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Acute cholangitis

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https://www.readbyqxmd.com/read/28106105/autoimmune-hepatitis-review-of-histologic-features-included-in-the-simplified-criteria-proposed-by-the-international-autoimmune-hepatitis-group-and-proposal-for-new-histologic-criteria
#1
Dana Balitzer, Nafis Shafizadeh, Marion G Peters, Linda D Ferrell, Najeeb Alshak, Sanjay Kakar
Simplified criteria for diagnosis of autoimmune hepatitis are based on autoantibodies, serum immunoglobulin G, histologic features, and negative viral serology. A score of 6 points is necessary for the designation of probable autoimmune hepatitis and 7 points or more for definite autoimmune hepatitis. The presence of three histologic features is required for categorizing a case as typical (2 points): interface hepatitis with portal lymphocytic/lymphoplasmacytic cells extending into lobule, emperipolesis, and rosettes...
January 20, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28101303/efficacy-of-multiple-biliary-stenting-for-refractory-benign-biliary-strictures-due-to-chronic-calcifying-pancreatitis
#2
Hiroshi Ohyama, Rintaro Mikata, Takeshi Ishihara, Yuji Sakai, Harutoshi Sugiyama, Shin Yasui, Toshio Tsuyuguchi
AIM: To investigate endoscopic therapy efficacy for refractory benign biliary strictures (BBS) with multiple biliary stenting and clarify predictors. METHODS: Ten consecutive patients with stones in the pancreatic head and BBS due to chronic pancreatitis who underwent endoscopic therapy were evaluated. Endoscopic insertion of a single stent failed in all patients. We used plastic stents (7F, 8.5F, and 10F) and increased stents at intervals of 2 or 3 mo. Stents were removed approximately 1 year after initial stenting...
January 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28090057/the-first-case-report-of-acute-cholangitis-and-bacteremia-due-to-neisseria-subflava
#3
Yoshifumi Uwamino, Kayoko Sugita, Eisuke Iwasaki, Hiroshi Fujiwara, Tomoyasu Nishimura, Naoki Hasegawa, Satoshi Iwata
We herein report a case of acute cholangitis and bacteremia caused by a commensal Neisseria species, Neisseria subflava, in an 82-year-old man with cholangiocarcinoma. Emergency endoscopic nasobiliary drainage and cefoperazone/sulbactam therapy were effective. Gram negative coccobacilli were isolated from both blood and bile cultures on 5% sheep blood agar. The isolate was identified as N.subflava biovar perflava by mass spectrometry, a sequence analysis of the 16S rRNA, and biochemical testing. Although biliary infections due to commensal Neisseria are extremely rare, this case demonstrates the possibility of its occurrence in patients undergoing bile duct treatment...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28086796/prophylaxis-of-post-erc-infectious-complications-in-patients-with-biliary-obstruction-by-adding-antimicrobial-agents-into-erc-contrast-media-a-single-center-retrospective-study
#4
Hella Wobser, Agnetha Gunesch, Frank Klebl
BACKGROUND: Patients with biliary obstruction are at high risk to develop septic complications after endoscopic retrograde cholangiography (ERC). We evaluated the benefits of local application of antimicrobial agents into ERC contrast media in preventing post-ERC infectious complications in a high-risk study population. METHODS: Patients undergoing ERC at our tertiary referral center were retrospectively included. Addition of vancomycin, gentamicin and fluconazol into ERC contrast media was evaluated in a case-control design...
January 13, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28076388/risk-factors-for-multi-drug-resistant-pathogens-and-failure-of-empiric-first-line-therapy-in-acute-cholangitis
#5
Philipp A Reuken, Dorian Torres, Michael Baier, Bettina Löffler, Christoph Lübbert, Norman Lippmann, Andreas Stallmach, Tony Bruns
BACKGROUND: Acute cholangitis (AC) requires the immediate initiation of antibiotic therapy in addition to treatment for biliary obstruction. Against a background of an increasing prevalence of multi-drug resistant (MDR) bacteria, the risk factors for the failure of empiric therapy must be defined. METHODS: Using a pathogen-based approach, 1764 isolates from positive bile duct cultures were retrospectively analyzed to characterize the respective pathogen spectra in two German tertiary centers...
