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https://www.readbyqxmd.com/read/28290970/severe-systemic-lead-toxicity-resulting-from-extra-articular-retained-shrapnel-presenting-as-jaundice-and-hepatitis-a-case-report-and-review-of-the-literature
#1
Ian A Grasso, Matthew R Blattner, Tyler Short, John W Downs
INTRODUCTION: Despite greater than 60,000 nonfatal firearm injuries per year in the United States, retained shrapnel is a relatively rare cause of systemic lead toxicity with less than 100 cases reported in the medical literature since 1867. While intra-articular retained shrapnel as a cause of lead toxicity is well-described, extra-articular fragments are less well known to cause symptomatic disease. CASE REPORT: A 31-year-old man initially presented with abdominal pain, constipation, jaundice, and elevated liver transaminases approximately 3 weeks after suffering a left lower extremity injury during athletic activity...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28273606/an-impressive-choledochal-cyst-and-its-surgical-resection
#2
Nhu Thao Nguyen Galván, Kayla Kumm, Dor Yoeli, Ellen Witte, Michael Kueht, Ronald Timothy Cotton, Abbas Rana, Christine A O'Mahony, John A Goss
INTRODUCTION: Choledochal cysts are rare congenital dilations of the biliary tree that can present with non-specific symptoms such as abdominal pain, jaundice, cholelithiasis and pancreatitis. Although most commonly identified in children, they can be found in the adult population. However, because of the non-specific symptoms, this diagnosis may be difficult to make in the adult. A physician therefore must keep this diagnosis within their differential, as it may arise in an unexpected patient population who may present with a convoluted work up...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28246490/cystic-adrenal-lesions-focus-on-pediatric-population-a-review
#3
REVIEW
Mara Carsote, Adina Ghemigian, Dana Terzea, Ancuta Augustina Gheorghisan-Galateanu, Ana Valea
BACKGROUND AND AIM: The cysts may potentially affect any organ; adrenals cysts are rare. This is a review of the literature regarding adrenal cysts, focusing on children and young adults. GENERAL DATA: Three major types have been described: pure cysts (endothelial, epithelial, and hemorrhagic or pseudocyst), parasitic (as hydatid) cysts and cystic part of a tumour (most frequent are neuroblastoma, ganglioneuroma, pheocromocytoma, and teratoma). The complications are: bleeding, local pressure effects; infection; rupture (including post-traumatic); arterial hypertension due to renal vessels compression...
2017: Clujul Medical (1957)
https://www.readbyqxmd.com/read/28240461/outcomes-in-laparoscopic-cholecystectomy-in-a-resource-constrained-environment
#4
S Z Mbatha, F Anderson
BACKGROUND: Laparoscopic cholecystectomy (LC) is a common surgical procedure performed for symptomatic gallstones. There is a trend towards early cholecystectomy for patients with acute cholecystitis who present timeously. Local inflammation has been identified as a risk factor for bile duct injuries. This study sought to assess the outcomes of LC in patients managed within a resource constrained environment where late presentation is common. METHOD: We performed a retrospective analysis of laparoscopic cholecystectomy performed from January 2010 to June 2011...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28238541/igg4-related-sclerosing-cholangitis-overlapping-with-autoimmune-hepatitis-report-of-a-case
#5
Hongyan Li, Li Sun, David R Brigstock, Lina Qi, Runping Gao
BACKGROUND: IgG4-related sclerosing cholangitis (IgG4-SC) is the biliary manifestation of IgG4-related disease (IgG4-RD) but the presence of IgG4-SC in the porta hepatis is difficult to differentiate from hilar cholangiocarcinoma (HCCA). IgG4-related autoimmune hepatitis (IgG4-related AIH) is extremely rare and it is not fully clear whether IgG4-related AIH is a hepatic manifestation of IgG4-RD or a subtype of AIH. CASE PRESENTATION: We present a rare case of a 52-year-old male who was admitted with obstructive jaundice and itchy skin...
