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Acute cholangitis

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https://www.readbyqxmd.com/read/29230246/usefulness-of-endoscopic-managements-in-patients-with-ceftriaxone-induced-pseudolithiasis-causing-biliary-obstruction
#1
Yasuhiro Doi, Yasushi Takii, Hiroyuki Ito, Norihiko Jingu, Kentaro To, Sinichiro Kimura, Koichi Kimura, Kensaku Sanefuji, Hirofumi Ikeda, Sayaka Tachibana, Takeshi Otsuka
Ceftriaxone (CTRX) is known to cause reversible biliary stones/sludge, which is called biliary pseudolithiasis. We report two rare cases of biliary obstruction by pseudolithiasis shortly after completing CTRX treatment. Stones and sludge, which had not been detected before CTRX administration, appeared in the gallbladder and common bile duct and led to biliary obstruction and acute cholangitis. The obstructions were successfully treated with endoscopic retrograde biliary drainage and endoscopic sphincterotomy...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29226107/cholangitis-diagnosis-treatment-and-prognosis
#2
REVIEW
Amir Houshang Mohammad Alizadeh
Cholangitis is a serious life-threatening situation affecting the hepatobiliary system. This review provides an update regarding the clinical and pathological features of various forms of cholangitis. A comprehensive search was performed in the PubMed, Scopus, and Web of Knowledge databases. It was found that the etiology and pathogenesis of cholangitis are heterogeneous. Cholangitis can be categorized as primary sclerosing (PSC), secondary (acute) cholangitis, and a recently characterized form, known as IgG4-associated cholangitis (IAC)...
December 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/29224663/obstruction-of-the-biliary-and-urinary-system
#3
William O'Connell, Jay Shah, Jason Mitchell, J David Prologo, Louis Martin, Michael J Miller, Jonathan G Martin
Biliary and urinary obstructions can be managed endoscopically or cystoscopically, surgically or by percutansous intervention or drainage. If the obtructed system is infected, emergent decompression is needed. Early recognition and treatment is paramount in both conditions. Acute cholangitis can present many different ways, from mild symptoms to fulminant sepsis. It is usually a result of ascending bacterial colonization and biliary obstruction resulting in bacterial overgrowth. Therefore, those patients with recent biliary instrumentation or previous biliary modification are at higher risk...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29218132/portal-vein-thrombosis-in-adult-omani-patients-a-retrospective-cohort-study
#4
Khalid Al Hashmi, Lamya Al Aamri, Sulayma Al Lamki, Anil Pathare
OBJECTIVES: We sought to study the occurrence of portal vein thrombosis (PVT) in adult Omani patients. Methods: We conducted a retrospective cross-sectional study in patients diagnosed with PVT, which was confirmed by radiological imaging, from two tertiary hospitals over a 10-year period. Results: Amongst the 39 patients enrolled in the study, 15 (38.4%) had cirrhosis of the liver, and 24 (61.5%) were non-cirrhotic. In the non-cirrhotic PVT patients, 15 (62.5%) had acute PVT, whereas nine (37...
November 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29217901/xanthogranulomatous-cholecystitis-analysis-of-108-patients
#5
Osman Yucel, Mehmet Ali Uzun, Metin Tilki, Sevcan Alkan, Zeynep Gamze Kilicoglu, Ceren Canbey Goret
The aim of this study was to evaluate the clinical and radiological features of xanthogranulomatous cholecystitis (XGC) and the results of surgical treatment. This retrospective study concerns clinical, radiological, and surgical data as well as histopathological findings and postoperative results of 108 patients with XGC who were identified after evaluating 7916 cholecystectomy specimens between 2004 and 2014 in a single institute. One hundred eight patients with XGC were evaluated (56 males and 52 females, mean age 62...
December 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29179696/secondary-sclerosing-cholangitis-in-localized-hepatobiliary-tuberculosis-simulating-cholangiocarcinoma-a-rare-case-report
#6
Aleena Jain, Rachana Chaturvedi, Chetan Kantharia, Amita Joshi, Mangesh Londhe, Mayura Kekan
BACKGROUND: Hepatobiliary tuberculosis includes miliary, tuberculous hepatitis or localized forms. The localised form is extremely uncommon and can mimic malignancy. Still rarer is its presentation as sclerosing cholangitis. CASE PRESENTATION: A 50 year male presented with acute onset jaundice, significant weight loss and elevated liver enzymes with clinico-radiological suspicion of cholangiocarcinoma. A left hepatectomy was done and dilated bile ducts filled with caseous necrotic material were seen intra-operatively...
November 28, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29161794/feasibility-of-temporary-pancreatic-stenting-after-early-endoscopic-retrograde-cholangiopancreatography-in-patients-with-acute-biliary-pancreatitis
#7
Jun Kyu Lee, Dong Kee Jang, Hyun Woo Kang, Sang Hyub Lee
Background/Aims: To assess the safety and effectiveness of temporary pancreatic stenting after early endoscopic retrograde cholangiopancreatography (ERCP) in patients with acute biliary pancreatitis regardless of the severity or concomitant cholangitis. Methods: Temporary pancreatic stenting was performed in 79 patients with visualized pancreatic duct during ERCP. The outcomes of 64 patients with adequate pancreatic stenting (PS) and 15 patients with inadequate pancreatic stenting (no PS) were compared in this prospective, observational trial...
