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https://www.readbyqxmd.com/read/28547873/can-clinical-factors-predict-the-need-for-intervention-after-positive-intraoperative-cholangiogram
#1
Mohammed Kaif, Deepak Agrawal, Jayaprakash Sreenarasimhaiah
BACKGROUND/AIMS: Intraoperative cholangiogram (IOC) is commonly used to detect retained bile duct stones. This often leads to another invasive procedure such as endoscopic retrograde cholangiopancreatography (ERCP). However, due to the variation in methods and results of IOC, it is unclear if clinical factors will aid in identifying true choledocholithiasis. METHODS: All cholecystectomies in a 3 year period were examined retrospectively for positive IOC. Sonographic bile duct dilation and transaminase levels at admission including trends during the course of hospitalization and prior to ERCP were evaluated...
May 26, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28516111/transhiatal-herniation-of-the-pancreas-a-rare-cause-of-acute-pancreatitis
#2
Jeremy Wang, Adarsh M Thaker, Wael Noor El-Nachef, Rabindra R Watson
Transhiatal herniation of the pancreas is rare. Acute pancreatitis secondary to this phenomenon is particularly unusual. A 102-year-old woman presented with 1 day of severe chest pain, vomiting, dyspnea, and diaphoresis. Serum lipase was elevated, and computed tomography angiogram of the chest and magnetic resonance cholangiopancreatography revealed a hiatal hernia containing the pancreas, with associated findings of pancreatitis. Pancreatitis in this setting may be due to repetitive trauma or ischemia from sliding, intermittent folding of the pancreatic duct, or pancreatic incarceration...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28507753/yield-of-magnetic-resonance-cholangiopancreatography-for-the-investigation-of-bile-duct-dilatation-in-asymptomatic-patients
#3
Shlomit Tamir, Marius Braun, Assaf Issachar, Gil N Bachar, Ofer Benjaminov
BACKGROUND: Biliary dilatation in the asymptomatic patient is a frequent incidental finding in the work-up for which there are no current guidelines. OBJECTIVES: The purpose of this study was to determine the yield of magnetic resonance cholangiopancreatography (MRCP) in asymptomatic patients with an incidental finding of biliary duct dilatation. METHODS: The study included 68 consecutive patients for evaluation of biliary duct dilatation found incidentally on computed tomography (CT) or ultrasound (US)...
April 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28506431/usefulness-of-three-dimensional-magnetic-resonance-cholangiopancreatography-with-partial-maximum-intensity-projection-for-diagnosing-autoimmune-pancreatitis
#4
Shin Yanagisawa, Yasunari Fujinaga, Takayuki Watanabe, Masahiro Maruyama, Takashi Muraki, Masaaki Takahashi, Akira Fujita, Sachie Fujita, Masahiro Kurozumi, Kazuhiko Ueda, Hideaki Hamano, Shigeyuki Kawa, Masumi Kadoya
PURPOSE: To compare three-dimensional magnetic resonance cholangiopancreatography (MRCP) with/without partial maximum intensity projection (MIP) and endoscopic retrograde cholangiopancreatography (ERCP) in patients with autoimmune pancreatitis (AIP). MATERIALS AND METHODS: Three-dimensional MRCP and ERCP images were retrospectively analyzed in 24 patients with AIP. We evaluated the narrowing length of the main pancreatic duct (NR-MPD), multiple skipped MPD narrowing (SK-MPD), and side branches arising from the narrowed portion of the MPD (SB-MPD) using four MRCP datasets: 5 original images (MIP5), 10 original images (MIP10), all original images (full-MIP), and a combination of these three datasets (a-MIP)...
May 5, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28503554/multimodality-imaging-of-intrahepatic-cholangiocarcinoma
#5
REVIEW
Kelly Fábrega-Foster, Mounes Aliyari Ghasabeh, Timothy M Pawlik, Ihab R Kamel
Intrahepatic cholangiocarcinomas account for approximately 20% of cases of cholangiocarcinomas. Three growth patterns or morphologic subtypes exist, including mass-forming, periductal-infiltrating, and intraductal-growth subtypes. Knowledge of these morphologic subtypes and their radiologic appearance aids in timely diagnosis, a key to optimizing patient outcomes. The morphologic variability of intrahepatic cholangiocarcinomas has a direct impact on the diagnostic sensitivity and specificity of various diagnostic imaging modalities, including ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP), and positron emission tomography (PET)...