2017: PloS One
https://www.readbyqxmd.com/read/28074277/patient-reported-outcomes-for-acute-gallstone-pathology
#6
Ed Parkin, Martyn Stott, Joy Brockbank, Simon Galloway, Ian Welch, Andrew Macdonald
BACKGROUND: A number of prominent surgical trials and clinical guidelines regard length of hospital stay and rates of daycase surgery as being of upmost importance following cholecystectomy. However, it is unclear whether these outcomes also matter to patients. This study aimed to identify the factors patients regard as most important when admitted with acute gallstone pathology. METHODS: A 41-item survey was produced by combining outcomes assessed in recent clinical trials with results from a preliminary patient questionnaire...
January 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28055006/biliary-tract-instillation-of-a-smac-mimetic-induces-trail-dependent-acute-sclerosing-cholangitis-like-injury-in-mice
#7
Maria Eugenia Guicciardi, Anuradha Krishnan, Steven F Bronk, Petra Hirsova, Thomas S Griffith, Gregory J Gores
Primary sclerosing cholangitis (PSC) is a cholestatic liver disease of unknown etiopathogenesis characterized by fibrous cholangiopathy of large and small bile ducts. Systemic administration of a murine TNF-related apoptosis-inducing ligand (TRAIL) receptor agonist induces a sclerosing cholangitis injury in C57BL/6 mice, suggesting endogenous TRAIL may contribute to sclerosing cholangitis syndromes. Cellular inhibitor of apoptosis proteins (cIAP-1 and cIAP-2) are negative regulators of inflammation and TRAIL receptor signaling...
January 5, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28035552/small-gallstone-size-and-delayed-cholecystectomy-increase-the-risk-of-recurrent-pancreatobiliary-complications-after-resolved-acute-biliary-pancreatitis
#8
Sung Bum Kim, Tae Nyeun Kim, Hyun Hee Chung, Kook Hyun Kim
INTRODUCTION: Acute biliary pancreatitis (ABP) is a severe complication of gallstone disease with considerable mortality, and its recurrence rate is reported as 50-90% for ABP patients who do not undergo cholecystectomy. However, the incidence of and risk factors for recurrent pancreatobiliary complications after the initial improvement of ABP are not well established in the literature. The aims of this study were to determine the risk factors for recurrent pancreatobiliary complications and to compare the outcomes between early (within 2 weeks after onset of pancreatitis) and delayed cholecystectomy in patients with ABP...
December 29, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28027992/short-course-antimicrobial-treatment-for-acute-cholangitis-with-gram-negative-bacillary-bacteremia
#9
Shunsuke Uno, Ryota Hase, Masayoshi Kobayashi, Toshiyasu Shiratori, So Nakaji, Nobuto Hirata, Naoto Hosokawa
OBJECTIVES: The optimal antimicrobial treatment duration for patients with acute cholangitis with bacteremia remains unknown. The updated Tokyo guidelines of 2013 recommend a minimum duration of 2 weeks only when bacteremia with Gram-positive cocci is present. Since May 2013, a shorter antimicrobial treatment duration of under 2 weeks has been implemented at the authors' institution for acute cholangitis with Gram-negative bacillary bacteremia. The aim of the present study was to validate this modified practice...
December 24, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28013213/environmental-xenoestrogens-super-activate-a-variant-murine-er-beta-in-cholangiocytes
#10
Stephanie K Meyer, Philip M E Probert, Anne K Lakey, Alastair C Leitch, Lynsay I Blake, Paul A Jowsey, Martin P Cooke, Peter G Blain, Matthew C Wright
High systemic levels of oestrogens are cholestatic and primary biliary cholangitis - which is characterised by hepatic ductular inflammation - is thought to be triggered by exposure to xenobiotics such as those around landfill sites. Xenoestrogens may be a component of this chemical trigger. We therefore hypothesised that xenoestrogens are present at higher levels in the proximity of landfill sites. To test this hypothesis, soil samples were collected, extracts prepared and biological oestrogenic activity examined using cell-based reporter gene assays...
