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https://read.qxmd.com/read/38576695/complicated-pregnancy-unveiling-the-dual-challenge-of-acute-cholecystitis-and-choledocholithiasis
#1
Ketki S Dantkale, Manjusha Agrawal
Gallstone-related complications during pregnancy, though relatively rare, present significant challenges necessitating careful clinical management. Among these complications, the simultaneous occurrence of acute cholecystitis and choledocholithiasis poses a unique dual challenge, especially considering the physiological changes and fetal considerations associated with pregnancy. This case report presents the management of a 27-year-old pregnant woman with acute cholecystitis and choledocholithiasis at 32 weeks of gestation...
March 2024: Curēus
https://read.qxmd.com/read/38570301/developmental-anaesthesia-neurotoxicity-in-humans-finding-the-sweet-spot
#2
EDITORIAL
Laszlo Vutskits
A recent human epidemiological study in this issue of British Journal of Anaesthesia examined the association between anaesthesia exposure in pregnant women undergoing appendicectomy or cholecystectomy and the subsequent diagnosis of behavioural disorders in their offspring. When compared with unexposed children, prenatally exposed children had ∼30% greater likelihood of a diagnosis of disruptive or internalising behavioural disorders. Although these data are new and interesting, they should be interpreted with caution...
April 2, 2024: British Journal of Anaesthesia
https://read.qxmd.com/read/38521515/menace-of-hepatitis-e-in-pregnancy-unleashing-the-threat-of-fulminant-liver-failure
#3
JOURNAL ARTICLE
Tanisha Gupta, Soniya Dhiman, Aparna Sharma
This case report presents a primigravida in her 20s with a history of seizure disorder and chronic cholecystitis, who presented at 30 weeks and 6 days of gestation with upper abdominal pain, fever and vomiting. Initially diagnosed with acute calculous cholecystitis, the patient's condition rapidly deteriorated, resulting in fetal demise and the development of severe complications. Subsequent investigations revealed an enlarged fatty liver and signs of acute liver failure. The diagnosis of acute fatty liver of pregnancy was initially considered but later ruled out, and the patient was diagnosed with hepatitis E based on positive anti-hepatitis E virus IgM antibodies...
March 22, 2024: BMJ Case Reports
https://read.qxmd.com/read/38304305/pregnant-patients-undergoing-cholecystectomy-nationwide-assessment-of-clinical-characteristics-and-outcomes
#4
JOURNAL ARTICLE
Genevieve R Mazza, Ariane C Youssefzadeh, Laurel S Aberle, Zachary S Anderson, Rachel S Mandelbaum, Joseph G Ouzounian, Kazuhide Matsushima, Koji Matsuo
BACKGROUND: Gallstone disease in pregnancy is one of the most common indications for nonobstetrical surgery during pregnancy. National-level data on contemporary surgical practice and outcomes are limited. OBJECTIVE: This study aimed to assess the clinical characteristics and outcomes of patients undergoing cholecystectomy during pregnancy. STUDY DESIGN: This cross-sectional study examined the Healthcare Cost and Utilization Project's 2 nationwide databases in the United States: the National Inpatient Sample and the Nationwide Ambulatory Surgery Sample...
February 2024: AJOG global reports
https://read.qxmd.com/read/38249273/acute-gallstone-pancreatitis-in-pregnancy-a-multidisciplinary-approach
#5
Mark Ayoub, Muhammed Ceesay, Carol Faris, Michael Iannetti
A common cause of gastrointestinal-related hospitalizations in the United States of America is acute pancreatitis (AP), with an annual incidence of up to 80 cases per 100,000 people. The incidence of AP in pregnancy varies and is approximately 1 in 1000 to 1 in 10,000 births due to the prevalence of obesity and gallstone-related conditions. Deciding on the timing of surgical intervention in acute biliary pancreatitis during pregnancy remains challenging, and there are no consensus recommendations. Gallstone pancreatitis has a high recurrence rate of up to 50% during the first trimester...
December 2023: Curēus
https://read.qxmd.com/read/38186520/laparoscopic-cholecystectomy-in-pregnancy-a-seven-year-retrospective-study-from-an-australian-tertiary-center
#6
JOURNAL ARTICLE
Xinyi Nan, Erick Chan, Kok Sum Chloe Wong, Justin Ng, Sara Izwan, Michelle Cooper, Ramesh Damodaran
Background Cholecystectomy is the second most common non-obstetric indication for surgery during pregnancy; however, there is little recent literature specifically exploring perioperative care approaches, and a paucity of Australian data exists. This study investigates the incidence of laparoscopic cholecystectomy (LC) during pregnancy, peri-operative management, and post-operative outcomes in a single Australian tertiary center. Methods A retrospective analysis of LCs performed on pregnant patients between the ages of 16 and 50 years at a tertiary hospital between 2016 and 2023 was completed...
