for cholecystitis. The gold standard treatment of acute cholecystitis is laparoscopic cholecystectomy. Operating early in the disease course decreases overall hospital stay and avoids increased complications, conversion to open procedures, and mortality. Cholecystitis during pregnancy is a challenging problem for surgeons. Operative intervention is generally safe for both mother and fetus, given the improved morbidity of the laparoscopic approach compared with open, although increased caution should be exercised in women with gallstone pancreatitis...
April 2014: Surgical Clinics of North America
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