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https://www.readbyqxmd.com/read/29472508/false-prolongation-of-international-normalized-ratio-associated-with-daptomycin
#1
Susan E Smith, Kelli A Rumbaugh
PURPOSE: Persistent elevation of prothrombin time (PT) and International Normalized Ratio (INR) values in a patient receiving daptomycin is reported. SUMMARY: A morbidly obese 51-year-old man was hospitalized for evaluation for surgical intervention for gallstone pancreatitis and biliary obstruction. Previously prescribed warfarin therapy was withheld due to suspected coagulopathy and an elevated INR (5.1), and warfarin reversal was initiated. After undergoing partial cholecystectomy on hospital day 6, the patient developed sepsis and was treated with i...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29465584/duplication-of-the-extrahepatic-bile-duct-a-case-report-and-review-of-the-literatures
#2
Xiaoxiao Fan, Lifeng He, P Asutosh Khadaroo, Daizhan Zhou, Hui Lin
RATIONALE: Duplication of the extrahepatic bile duct is an extremely rare congenital anomaly of the biliary system. PATIENT CONCERNS: A 44-year-old woman presented with a history of continuous upper abdominal pain and vomiting. DIAGNOSES: Magnetic resonance cholangiopancreatography (MRCP) disclosed diffuse dilatation of the intrahepatic and extrahepatic bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP) showed the presence of two extrahepatic bile ducts with calculus at the distal end of the CBD...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29462081/the-opioid-epidemic-in-acute-care-surgery-characteristics-of-overprescribing-following-laparoscopic-cholecystectomy
#3
Kristine T Hanson, Cornelius A Thiels, Stephanie F Polites, Halena M Gazelka, Mohamed D Ray-Zack, Martin D Zielinski, Elizabeth B Habermann
BACKGROUND: Postoperative prescribing following acute care surgery must be optimized to limit excess opioids in circulation as misuse and diversion are frequently preceded by a prescription for acute pain. This study aimed to identify patient characteristics associated with higher opioid prescribing following laparoscopic cholecystectomy (LC). METHODS: Among patients age ≥18 years who underwent LC at a single institution 2014-2016, opioids prescribed at discharge were converted to oral morphine equivalents (OME) and compared to developing state guidelines (max 200 OME)...
February 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29459583/ruptured-cystic-artery-pseudoaneurysm-successfully-treated-with-urgent-cholecystectomy-a-case-report-and-literature-review
#4
Yuji Fujimoto, Yoshito Tomimaru, Hisanori Hatano, Kozo Noguchi, Hirotsugu Nagase, Atsushi Hamabe, Masashi Hirota, Kazuteru Oshima, Tsukasa Tanida, Shunji Morita, Hiroshi Imamura, Takashi Iwazawa, Kenzo Akagi, Keizo Dono
BACKGROUND Cystic artery pseudoaneurysm is rare, and some cases are associated with inflammation of the gallbladder. There is limited information regarding this condition, and the clinical features remain unclear. This report is a case of ruptured cystic artery pseudoaneurysm diagnosed by computed tomography (CT) imaging and treated with urgent cholecystectomy and is supported by a literature review of previous cases. CASE REPORT A 90-year-old man, who had developed acute cholecystitis due to a gallstone one month previously, was referred to our hospital...
February 20, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29442062/gallstone-ileus-in-a-ninety-two-years-old-colecistectomized-patient-after-endoscopic-biliary-sphincterotomy-a-case-report
#5
S Fedele, P Lobascio, G Carbotta, G Balducci, R Laforgia, M G Sederino, M Minafra, A Delvecchio, N Palasciano
INTRODUCTION: Gallstone ileus is an uncommon condition of mechanical bowel obstruction caused by the passage of a gallstone into the bowel. It occurs more frequently in female patients older than 65 years and often for a biliary-enteric fistula. The pathognomonic features of gallstone ileus - the Rigler's triad - are pneumobilia, ectopic gallstone and bowel obstruction. Less commonly, a gallstone may enter the intestinal lumen through the common bile duct, after endoscopic retrograde cholangiopancreatography, and very rarely in colecistectomized patient...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29441341/single-incision-laparoscopic-cholecystectomy-for-patients-with-mirizzi-syndrome
#6
Won-Bae Chang, Ho-Seong Han, Yoo-Seok Yoon, Jai Young Cho, YoungRok Choi
Since multiport laparoscopic cholecystectomy has become a standard treatment for gallbladder (GB) disease, a single incision laparoscopic surgical technique has been tried to decrease the surgical site pain and achieve a better cosmetic out come in selected patients. The development of devices dedicated for single incision laparoscopic cholecystectomy (SILC) is expanding the indication of this single incision laparoscopic technique to more complicated GB diseases. Mirizzi syndrome (MS) is one of the complex uncommon gallstone diseases in patients undergoing cholecystectomy...