April 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/28474177/evaluation-of-biliary-ductal-anatomy-in-potential-living-liver-donors-comparison-between-mrcp-and-gd-eob-dtpa-enhanced-mri
#6
D Santosh, A Goel, I W Birchall, A Kumar, K H Lee, V H Patel, G Low
PURPOSE: To compare magnetic resonance cholangiopancreatography (MRCP) and Gd-EOB-DTPA-enhanced MRI in the evaluation of the biliary anatomy in potential living liver donors (LLDs). METHODS: A retrospective study was conducted in a tertiary care liver transplant center after obtaining ethics and institutional approvals. A total of 42 potential LLD MRI examinations were performed between November 2013 and March 2016. All patients underwent a standard MRI protocol which included MRCP and Gd-EOB-DTPA-enhanced MRI sequences in a single session...
May 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28462653/management-of-ampullary-tumours-in-children-still-a-challenge
#7
P Fernandez-Eire, J L Vazquez Castelo, M Herreros Villaraviz, B Fernandez Caamaño, J Gonzalez-Carreró, F Ausania
This study describes the case of the youngest patient ever reported with ampullary adenoma. The incidence of ampullary adenomas in childhood is unknown. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound are used in adults to assess and treat these lesions, although there are no instruments designed specifically for use in young children. A six-year-old girl was admitted for abdominal pain, vomiting, pruritus and weight loss. Abdominal ultrasound showed biliary tree (8mm) and pancreatic duct dilatation (4mm)...
May 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28458308/inflammatory-bile-duct-obstruction-during-the-healing-stage-of-severe-acute-pancreatitis
#8
Akane Yamabe, Atsushi Irisawa, Goro Shibukawa, Ai Sato, Mariko Fujisawa, Noriyuki Arakawa, Yoshitsugu Yoshida, Ryo Igarashi, Takumi Maki, Shogo Yamamoto, Tsunehiko Ikeda, Yoko Abe, Koki Hoshi
The patient was a 62-year-old woman with a history of severe acute pancreatitis complicated by walled-off necrosis (WON), who developed obstructive jaundice during the recovery phase from WON. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) revealed the complete obstruction of the distal bile duct, and endoscopic ultrasonography (EUS) revealed thickening of the duct wall, with a uniform distribution, and a relatively well-preserved layered structure...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28450694/diagnostic-approach-in-biliary-strictures-after-pediatric-liver-transplantation
#9
Dorota Jarzębicka, Piotr Czubkowski, Anna Kamińska, Małgorzata Markiewicz-Kijewska, Katarzyna Nowak, Dorota Broniszczak, Maciej Dądalski, Irena Jankowska, Joanna Pawłowska
BACKGROUND The diagnosis of post-liver transplant biliary strictures (BS) requires a high degree of clinical suspicion because of the diversity of symptoms and usually mild clinical presentation. If quickly treated, successful outcome is achieved most cases. The aim of our study was to analyze the value of diagnostic methods in BS after pediatric LTx. MATERIAL AND METHODS We retrospectively reviewed clinical data of children with BS after liver transplantation, with the main focus on diagnostic methods, including imaging studies and histology...
