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https://www.readbyqxmd.com/read/28414680/a-rare-cause-of-abdominal-pain
#1
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
#2
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
#3
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
#4
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
#5
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
#6
Luis F Lara, Morihito Takita, James S Burdick, Daniel C DeMarco, Ronnie R Pimentel, Tolga Erim, Marlon F Levy
BACKGROUND & AIMS: Direct pancreas juice testing of bicarbonate, lipase, or trypsin after stimulation by secretin or cholecystokinin (CCK) is used to determine exocrine function, a surrogate for diagnosing chronic pancreatitis (CP). Endoscopic pancreas function tests (ePFT) 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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28364277/pediatric-choledochal-cysts-diagnosis-and-current-management
#10
REVIEW
Kevin C Soares, Seth D Goldstein, Mounes A Ghaseb, Ihab Kamel, David J Hackam, Timothy M Pawlik
Choledochal cysts are rare congenital disorders first described by Vater and Ezler in 1723. Their exact etiology remains incompletely understood; however, an anomalous pancreaticobiliary union (APBDU) and subsequent reflux of biliary contents into the biliary tree are thought to play a role. Accordingly, APBDU-associated choledochal cyst patients are significantly more likely to have evidence of hepatitis, cholangitis or pancreatitis and pathologically confirmed inflammation. In 1977, Todani and colleagues modified the original Alonso-Lej classification to include five types of CC...
March 31, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28360977/endoscopic-retrograde-cholangiopancretography-in-modified-double-tracks-anastomosis-with-anastomotic-stenosis
#11
Xiao-Song Wang, Fei Wang, Quan-Peng Li, Lin Miao, Xiu-Hua Zhang
A 63-year-old man presented at our hospital with right upper abdomen pain and fever for 4 d. The patient's magnetic resonance cholangiopancreatography revealed dilated common bile duct and choledocholithiasis. In his past history, he received proximal gastrectomy and modified double tracks anastomosis. Endoscopic retrograde cholangiopancretography in modified double tracks anastomosis, especially accompanied with anastomotic stenosis, has been rarely reported. In the present case, the duodenoscope was successfully introduced over the guidewire and the stone taken out using a basket...
March 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28353569/case-report-and-systematic-literature-review-of-a-novel-etiology-of-sinistral-portal-hypertension-presenting-with-ugi-bleeding-left-gastric-artery-pseudoaneurysm-compressing-the-splenic-vein-treated-by-embolization-of-the-pseudoaneurysm
#12
REVIEW
Seifeldin Hakim, Jared Bortman, Molly Orosey, Mitchell S Cappell
INTRODUCTION: A novel case is reported of upper gastrointestinal (UGI) bleeding from sinistral portal hypertension, caused by a left gastric artery (LGA) pseudoaneurysm (PA) compressing the splenic vein (SV) that was successfully treated with PA embolization. CASE REPORT: A 41-year-old man with previous medical history of recurrent, alcoholic pancreatitis presented with several episodes of hematemesis and abdominal pain for 48 hours. Physical examination revealed a soft abdomen, with no abdominal bruit, no pulsatile abdominal mass, and no stigmata of chronic liver disease...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28348938/giardia-filled-pancreatic-mass-in-a-patient-with-recently-treated-t-cell-rich-b-cell-lymphoma
#13
Raj Shah, Talal Asif, Richard Johnson
Giardia lamblia (G. lamblia)-filled pancreatic masses are a rarely reported entity. Furthermore, there are only a few case reports in literature on the association of these masses with cancer. We present a case of a G. lamblia-filled pancreatic cystic mass in a patient with a history of T-cell-rich B-cell lymphoma. The authors performed a PubMed search using (Medical Subject Headings) MeSH terms of pancreas, mass, Giardia, and lymphoma.  A 53-year-old male with past medical and surgical history of T-cell-rich B-cell lymphoma, status post R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab) therapy with positron emission tomography (PET) scan showing no residual disease, essential hypertension, and alcohol use disorder presented to the emergency department (ED) with epigastric pain and nausea for one week...