December 2023: Curēus
https://read.qxmd.com/read/38096854/gallbladder-stones-during-pregnancy-are-we-doing-the-right-thing-in-mexico
#7
JOURNAL ARTICLE
Gerardo Chávez-Saavedra, Elia Lara-Lona, Daniel Díaz-Martínez, Laura Villaseñor-López-Velarde, Angélica Espinosa-Hinojosa, Manuel Rivera-Sahagún
OBJECTIVE: To present the treatment of choice and approach in pregnant and postpartum women with a diagnosis of gallstones in Mexico and to compare it with the recommendations of international guidelines. METHOD: Observational, descriptive, and retrospective study based on information from the 2019 Dynamic Cubes database of pregnant women diagnosed with cholecystitis and/or cholelithiasis who had undergone cholecystectomy. RESULTS: During 2019, 937 patients with cholelithiasis and cholecystitis were registered, 516 (55%) pregnant and 421 (45%) in puerperium...
2023: Cirugia y Cirujanos
https://read.qxmd.com/read/37982683/new-onset-primary-adrenal-insufficiency-in-pregnancy-associated-with-a-unilateral-adrenal-infarction-a-case-report
#8
JOURNAL ARTICLE
Lakshmi Menon, Dinesh Edem, Jhansi Maradana, Pranjali Sharma, Shrikant Tamhane
SUMMARY: New-onset primary adrenal insufficiency is rare in pregnancy. The symptoms of adrenal insufficiency such as nausea, vomiting and dizziness may be attributed to the pregnancy itself, which can lead to a delay in the diagnosis. The presence of hypotension, hypoglycemia or hyperkalemia should raise the suspicion for adrenal insufficiency. We report the case of a 25-year-old woman who presented with tachycardia, left flank pain and vomiting at 36 weeks' gestation. She was found to have primary adrenal insufficiency and started on hydrocortisone and fludrocortisone with resolution of the vomiting and tachycardia...
October 1, 2023: Endocrinology, Diabetes & Metabolism Case Reports
https://read.qxmd.com/read/37966823/operative-vs-nonoperative-management-of-acute-cholecystitis-during-the-different-trimesters-of-pregnancy
#9
JOURNAL ARTICLE
Mariam N Hantouli, David J Droullard, Michael G Nash, Lyndsey S Benson, Andrew S Wright, David R Flum, Giana H Davidson
IMPORTANCE: Acute cholecystitis (AC) management during pregnancy requires balancing the risk of pregnancy loss or preterm delivery (adverse pregnancy outcomes [APOs]) with or without surgery. Guidelines recommend cholecystectomy across trimesters; however, trimester-specific evidence on the risks of AC and its management is lacking. OBJECTIVE: To assess cholecystectomy frequency in pregnant people with AC, compare the rates of APOs in pregnant people with or without AC, and compare the rates of APOs in people with AC who did or did not undergo cholecystectomy...
January 1, 2024: JAMA Surgery
https://read.qxmd.com/read/37950239/management-strategies-for-acute-cholecystitis-in-late-pregnancy-a-multicenter-retrospective-study
#10
MULTICENTER STUDY
Wei Zhang, Huiming Yi, Ming Cai, Jian Zhang
OBJECTIVE: This study aims to investigate the management strategies for acute cholecystitis in the third trimester of pregnancy by comparing the effectiveness of three different treatments. METHODS: Clinical data of 102 patients with acute cholecystitis in third trimester of pregnancy admitted to three Tertiary Hospitals from January 2010 to June 2020 were collected and divided into 3 groups according to the primary treatment during their first hospitalization: Group A (surgical group; n = 11), Group B (percutaneous transhepatic gallbladder drainage (PTGD) group, n = 29) and Group C (conservative treatment group, n = 62)...
November 10, 2023: BMC Surgery
https://read.qxmd.com/read/37915236/acute-cholecystitis-in-pregnant-women-a-therapeutic-challenge-in-a-developing-country-center
#11
JOURNAL ARTICLE
Mohamed Fares Mahjoubi, Anis Ben Dhaou, Mohamed Maatouk, Nada Essid, Bochra Rezgui, Yasser Karoui, Mounir Ben Moussa
BACKGROUNDS/AIMS: Acute cholecystitis is a rare condition in pregnant women, potentially affecting the maternal and fetal prognosis. Our aim was to report the main clinical and paraclinical features of acute cholecystitis during pregnancy and therapeutic modalities. METHODS: We conducted a case series analysis recording pregnant patients with acute cholecystitis admitted to our surgery department over a period of 11 years. We collected clinical data, paraclinical features, and management modalities related to cholecystitis...