February 2018: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29424395/-effect-of-a-high-fat-diet-on-cholesterol-gallstone-formation
#7
Reginald Del Pozo, Lorena Mardones, Marcelo Villagrán, Katia Muñoz, Susana Roa, Francisca Rozas, Valeska Ormazábal, Mirna Muñoz
BACKGROUND: It is known that some nutrients play an important role in the development of cholelithiasis. Cholesterol is carried by micelles and vesicles in the bile. During the first stage of gallstone formation, cholesterol crystals derive from thermodynamically unstable vesicles. AIM: To determine the effect of a high fat diet on blood lipids and bile composition, and its implication in the formation of gallstones. MATERIAL AND METHODS: Two groups of 15 BALB/c mice each, coming from the same litter, were treated with a control or with a high-fat diet (64% fat and 0...
September 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29423151/a-case-of-bouveret-s-syndrome-treated-with-gastrojejunal-anastomosis
#8
Ioannis D Kostakis, Zoe Garoufalia, Themistoklis Feretis, Stylianos Kykalos, Dimitrios Mantas
Bouveret's syndrome is a rare cause of proximal gallstone ileus with obstruction of duodenum or gastric outlet. We report a case of an 87-year-old female patient presented with 1 week history of vomiting whose plain radiograms showed ileus and pneumobilia. The abdominal computed tomography confirmed pneumobilia and revealed free air and leakage of oral contrast agent in the hepatic hilum and subhepatic space and an impacted gallstone in the third portion of the duodenum. The patient underwent exploratory laparotomy, which showed that the duodenal perforation was circumvallated, and a side-to-side retrocolic gastrojejunal anastomosis was performed in order to surpass the impacted gallstone...
October 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29422240/screen-detected-gallstone-disease-and-autoimmune-diseases-a-cohort-study
#9
Daniel Mønsted Shabanzadeh, Allan Linneberg, Tea Skaaby, Lars Tue Sørensen, Torben Jørgensen
BACKGROUND: Gallstone disease is highly prevalent and is associated with systemic inflammation. AIMS: To determine whether screen-detected gallstones or cholecystectomy are associated with the occurrence of autoimmune and autoinflammatory diseases and the most common subgroups thereof. METHODS: A cohort study of three randomly selected general population samples from Copenhagen was performed. Participants (n = 5928) were examined in the period 1982-1992, underwent abdominal ultrasound examination to detect gallstone disease, and followed through national registers until December 2014 (median 24...
January 31, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29421933/predictors-for-choledocholitiasis-in-patients-undergoing-endoscopic-ultrasound
#10
Julie Vaynshtein, Gilbert Sabbag, Ilya Pinsk, Ilan Rahmani, Avraham Reshef
AIM: Biliary lithiasis is common in most western countries. Symptomatic patients will also have choledocholithiasis in 10% of the cases. For patients with intermediate probability of CBD stones, the recommended imaging studies are endoscopic ultrasound (EUS) or MRCP. This study aims to identify early factors that can be used as predictors for the presence of CBD stones, and by that to find which patient should undergo ERCP without an early EUS. METHODS: This is a retrospective cohort study including all patients who underwent EUS for suspected choledocholithiasis at the Soroka University Medical Center (SUMC) in the years 2009-2014...
February 8, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29417009/hepatobiliary-dysfunction-in-type-2-diabetes-mellitus
#11
Piyush Manoria, Sameer Inamdar, Ravindra Kumar
Objective: Nonalcoholic fatty liver disease (NAFLD) and gallstones are frequently present in diabetics, but its exact prevalence is not well studied in India. We have done a prevalence study of hepatobiliary involvement in Type-2 diabetes mellitus (T2DM) and also studied the other risk factors of NAFLD. Materials and Methods: Two hundred diabetics and 200 controls underwent anthropometric measurements, abdominal ultrasonography, (USG) and biochemical tests at a tertiary care hospital...
July 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29414501/gallstone-ileus-a-possible-cause-of-bowel-obstruction-in-the-elderly-population
#12
Marco De Monti, Giovanni Cestaro, Suleiman Alkayyali, Jacopo Galafassi, Fabrizio Fasolini
INTRODUCTION: Gallstone ileus (GI) is characterized by a mechanical occlusion of the ileal lumen as a result of migration of one or more gallstones in the intestinal tract. Less than 1-4% of all cases of intestinal obstruction are derived from this etiology (1,2,3). CASE REPORT: We present a case of small intestinal obstruction owing to a large gallstone in lower ileum in a 66 years old woman. The diagnosis was made by computed tomography, and treated successfully with an enterotomy, with a removal of a 5 cm gallstone, carried out through a longitudinal incision on the antimesenteric border...