February 10, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28238521/solid-pseudopapillary-neoplasm-of-the-pancreas-management-and-long-term-outcome
#6
N Lubezky, M Papoulas, Y Lessing, G Gitstein, E Brazowski, I Nachmany, G Lahat, Y Goykhman, A Ben-Yehuda, R Nakache, J M Klausner
BACKGROUND: Solid pseudopapillary neoplasm (SPN) of pancreas is a rare pancreatic neoplasm with a low metastatic potential. Our aim was to study the clinical-pathological characteristics, and long-term outcome of this tumor. MATERIALS: Rretrospective single center study of patients operated for SPN of pancreas. Clinical and pathological data were collected. RESULTS: From 1995 to 2016, 1320 patients underwent pancreatic resection. SPN was confirmed in 32 cases (2...
February 10, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28213744/intraductal-papillary-neoplasm-originating-from-an-anomalous-bile-duct
#7
Harufumi Maki, Taku Aoki, Takeaki Ishizawa, Mariko Tanaka, Takashi Sakatani, Yoshifumi Beck, Kiyoshi Hasegawa, Yoshihiro Sakamoto, Norihiro Kokudo
An 82-year-old woman who had been suffering from repeated obstructive jaundice for 7 years was referred to our hospital. Although endoscopic aspiration of the mucin in the common bile duct had been temporally effective, origin of the mucin production had not been detectable. The patient thus had been forced to be on long-term follow-up without curative resection. Endoscopic retrograde cholangioscopy on admission revealed massive mucin in the common bile duct. In addition, an anomalous bile duct located proximal to the gallbladder was identified...
April 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28205125/does-hyperbilirubinemia-contribute-to-adverse-patient-outcomes-following-pancreatoduodenectomy
#8
Scott Dolejs, Ben L Zarzaur, Nicholas J Zyromski, Henry A Pitt, Taylor S Riall, Bruce L Hall, Stephen W Behrman
BACKGROUND: Jaundice due to biliary obstruction leads to multiple physiologic derangements and a decline in performance status that may result in unfavorable intra- and postoperative outcomes following a Whipple procedure. While preoperative biliary decompression may improve synthetic function, this strategy has been reported to increase the incidence of infectious complications following surgery. We hypothesized that hyperbilirubinemia at the time of pancreatoduodenectomy (PD) would be a risk factor for increased morbidity and mortality postoperatively...
April 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28203125/migration-of-surgical-clips-into-the-common-bile-duct-after-laparoscopic-cholecystectomy
#9
Krishn Kant Rawal
Laparoscopic cholecystectomy (LC) is currently the treatment of choice for symptomatic gallstones. Associated complications include bile duct injury, retained common bile duct (CBD) stones, and migration of surgical clips. Clip migration into the CBD can present with recurrent cholangitis over a period of time. Retained CBD stones can be another cause of recurrent cholangitis. A case of two surgical clips migrating into the common bile duct with few retained stones following LC is reported here. The patient had repeated episodes of fever, pain at epigastrium, jaundice, and pruritus 3 months after LC...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28196024/clinical-and-morphological-features-of-paraduodenal-pancreatitis-an-italian-experience-with-120-patients
#10
Nicolò de Pretis, Fabiana Capuano, Antonio Amodio, Mattia Pellicciari, Luca Casetti, Riccardo Manfredi, Giuseppe Zamboni, Paola Capelli, Riccardo Negrelli, Pietro Campagnola, Arnaldo Fuini, Armando Gabbrielli, Claudio Bassi, Luca Frulloni
OBJECTIVES: This study aimed to evaluate the clinical and radiological features and clinical outcomes of paraduodenal pancreatitis (PP). METHODS: A final diagnosis of PP was based on surgical specimens in resected patients and on imaging in nonoperated patients. Clinical, radiological, and pathological data were collected and reevaluated. RESULTS: We studied 120 patients, 97.5% of whom were drinkers and 97.5% were smokers. Symptoms at clinical onset were acute pancreatitis in 78 patients (65%) and continuous pain in 68 patients (55...