December 24, 2016: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28002647/il-7-and-procalcitonin-are-useful-biomarkers-in-the-comprehensive-evaluation-of-the-severity-of-acute-cholangitis
#11
Yusuke Suwa, Ryusei Matsuyama, Koki Goto, Toshiaki Kadokura, Mari Sato, Ryutaro Mori, Takafumi Kumamoto, Masataka Taguri, Taku Miyasho, Itaru Endo
BACKGROUND: The incidence of biliary tract infection (BTI), especially healthcare-associated cholangitis, is increasing. However, there are few reports concerning biomarkers of acute cholangitis. We therefore performed an exhaustive investigation of several biomarkers. METHODS: We retrospectively measured eleven cytokines, six chemokines and procalcitonin (PCT), and endotoxin activity assay (EAA) values (IRB: 110512019) of sixty-one samples with acute cholangitis...
December 21, 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27999888/imaging-of-autoimmune-hepatitis-and-overlap-syndromes
#12
Neera Malik, Sudhakar K Venkatesh
Autoimmune hepatitis (AIH) is an uncommon, chronic inflammatory, and relapsing liver disease of unknown origin that may lead to liver cirrhosis, hepatocellular carcinoma, liver transplantation, or death. AIH occurs in all age groups and races but can frequently manifest as acute fulminant hepatitis. Clinical presentation of AIH can have features similar to primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC), and these diseases may coexist leading to overlap syndromes. Although histological diagnosis is necessary, imaging features often can demonstrate characteristics that may be helpful to distinguish these diseases...
January 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/27924081/liver-guardian-modifier-and-target-of-sepsis
#13
REVIEW
Pavel Strnad, Frank Tacke, Alexander Koch, Christian Trautwein
Sepsis and septic shock are characterized by life-threatening organ dysfunction caused by a dysregulated host response to infection. The liver has a central role during sepsis, and is essential to the regulation of immune defence during systemic infections by mechanisms such as bacterial clearance, acute-phase protein or cytokine production and metabolic adaptation to inflammation. However, the liver is also a target for sepsis-related injury, including hypoxic hepatitis due to ischaemia and shock, cholestasis due to altered bile metabolism, hepatocellular injury due to drug toxicity or overwhelming inflammation, as well as distinct pathologies such as secondary sclerosing cholangitis in critically ill patients...
January 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27919851/urgent-ercp-for-acute-cholangitis-reduces-mortality-and-hospital-stay-in-elderly-and-very-elderly-patients
#14
Chan Sun Park, Hee Seok Jeong, Ki Bae Kim, Joung-Ho Han, Hee Bok Chae, Sei Jin Youn, Seon Mee Park
BACKGROUND: Acute cholangitis in old people is a cause of mortality and prolonged hospital stay. We evaluated the effects of methods and timing of biliary drainage on the outcomes of acute cholangitis in elderly and very elderly patients. METHODS: We analyzed 331 patients who were older than 75 years and were diagnosed with acute calculous cholangitis. They were admitted to our hospital from 2009 to 2014. Patients' demographics, severity grading, methods and timing of biliary drainage, mortality, and hospital stay were retrospectively obtained from medical records...