April 28, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28449428/a-rare-case-of-pancreas-divisum-accompanied-by-acute-pancreatitis-following-endoscopic-hemostasis-for-duodenal-ulcer-bleeding
#10
Yong Hyeok Choi, Soon Man Yoon, Eun Bee Kim, Youngmin Oh, Keunmo Kim, Jisun Lee, Seon Mee Park, Sei Jin Youn
Peptic ulcer bleeding is treated using endoscopic hemostasis using clips or bands. Pancreas divisum (PD), a congenital anomaly of the pancreas, usually has no clinical symptoms; however, pancreatitis may occur if there are disturbances in the drainage of pancreatic secretions. We report an unusual case of PD accompanied by acute pancreatitis, following endoscopic band ligation for duodenal ulcer bleeding. A 48-year-old woman was admitted to our hospital due to melena. An upper endoscopy revealed a small ulcer with oozing adjacent minor papilla...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28448309/clinical-feasibility-of-3-dimensional-magnetic-resonance-cholangiopancreatography-using-compressed-sensing-comparison-of-image-quality-and-diagnostic-performance
#11
Jeong Hee Yoon, Sang Min Lee, Hyo-Jin Kang, Elisabeth Weiland, Esther Raithel, Yohan Son, Berthold Kiefer, Jeong Min Lee
OBJECTIVE: The aim of this study was to evaluate the clinical feasibility of fast 3-dimensional (3D) magnetic resonance cholangiopancreatography (MRCP) using compressed sensing (CS) in comparison with conventional navigator-triggered 3D-MRCP. MATERIALS AND METHODS: This retrospective study was approved by our institutional review board, and the requirement of informed consent was waived. A total of 84 patients (male-to-female ratio, 41:43; mean age, 47.3 ± 18.8 years) who underwent conventional 3D navigator-triggered T2-weighted MRCP using sampling perfection with application optimized contrasts (SPACE) and fast 3D MRCP using SPACE with high undersampling combined with CS reconstruction (CS SPACE; CS-MRCP) on a 3 T scanner were included...
April 26, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28414680/a-rare-cause-of-abdominal-pain
#12
E M Dauchy, M Modica, N Masri
CASE: A 54 year old woman with hypothyroidism presented with right flank pain that began acutely one week prior to presentation. She was told initially she had a urinary tract infection and treatment resulted in mild symptomatic improvement. The pain returned and she presented to another Emergency Department (ED); and was told the pain was due to constipation. She returned to the ED the next day when her pain worsened and her labs were notable for WBC of 19,000/uL, BUN/Cr of 28/0.75 mg/dL, AST of 31 U/L, ALT of 92 U/L and total bilirubin of 0...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28411347/pure-3d-laparoscopic-living-donor-right-hemihepatectomy-in-a-donor-with-separate-right-posterior-and-right-anterior-hepatic-ducts-and-portal-veins
#13
Suk Kyun Hong, Kyung-Suk Suh, Hyo-Sin Kim, Kyung Chul Yoon, Sung-Woo Ahn, Dongkyu Oh, Hyeyoung Kim, Nam-Joon Yi, Kwang-Woong Lee
BACKGROUND: Despite increases in the performance of pure laparoscopic living donor hepatectomy, variations in the bile duct or portal vein have been regarded as relative contraindications to this technique [1-3]. This report describes a donor with separate right posterior and right anterior hepatic ducts and portal veins who underwent pure laparoscopic living donor right hemihepatectomy, integrated with 3D laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography [1, 4, 5]...
April 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28409358/added-value-of-gadoxetic-acid-enhanced-t1-weighted-magnetic-resonance-cholangiography-for-the-diagnosis-of-post-transplant-biliary-complications
#14
Sonja Kinner, Tilman B Schubert, Adnan Said, Joshua D Mezrich, Scott B Reeder
OBJECTIVES: Biliary complications after liver transplantation (LT) are common. This study aimed to ascertain the value of gadoxetic acid-enhanced T1-weighted (T1w) magnetic resonance cholangiography (MRC) to evaluate anastomotic strictures (AS), non-anastomotic strictures (NAS) and biliary casts (BC). METHODS: Sixty liver-transplanted patients with suspicion of biliary complications and T2w-MRCP and T1w-MRC followed by endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) were analysed...
April 13, 2017: European Radiology
https://www.readbyqxmd.com/read/28397681/-isolated-gallbladder-agenesis-without-biliary-atresia-in-a-16-year-old-boy
#15
Bojan Kovacevic, Laura Sophie Mössinger, Thomas Boel
We present a case of a 16-year-old male patient with recurrent abdominal pain in the upper right quadrant, signed up for elective laparoscopic cholecystectomy due to a single gallstone seen on preoperative abdominal ultrasound. Because of dilatation of the common bile duct subsequent magnetic resonance cholangiopancreatography was performed, and surprisingly, the gallbladder was found missing. The operation was therefore cancelled. Even though gallbladder agenesis is a rare condition, it still represents a diagnostic challenge as most cases are found peroperatively, and the patients undergo unnecessary surgery...