April 2017: Pancreas
https://www.readbyqxmd.com/read/28194287/acute-acalculous-cholecystitis-a-rare-presentation-of-primary-epstein-barr-virus-infection-in-adults-case-report-and-review-of-the-literature
#11
Zuhal Yesilbag, Asli Karadeniz, Fatih Oner Kaya
Primary Epstein-Barr virus (EBV) infection is almost always a self-limited disease characterized by sore throat, fever, and lymphadenopathy. Hepatic involvement is usually characterized by mild elevations of aminotransferases and resolves spontaneously. Although isolated gallbladder wall thickness has been reported in these patients, acute acalculous cholecystitis is an atypical presentation of primary EBV infection. We presented a young women admitted with a 10-day history of fever, nausea, malaise who had jaundice and right upper quadrant tenderness on the physical examination...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28179982/spontaneous-biloma-due-to-an-intrahepatic-cholangiocarcinoma-an-extremely-rare-case-report-with-long-term-survival-and-literature-review
#12
Georgios K Georgiou, Athina Tsili, Anna Batistatou, Alexandra Papoudou-Bai, Georgios Papadopoulos, Michalis Fatouros, Georgios K Glantzounis
Cholangiocarcinomas are tumors that arise from the ductal epithelium of the intrahepatic or extra-hepatic bile ducts. Patients are usually asymptomatic or may present with weight loss, fatigue, loss of appetite and abdominal pain (intrahepatic cholangiocarcinomas) or jaundice (extra-hepatic cholangiocarcinomas). Subcapsular bile vessel rupture, due to intrahepatic cholangiocarcinoma, is an extremely rare clinical presentation, which is an emergent and potentially life-threatening complication. We report the case of a 79-year-old female patient suffering from an intrahepatic cholangiocarcinoma that completely obliterated the left main hepatic duct...
February 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28133338/-a-case-of-axillary-lymph-node-metastases-from-distal-bile-duct-cancer
#13
Makoto Muto, Takashi Kimura, Naoya Sato, Junichiro Watanabe, Kotaro Endo, Shigeru Marubashi, Akira Kenjo, Mitsukazu Gotoh
A 67-year-old man suffered from obstructive jaundice due to distal bile duct cancer. He underwent surgery after percutaneous biliary drainage and did not received adjuvant chemotherapy afterwards. Two years after surgery, some subcutaneous nodules were detected in the left axilla and the lateral chest on enhanced CT imaging. The nodules were diagnosed as metachronous distant metastases from bile duct cancer based on pathological findings. He was treated postoperatively with S-1 and new lesions have not been detected during the 3 months after the surgery...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28119271/cystobiliary-communication-in-hepatic-hydatid-cyst-predictors-and-outcome
#14
Ayman El Nakeeb, Ali Salem, Mohamed El Sorogy, Youssef Mahdy, Mohamed Abd Ellatif, Ahmed Moneer, Rami Said, Ahmed El Ghawalby, Helmy Ezzat
BACKGROUND/AIMS: Cystobiliary communication (CBF) with hepatic hydatid disease is responsible for postoperative bile leakage after surgical management. This study aims to detect various predictors of CBF and its outcome after surgical management. MATERIALS AND METHODS: This is a retrospective, cohort study of all patients who underwent surgical management for hydatid disease of the liver. Patient data were recorded on an internal web-based registry system supplemented by paper records...