February 9, 2017: Curēus
https://www.readbyqxmd.com/read/28348578/contrast-enhanced-magnetic-resonance-cholangiography-practical-tips-and-clinical-indications-for-biliary-disease-management
#14
REVIEW
Stefano Palmucci, Federica Roccasalva, Marina Piccoli, Giovanni Fuccio Sanzà, Pietro Valerio Foti, Alfonso Ragozzino, Pietro Milone, Giovanni Carlo Ettorre
Since its introduction, MRCP has been improved over the years due to the introduction of several technical advances and innovations. It consists of a noninvasive method for biliary tree representation, based on heavily T2-weighted images. Conventionally, its protocol includes two-dimensional single-shot fast spin-echo images, acquired with thin sections or with multiple thick slabs. In recent years, three-dimensional T2-weighted fast-recovery fast spin-echo images have been added to the conventional protocol, increasing the possibility of biliary anatomy demonstration and leading to a significant benefit over conventional 2D imaging...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28344685/focal-biliary-system-obstruction-and-atypical-liver-mass-intrabiliary-ruptured-cyst-hydatid-case-report
#15
Esra Ummuhan Mermi, Nurdan Fidan, Muammer Murat
BACKGROUND: Hydatid disease can involve any part of the body, but the liver is the most frequently affected organ. Intrabiliary rupture is one of the most serious complications of a hepatic hydatid cyst. Radiological findings, especially magnetic resonance imaging and magnetic resonance cholangiopancreatography (MRI/MRCP), are helpful in the diagnosis of hydatid disease. CASE REPORT: We present a 48-year-old female patient with complaints of abdominal pain and jaundice...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28337383/pancreatic-cancer-screening-in-different-risk-individuals-with-family-history-of-pancreatic-cancer-a-prospective-cohort-study-in-taiwan
#16
Ming-Chu Chang, Chih-Horng Wu, Shih-Hung Yang, Po-Chin Liang, Bang-Bin Chen, I-Shiow Jan, Yu-Ting Chang, Yung-Ming Jeng
Pancreatic cancer (PC) is usually diagnosed at advanced stage. Our aim was to investigate the risk of malignant and premalignant pancreatic lesions in individuals with family history of PC. Individuals at risk of PC were enrolled prospectively in a screening program in Taiwan. All risk individuals received genetic testing of cationic trypsinogen (PRSS1) gene and the serine protease inhibitor Kazal type 1 (SPINK1) gene. They were stratified into three risk groups (high, moderate, and low) based on the family history and genetic testing...
2017: American Journal of Cancer Research
https://www.readbyqxmd.com/read/28324003/biliary-anomalies-in-patients-with-hnf1b-diabetes
#17
Jarno Lt Kettunen, Helka Parviainen, Päivi J Miettinen, Martti Färkkilä, Marjo Tamminen, Pia Salonen, Eila Lantto, Tiinamaija Tuomi
Context: The clinical spectrum of organogenetic anomalies associated with HNF1B mutations is heterogeneous. Besides cystic kidney disease, diabetes, and various other manifestations, odd cases of mainly neonatal and post-transplant cholestasis have been described. The biliary phenotype is incompletely defined. Objective: To systematically characterize HNF1B-related anomalies in the bile ducts by imaging with MRI or MRCP. Setting and Patients: Fourteen patients with HNF1B mutations in the catchment area of the Helsinki University hospital were evaluated with upper abdominal MRI and MRCP...
March 17, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28321346/a-perplexing-case-of-abdominal-pain-that-led-to-the-diagnosis-of-zollinger-ellison-syndrome
#18
Adrienne Lenhart, Mona Hassan, Alireza Meighani, Omar Sadiq, Yousuf Siddiqui
Zollinger-Ellison syndrome (ZES) is a rare clinical disorder, characterized by hypersecretion of gastric acid and multiple ulcers distal to the duodenal bulb. This occurs via the release of gastrin by neuroendocrine tumors known as gastrinomas. Patients with ZES present with nonspecific GI symptoms, which often leads to a delay in diagnosis. Our patient is a 55-year-old female with chronic abdominal pain, nausea, and diarrhea. She underwent EGD, EUS, MRCP, CT scans, and cholecystectomy, which did not reveal the cause of her symptoms...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28320629/is-acute-recurrent-pancreatitis-in-children-a-precursor-of-chronic-pancreatitis-a-long-term-follow-up-study-of-93-cases
#19
Ujjal Poddar, Surender K Yachha, Vibhor Borkar, Anshu Srivastava
BACKGROUND/AIMS: In view of paucity of literature we analyzed our experience of acute recurrent pancreatitis (ARP) to study clinical profile and long-term outcome. METHODS: Over 13 years, 93 consecutive children (≤18 years) diagnosed to have ARP were included in this study. Magnetic resonance cholangiopancreatography was done at baseline and on follow-up. Common mutations for serine-protease-inhibitor (SPINK1 N34S), protease inhibitor (PRSS1 R122S) and cystic fibrosis transmembrane conductance regulator (CFTR deltaF508, 5T) were studied in 22 idiopathic cases...
March 6, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28315036/diagnosing-chronic-pancreatitis
#20
REVIEW
Ahmad Anaizi, Phil A Hart, Darwin L Conwell
Diagnosing CP can range from routine in those with severe disease and obvious calcifications on CT imaging to elusive in those patients with early changes in CP. The workup of suspected CP should follow a progressively noninvasive to more invasive STEP-wise approach in a patient with a suspicious clinical presentation and risk factors that raise their pretest probability of disease. After a thorough history and physical examination, basic laboratories should be obtained such as lipase, amylase, metabolic panel, and indirect PFTs (fecal elastase-1, serum trypsin)...
March 17, 2017: Digestive Diseases and Sciences
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