January 29, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29407312/complication-follow-up-with-ultrasonographic-analyses-of-91-cases-with-donor-gallbladder-preservation-in-living-donor-liver-transplantation-of-left-lateral-sectionectomies
#13
F Su, E He, L Qian, Z Zhu, L Wei, Z Zeng, W Qu, R Xu, Z Yi
BACKGROUND: Preserving the donor's gallbladder during living donor liver transplantation (LDLT) is a better method for liver transplantation surgery, but not enough is known about gallbladder complications after the operation. METHODS: We retrospectively investigated postsurgical donor gallbladder complications in clinical LDLT with gallbladder preservation. The feasibility of retaining the gallbladder during liver graft procurement is discussed. Ninety-one donors with retained gallbladder after LDLT with the hepatic left lateral sectionectomy (from June 2013 to October 2015) were retrospectively analyzed...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29401491/urgent-endoscopic-retrograde-cholangiopancreatography-is-not-superior-to-early-ercp-in-acute-biliary-pancreatitis-with-biliary-obstruction-without-cholangitis
#14
Hee Seung Lee, Moon Jae Chung, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Si Young Song, Jae Bock Chung
Acute pancreatitis is a common diagnosis worldwide, with gallstone disease being the most prevalent cause (50%). The American College of Gastroenterology recommends urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 h) for patients with biliary pancreatitis accompanied by cholangitis. Most international guidelines recommend that ERCP be performed within 72 h in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, but the optimal timing for endoscopy is controversial...
2018: PloS One
https://www.readbyqxmd.com/read/29394858/-case-of-adenocarcinoma-with-neuroendocrine-carcinoma-component-in-the-gallbladder
#15
Yu Takeda, Kozo Noguchi, Yoshito Tomimaru, Hirotsugu Nagase, Atsushi Hamabe, Masashi Hirota, Tsukasa Tanida, Kazuteru Oshima, Shunji Morita, Hiroshi Imamura, Takashi Iwazawa, Kenzo Akagi, Hiroka Ando, Shiro Adachi, Keizo Dono
A 73-year-old man visited our hospital complaining of abdominal pain. An abdominal CT scan revealed diffuse wall thickening of the gallbladder with a gallstone. Urgent laparoscopic cholecystectomy was performed with the diagnosis of acute cholecystitis. Histopathological examination indicated adenocarcinoma with a small neuroendocrine carcinoma component invading the subserous layer. Additional gallbladder bed resection and lymphadenectomy were performed. The final pathological diagnosis was adenocarcinoma with NEC, pT2N0M0, pStage II ...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29394822/-a-case-of-xanthogranulomatous-cholecystitis-that-changed-over-time-and-was-difficult-to-distinguish-from-advanced-gallbladder-cancer
#16
Kei Adachi, Kazuhiko Hashimoto, Ryoji Nonaka, Jeong-Ho Moon, Yujiro Fujie, Shoichiro Fujita, Keiko Kojima, Jun Hanai, Shingi Imaoka, Tadashi Ohnishi
A 70-year-old man was referred because of suspected gallbladder cancer and gallstones. Contrast-enhanced CT, EOB-MRI and PET-CT could not completely rule out gallbladder cancer. The patient preferred follow-up without surgery. At 4 months after initial examination, the gallbladder wall thickening showed improvement, but appeared worse at 9 months after initial examination. Therefore, we decided to perform surgery. Since malignant findings were not observed on rapid intraoperative pathology, we performed a cholecystectomy and right hemicolectomy because of inflammation in the transverse colon...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29393043/new-determinants-for-gallstone-disease
#17
Daniel Mønsted Shabanzadeh
Gallstone disease is highly prevalent in Denmark and other countries of northern Europe, and cholecystectomy for the treatment of clinical gallstone disease is one the most frequently performed surgical procedures. Research efforts for the identification of mechanisms involved in gallstone formation have a long history and the most established include bile cholesterol saturation, gallbladder motor function, and the enterohepatic circulation of secondary bile salts produced by fecal microbiota. A small number of determinants that are believed to affect these mechanisms have been identified until now...
February 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29392773/the-characteristics-of-small-intestinal-bacterial-overgrowth-in-patients-with-gallstone-diseases
#18
Dae Bum Kim, Chang-Nyol Paik, Do Seon Song, Yeon Ji Kim, Ji Min Lee
BACKGROUND AND AIM: Small intestinal bacterial overgrowth (SIBO) might be prevalent in gallstone disease, including cases involving cholecystectomy and gallstones. The study aimed to investigate the prevalence and characteristics of SIBO in patients with gallstone disease. METHODS: This prospective study evaluated 265 patients for gallstone disease (200, gallstones; 65, cholecystectomy) and 39 healthy controls. Laboratory data, abdominal ultrasonography, and glucose breath test (GBT) with bowel symptom questionnaire were performed...
February 2, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29392151/pearl-white-gallstones-causing-choledocholithiasis
#19
Patrick Stoner, Alexander Schlachterman, Eric Hilgenfeldt, Peter Draganov
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29388462/safety-and-tolerability-of-new-generation-anti-obesity-medications-a-narrative-review
#20
Dhiren K Patel, Fatima Cody Stanford
The prevalence of obesity and associated comorbidities is rising. Despite their weight-loss efficacy, new generation anti-obesity medications are only prescribed to a minority of adults with obesity, possibly, which in part may be due to safety concerns. This review presents detailed safety profiles for orlistat, phentermine/topiramate, lorcaserin, naltrexone/bupropion and liraglutide 3.0 mg, and discusses the associated risk-benefit profiles. Two anti-obesity medications presented safety issues that warranted further discussion; phentermine/topiramate (fetal toxicity) and liraglutide 3...
February 8, 2018: Postgraduate Medicine
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