January 25, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28090475/use-of-omega-3-polyunsaturated-fatty-acids-to-treat-inspissated-bile-syndrome-a-case-report
#15
Woo Young Jun, Min Jeng Cho, Hye Seung Han, Sun Hwan Bae
Inspissated bile syndrome (IBS) is a rare condition in which thick intraluminal bile, including bile plugs, sludge, or stones, blocks the extrahepatic bile ducts in an infant. A 5-week-old female infant was admitted for evaluation of jaundice and acholic stool. Diagnostic tests, including ultrasound sonography, magnetic resonance cholangiopancreatography, and a hepatobiliary scan, were not conclusive. Although the diagnosis was unclear, the clinical and laboratory findings improved gradually on administration of urodeoxycholic acid and lipid emulsion containing omega-3 polyunsaturated fatty acids (PUFAs) for 3 weeks...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28088598/are-the-current-guidelines-for-the-surgical-management-of-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-adequate-a-multi-institutional-study
#16
Gregory C Wilson, Shishir K Maithel, David Bentrem, Daniel E Abbott, Sharon Weber, Clifford Cho, Robert C G Martin, Charles R Scoggins, Hong Jin Kim, Nipun B Merchant, David A Kooby, Michael J Edwards, Syed A Ahmad
BACKGROUND: Controversy persists regarding the management of patients with intraductal papillary mucinous neoplasms (IPMN). International consensus guidelines stratify patients into high-risk, worrisome, and low risk categories. STUDY DESIGN: The medical records of 7 institutions were reviewed for patients who underwent surgical management of IPMN between 2000 and 2015. RESULTS: There were 324 patients included in the analysis; 60.4% of patients had main-duct/mixed type, and 39...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28062877/-right-hepatectomy-in-block-with-hiliar-extra-hepatic-bile-duct-for-gallbladder-cancer-clinical-case
#17
Claudio Mengoa Quintanilla, Giovanni De la Cruz Robles, Sergio Puma Condori, Carol Durand Mendoza
Gallbladder cancer is the most common malignancy of the biliary tract. Usually seen in advanced stages. There are still many controversies about the type of curative surgical treatment for each stage of the disease. The only chance of long term survival for patients with advanced tumors is aggressive, large surgeries that implies multiorgan resection.We report the case of a patient with gallbladder cancer with jaundice at diagnosis, who underwent extended hepatectomy (segment IV B, segment I and extra hepatic hilar bile duct included)...
October 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28051047/evaluation-of-the-use-of-laparoscopic-guided-cholecystocholangiography-and-liver-biopsy-in-definitive-diagnosis-of-neonatal-cholestatic-jaundice
#18
Khalid Shreef, Abdullah Alhelal
BACKGROUND: Once it is established that a jaundiced infant has direct hyperbilirubinemia, the principal diagnostic concern is to differentiate hepatocellular from obstructive cholestasis. Traditional tests such as ultrasonography, percutaneous liver biopsy and technetium 99 m hepatobiliary iminodiacetic acid (HIDA) scan are often not sufficiently discriminating. Definitive exclusion of biliary atresia (BA) in the infant with cholestatic jaundice usually requires mini-laparotomy and intra-operative cholangiography...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28018098/therapeutic-approaches-for-portal-biliopathy-a-systematic-review
#19
REVIEW
Irene Franceschet, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Marco Senzolo
Portal biliopathy (PB) is defined as the presence of biliary abnormalities in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and portal cavernoma (PC). The pathogenesis of PB is due to ab extrinseco compression of bile ducts by PC and/or to ischemic damage secondary to an altered biliary vascularization in EHPVO and PC. Although asymptomatic biliary abnormalities can be frequently seen by magnetic resonance cholangiopancreatography in patients with PC (77%-100%), only a part of these (5%-38%) are symptomatic...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28012336/forgotten-cbd-stent-102-months-with-stone-stent-complex-a-case-report
#20
Varsha Barai, Jagadish Hedawoo, Sanjay Changole
INTRODUCTION: Choledocholithiasis is presence of stone in Common bile duct (CBD) which can be treated by endoscopy or surgery [1]. Retained foreign bodies like stents forms a nidus for stone formation resulting in pain, fever, jaundice. CASE PRESENTATION: 60 years female patient admitted in surgery ward with features of cholangitis with computed tomography showing cholangitic abscess with dilated common bile duct and sludge around stent in situ. Stone was found at proximal end of stent during surgery...
December 7, 2016: International Journal of Surgery Case Reports
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