November 2, 2023: Annals of Hepato-Biliary-Pancreatic Surgery
https://read.qxmd.com/read/37876566/non-obstetric-acute-abdomen-in-pregnancy-a-review-of-literature
#12
REVIEW
Humood A Alsadery, Omar A Bamalan, Hussain J Aljubran, Lama J Albaish, Basmah Z Al Ghanim
BACKGROUND: Acute abdomen in pregnancy (AAP) is defined as intensive abdominal pain lasting less than 24 hours that may require urgent surgery. It is a challenging situation to diagnose and manage, as it is associated with pain due to the normal anatomical and physiological changes that occur during pregnancy. OBJECTIVE: Therefore, understanding these changes and their effect on almost every system, will help us appreciate the upcoming causes of AAP, mainly the non-obstetric surgical emergencies (e...
2023: Medical Archives
https://read.qxmd.com/read/37868279/the-association-of-polish-surgeons-aps-clinical-guidelines-for-the-use-of-laparoscopy-in-the-management-of-abdominal-emergencies-part-ii
#13
JOURNAL ARTICLE
Jacek Sobocki, Michał Pędziwiatr, Justyna Bigda, Wacław Hołówko, Piotr Major, Kryspin Mitura, Piotr Myśliwiec, Małgorzata Nowosad, Aneta Obcowska-Hamerska, Michał Orłowski, Monika Proczko-Stepaniak, Jacek Szeliga, Grzegorz Wallner, Marek Zawadzki
INTRODUCTION: Over the past three decades, almost every type of abdominal surgery has been performed and refined using the laparoscopic technique. Surgeons are applying it for more procedures, which not so long ago were performed only in the classical way. The position of laparoscopic surgery is therefore well established, and in many operations it is currently the recommended and dominant method. AIM: The aim of the preparation of these guidelines was to concisely summarize the current knowledge on laparoscopy in acute abdominal diseases for the purposes of the continuous training of surgeons and to create a reference for opinions...
September 2023: Videosurgery and Other Miniinvasive Techniques
https://read.qxmd.com/read/37838464/general-surgery-during-pregnancy-and-gynecologic-emergencies
#14
REVIEW
Raymond Traweek, Vivy Phan, Chad Griesbach, Chad Hall
Nonobstetrical surgical emergencies can occur throughout pregnancy but are often difficult to diagnose due to the physiologic and anatomical changes that occur during pregnancy. Medical providers should have insight into these changes and be familiar with options for the diagnosis and management of common nonobstetrical surgical emergencies, such as appendicitis, cholecystitis, and small bowel obstruction. Surgeons should also be aware of obstetrical emergencies, such as ectopic pregnancy and severe vaginal bleeding, which may be life threatening to mother and the fetus...
December 2023: Surgical Clinics of North America
https://read.qxmd.com/read/37807993/safety-of-laparoscopic-cholecystectomy-for-cholecystitis-during-pregnancy
#15
JOURNAL ARTICLE
Ahmed Itaimi, Imed Abbassi, Oussama Baraket, Ahmed Kotti, Wissem Triki, Sami Bouchoucha
OBJECTIVES: The aim of this study is to evaluate the safety of laparoscopic cholecystectomy to treat acute cholecystitis during pregnancy. MATERIALS AND METHODS: We conducted a retrospective multicenter study including pregnant women with acute cholecystitis managed in surgery departments in Tunisia from January 1, 2015, to December 31, 2019. RESULTS: Seventeen centers of surgery department participated in this study including 107 cases of acute cholecystitis...
2023: Gynecology and Minimally Invasive Therapy
https://read.qxmd.com/read/37761267/sonographic-detection-of-fetal-cholelithiasis
#16
JOURNAL ARTICLE
Nicolae Gică, Andra Radoi, Corina Gică, Anca Maria Panaitescu, Gheorghe Peltecu, Iulia Huluță
Fetal biliary lithiasis is a benign condition characterized by the presence of gallstones in the gallbladder of a developing fetus. It is typically detected incidentally during a routine obstetric echography. The incidence of this condition varies from 0.03% to 2.3%. In most cases, fetal cholelithiasis resolves spontaneously and has an excellent prognosis. However, there are certain risk factors that may contribute to its development. Maternal factors that increase the risk of fetal cholelithiasis include placental abruption, elevated estrogen levels, narcotic use, diabetes, enteral nutrition, and specific medications, such as ceftriaxone, furosemide, and prostaglandin E2...