December 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27904248/percutaneous-cholecystostomy-evidence-based-current-clinical-practice
#15
REVIEW
Karan Gulaya, Shamit S Desai, Kent Sato
The role of percutaneous cholecystostomy (PC) in the management of acute cholecystitis and cholangitis is outlined in the revised 2013 Tokyo Guidelines. These two emergencies constitute the vast majority of PC performed today for therapeutic purposes, and research has repeatedly shown the utility of PC in these conditions. PC is typically employed in the management of critically ill patients who are not surgical candidates. Indications and contraindications to PC are reviewed. Additional innovative applications of PC have been developed since it was first described in 1980...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27893641/routine-surveillance-cholangiography-after-percutaneous-cholecystostomy-delays-drain-removal-and-cholecystectomy
#16
Tyler J Loftus, Scott C Brakenridge, Frederick A Moore, Camille G Dessaigne, George A Sarosi, William J Zingarelli, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Alicia M Mohr
INTRODUCTION: Percutaneous cholecystostomy (PC) is often performed for patients with acute cholecystitis who are at high risk for operative morbidity and mortality. However, the necessity for routine cholangiography after PC remains unclear. We hypothesized that routine surveillance cholangiography (RSC) after PC would provide no benefit compared to on-demand cholangiography (ODC) triggered by signs or symptoms of biliary pathology. METHODS: We performed a 3-year retrospective cohort analysis of patients managed with PC for acute cholecystitis at two tertiary care hospitals...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27875357/optimal-timing-of-endoscopic-retrograde-cholangiopancreatography-in-acute-cholangitis
#17
Linda A Hou, Loren Laine, Nima Motamedi, Ara Sahakian, Christianne Lane, James Buxbaum
OBJECTIVES: Acute cholangitis mandates resuscitation, antibiotic therapy, and biliary decompression. Our aim was to define the optimal timing of endoscopic retrograde cholangiopancreatography (ERCP) for patients with acute cholangitis. METHODS: Clinical data on all cases of cholangitis managed by ERCP were prospectively collected from September 2010 to July 2013. The clinical impact of the time to ERCP, defined as the time from presentation in the emergency department to the commencement of the ERCP, was determined...
November 21, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27864721/intraoperative-endoscopic-nasobiliary-drainage-over-primary-closure-of-the-common-bile-duct-for-choledocholithiasis-combined-with-cholecystolithiasis-a-cohort-study-of-211-cases
#18
Pei Yin, Min Wang, Renyi Qin, Jian Zhang, Guangqin Xiao, Haifeng Yu, Zhiqiang Ding, Yahong Yu
BACKGROUND: Endoscopic nasobiliary drainage (ENBD) was often used for preoperative biliary drainage in cases like cholangiocarcinoma or acute obstructive suppurative cholangitis, reports on endoscopic nasobiliary drainage (ENBD) over primary closure of the common bile duct (CBD) are limited. This study compares outcomes of laparoscopic cholecystectomy (LC) + laparoscopic CBD exploration (LCBDE) + intraoperative ENBD + primary closure of CBD with equivalent patients who underwent preoperative endoscopic retrograde cholangiopancreatography (ERCP) and subsequent LC...
November 18, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27851341/1706-failure-of-biliary-stent-requiring-second-ercp-with-stone-extraction-in-acute-cholangitis
#19
Colin Wolslegel, Charles Ruzkowski, Matthew Lute, Henrique Fernadez
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27796825/complete-response-to-post-transplant-lymphoproliferative-disorder-by-surgical-resection-and-rituximab-after-living-donor-liver-re-transplantation-for-recurrent-primary-sclerosing-cholangitis
#20
Koichiro Haruki, Hiroaki Shiba, Junichi Shimada, Norimitsu Okui, Tomonori Iida, Katsuhiko Yanaga
Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication of solid organ transplantation. We herein report a case of PTLD after living-donor liver re-transplantation (reLDLT) for recurrent primary sclerosing cholangitis (PSC), for which complete response was achieved by surgical resection and rituximab. A 47-year-old man, who had undergone living-donor liver transplantation (LDLT) twice at age of 43 and 45 years for end-stage liver disease firstly for PSC and secondary for recurrent PSC, suffered liver dysfunction due to an acute cellular rejection (ACR) 17 months after reLDLT...
October 31, 2016: Clinical Journal of Gastroenterology
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