February 6, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28396555/heterotopic-pancreatic-tissue-associated-with-type-1-choledochal-cyst-cystolithiasis-and-gall-bladder-stones-a-rare-entity-with-review-of-literature
#16
Aditi Arora, Pradyumn Singh, Nidhi Anand, Nuzhat Husain
Choledochal cyst is a rare congenital malformation, particularly when associated with stones in cyst (cystolithiasis), gallstones and heterotopic pancreatic tissue within the cyst wall. The current case represents a 5-year-old boy with abdominal pain, pale colored stools, and jaundice. Magnetic resonance cholangiopancreatography showed a cystic lesion, arising from common bile duct with cystolithiasis and cholelithiasis. He underwent excision of choledochal cyst and gallbladder with Roux-en-Y hepaticojejunostomy...
April 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28385584/a-study-of-the-clinical-utility-of-a-20-minute-secretin-stimulated-endoscopic-pancreas-function-test-and-performance-according-to-clinical-variables
#17
Luis F Lara, Morihito Takita, James S Burdick, Daniel C DeMarco, Ronnie R Pimentel, Tolga Erim, Marlon F Levy
BACKGROUND AND AIMS: Direct pancreas juice testing of bicarbonate, lipase, or trypsin after stimulation by secretin or cholecystokinin is used to determine exocrine function, a surrogate for diagnosing chronic pancreatitis (CP). Endoscopic pancreas function tests (ePFTs), where a peak bicarbonate concentration (PBC) ≥80 mEq/L in pancreas juice is considered normal, are now used more frequently. In this ePFT, aspirates start 35 minutes after secretin administration because pancreas output peaks 30 minutes after secretagogue administration...
April 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28376418/a-case-report-of-bloody-pancreatitis
#18
Lemuel Pran, Reena Moonsie, James Byam, Shivraj BahadurSingh, Gurubasavaiah Manjunath, Marlon Seenath, Shanta Baijoo
INTRODUCTION: Haemobilia is an uncommon entity even though its frequency has increased with hepato-biliary instrumentation and procedures. It can be associated with obstructive jaundice and pancreatitis (Green et al., 2001) [1]. Haemobilia following cholecystectomy has frequently been reported in association with hepatic artery pseudo-aneurysm (Curet et al., 1981; Ribeiro et al., 1998) [2,3]. The authors wish to report a case of haemobilia due to a porto-biliary fistula presenting as acute pancreatitis...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28367391/igg4-related-disease-presenting-as-a-pancreatic-mass-and-bilateral-lacrimal-gland-swelling
#19
Uroosa Ibrahim, Amina Saqib, Nikhil Nalluri, Muhammad R Raza, Mark Goldstein
IgG4-related disease is characterized by multi-system inflammation and possible elevation in serum immunoglobulin-G4 level. Treatment regimens include glucocorticoids, disease-modifying anti-rheumatic agents and recently, rituximab infusions have been reported to be effective in treatment-refractory disease. We present a case of a 64-year-old male presenting with acute abdominal pain and scleral icterus. An abdominal ultrasound demonstrated extensive biliary ductal dilatation. A computed tomography (CT) scan and a magnetic resonance cholangiopancreatography (MRCP) revealed a 4...
February 24, 2017: Curēus
https://www.readbyqxmd.com/read/28365715/gall-bladder-agenesis-a-rare-embryonic-cause-of-recurrent-biliary-colic
#20
Aarthi Rajkumar, Albina Piya
BACKGROUND Gallbladder agenesis (GA) is an extremely rare anatomic anomaly with a reported incidence of less than 0.5%. It is usually asymptomatic, but can present with features of biliary colic and cholecystitis. We present here a case of GA in a patient with recurrent biliary colic.  CASE REPORT A 24-year-old African American woman presented with recurrent episodes of right upper-quadrant abdominal pain. During her first episode, she was found to have elevated transaminases and clinical features of cholecystitis, but ultrasound did not visualize a gallbladder and she was discharged with a diagnosis of biliary colic...
April 2, 2017: American Journal of Case Reports
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