September 11, 2023: Diagnostics
https://read.qxmd.com/read/37691763/imaging-findings-of-fibroid-torsion-in-pregnancy-a-case-report
#17
Rebecca Joseph, Amanda Ferraro, Kevin Hoag, Samuel P Barasch, Landon Melchior, Edward Gillis, Thorsten Krebs
When our patient presented emergently to labor and delivery at 18 weeks pregnant with severe right abdominal pain, the common diagnoses (such as appendicitis, cholecystitis, etc.) were on the top of the differential. However, US and MRI revealed a rarer cause of her pain, a pedunculated fibroid. The most important question then became whether this fibroid had torsed, which would require surgical intervention to prevent life-threatening sequelae. Unfortunately, presurgical imaging diagnosis of fibroid torsion in pregnancy is difficult...
November 2023: Radiology Case Reports
https://read.qxmd.com/read/37680734/the-association-of-polish-surgeons-aps-clinical-guidelines-for-the-use-of-laparoscopy-in-the-management-of-abdominal-emergencies-part-i
#18
JOURNAL ARTICLE
Jacek Sobocki, Michał Pędziwiatr, Justyna Bigda, Wacław Hołówko, Piotr Major, Kryspin Mitura, Piotr Myśliwiec, Małgorzata Nowosad, Aneta Obcowska-Hamerska, Michał Orłowski, Monika Proczko-Stepaniak, Jacek Szeliga, Grzegorz Wallner, Marek Zawadzki, Tomasz Banasiewicz, Andrzej Budzyński, Adam Dziki, Michał Grąt, Marek Jackowski, Wojciech Kielan, Andrzej Matyja, Krzysztof Paśnik, Piotr Richter, Antoni Szczepanik, Mirosław Szura, Wiesław Tarnowski, Krzysztof Zieniewicz
INTRODUCTION: Over the past three decades, almost every type of abdominal surgery has been performed and refined using the laparoscopic technique. Surgeons are applying it for more procedures, which not so long ago were performed only in the classical way. The position of laparoscopic surgery is therefore well established, and in many operations it is currently the recommended and dominant method. AIM: The aim of the preparation of these guidelines was to concisely summarize the current knowledge on laparoscopy in acute abdominal diseases for the purposes of the continuous training of surgeons and to create a reference for opinions...
June 2023: Videosurgery and Other Miniinvasive Techniques
https://read.qxmd.com/read/37678869/retrospective-analysis-of-the-clinical-features-and-pregnancy-outcomes-in-124-pregnant-patients-with-non-obstetric-acute-abdomen
#19
JOURNAL ARTICLE
Jun Gao, Yawen Liu, Yanxin Zhang, Dan Lu
OBJECTIVE: To retrospectively analyze the clinical characteristics and pregnancy outcomes of patients with the non-obstetric acute abdomen (AAD) during pregnancy. METHODS: A total of 124 patients with non-obstetric AAD during pregnancy were selected, including acute gastroenteritis (n = 42), acute appendicitis (n = 24), pedicle torsion of ovarian tumor (n = 21), acute pancreatitis (n = 10), urinary stones (n = 8), acute cholecystitis (n = 5), ruptured ovarian cyst (n = 6), red degeneration of hysteromyoma (n = 4), pedicle torsion of subserosal hysteromyoma (n = 3) and intestinal obstruction (n = 1)...
November 2023: Alternative Therapies in Health and Medicine
https://read.qxmd.com/read/37330492/post-cesarean-section-laparoscopic-cholecystectomy-a-case-report
#20
JOURNAL ARTICLE
Sarah Magdy Abdelmohsen, Mohamed Mahmoud Zidan, Sherif Salah Eldeen Fahmy, Ahmed Saleh Baghdady
BACKGROUND: Laparoscopic cholecystectomy at the time of cesarean section is novel in medicine. It is safe, feasible, and cost-effective. CASE PRESENTATION: A 29-year-old G3P2 + 0 woman had two previous cesarean sections. She was pregnant at 32 weeks. The fetus had anencephaly. She had acute cholecystitis. Laparoscopic cholecystectomy done at the time of termination of pregnancy by cesarean section. CONCLUSIONS: In a critical period, such as acute cholecystitis, the combination of laparoscopic cholecystectomy immediately post cesarean section is effective if the surgeon is highly qualified and experienced...
June 17, 2023: BMC Pregnancy and Childbirth
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