November 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29132521/gallbladder-dysfunction-cholecystitis-choledocholithiasis-cholangitis-and-biliary-dyskinesia
#8
REVIEW
Thad Wilkins, Edward Agabin, Jason Varghese, Asif Talukder
The prevalence of gallstones is 10% to 15% in adults. Individuals with acute cholecystitis present with right upper quadrant pain, fever, and leukocytosis. Management includes supportive care and cholecystectomy. The prevalence of choledocholithiasis is 10% to 20%, and serious complications include cholangitis and gallstone pancreatitis. The goal of management in individuals with choledocholithiasis consists of clearing common bile duct stones. Acute ascending cholangitis is a life-threatening condition involving acute inflammation and infection of the common bile duct...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132116/the-outcome-of-laparoscopic-subtotal-cholecystectomy-in-difficult-cases-a-case-series
#9
Caroline Supit, Tommy Supit, Yarman Mazni, Ibrahim Basir
INTRODUCTION: Laparoscopic subtotal cholecystectomy (LSC) is a widely used technique for managing cholelithiasis with severe cholecystitis. The increasing popularity its utilization is due to the good safety profile and acceptable results. This case series evaluates the short- and long-term results of Indonesian patients who underwent LSC with an objective to determine whether the procedure can be a standard approach for difficult cholecystectomy in our institution. PRESENTATION OF CASE: Thirty-four Indonesian patients (26 men, 8 women) with the mean age of 54...
November 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29118687/renoportal-anastomosis-in-left-lateral-lobe-living-donor-liver-transplantation-a-pediatric-case
#10
Hiroyuki Ogasawara, Chikashi Nakanishi, Shigehito Miyagi, Kazuaki Tokodai, Yasuyuki Hara, Wataru Nakanishi, Koji Miyazawa, Kenji Shimizu, Hiroyuki Kumata, Hitoshi Goto, Masafumi Goto, Michiaki Unno, Takashi Kamei
In adult liver transplantation, renoportal anastomosis (RPA) has been introduced as a useful technique for patients with grade 4 portal vein thrombosis and a splenorenal shunt. Here, we report a pediatric case in which RPA allowed a left lateral lobe living donor liver transplantation (LDLT) despite portal vein thrombosis and a large splenorenal shunt. At 36 days old, the patient underwent a Kasai operation for biliary atresia. At 17 months old, she underwent LDLT because of repetitive cholangitis. Pretransplant examinations revealed a large splenorenal shunt and portal vein thrombosis...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29113359/hepatointestinal-complications-in-polycystic-kidney-disease
#11
Shih-Ting Huang, Ya-Wen Chuang, Tung-Min Yu, Cheng-Li Lin, Long-Bin Jeng
Background: The objective of this study was to determine the incidence of major hepatointestinal complications in patients with polycystic kidney disease (PKD). Methods: We analyzed the Taiwan National Health Insurance claims data (2000-2010) of 6031 patients with PKD and 23,976 non-PKD hospitalized controls. The control cohort was propensity score matched with the PKD cohort at a 1:4 ratio. All patients were followed up from the index date to the first inpatient diagnosis of hepatointestinal complications, death, or 31 December, 2011...
October 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/29112915/acute-abdomen-secondary-to-a-spontaneous-perforation-of-the-biliary-tract-a-rare-complication-of-choledocholithiasis
#12
G A Gómez-Torres, F M Rodríguez-Navarro, C R López-Lizárraga, C A Bautista-López, O S Ortega-García, G Becerra-Navarro, A Águila-Barragán, C F Ploneda-Valencia
INTRODUCTION: The spontaneous perforation of the biliary tract (SPBT) is an extremely rare cause of peritonitis, which was first described by Freeland in 1982, to date only around 70 cases have been reported. Here we present a case of spontaneous perforation of the biliary tract, in a patient with choledocholithiasis, which was treated with ultrasound-guided drainage and ERCP. CASE REPORT: A 51-year-old male was admitted to the emergency room for 15-day evolution jaundice, localized pain in the right flank and hypochondrium of 3days...
October 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29112097/predictive-factors-for-long-operative-duration-in-patients-undergoing-laparoscopic-cholecystectomy-after-endoscopic-retrograde-cholangiography-for-combined-choledochocystolithiasis
#13
Ryukyung Lee, Heontak Ha, Young Seok Han, Min Kyu Jung, Jae Min Chun
PURPOSE: Choledochocystolithiasis and its associated complications such as cholangitis and pancreatitis are managed by endoscopic retrograde cholangiography (ERC), with endoscopic stone extraction followed by laparoscopic cholecystectomy (LC). However, affected patients present with complex conditions linked to operative difficulties in performing LC. The aim of this study was to elucidate the predictive factors for a prolonged LC procedure following ERC for treating patients with choledochocystolithiasis...
November 3, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29108980/radiofrequency-ablation-combined-with-biliary-stent-placement-versus-stent-placement-alone-for-malignant-biliary-strictures-a-systematic-review-and-meta-analysis
#14
REVIEW
Aijaz Ahmed Sofi, Muhammad Ali Khan, Ananya Das, Mankanwal Sachdev, Sadik Khuder, Ali Nawras, Wade Lee
Unresectable malignant biliary strictures are generally managed by palliative stent placement for drainage of biliary tree. Recently, radiofrequency ablation (RFA) has been used to improve the patency of biliary stents in these patients. Several studies have evaluated the effectiveness of biliary stent placement with RFA on stent patency and patient survival with variable results. We performed this meta-analysis to evaluate the efficacy and safety of biliary stent placement with RFA compared with stent placement alone in patients with malignant biliary strictures...
November 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29100348/changes-of-foxo3a-in-pbmcs-and-its-associations-with-stress-hyperglycemia-in-acute-obstructive-suppurative-cholangitis-patients
#15
Niu Bailin, Chen Nan, Li Peizhi, He Kun, Zhu Xiwen, Ren Guosheng, Gong Jianping, Zhang Wenfeng
Objective: The levels of Foxo3a in the peripheral blood mononuclears cells (PBMCs) before and after treatment were detected in acute obstructive suppurative cholangitis (AOSC) patients to evaluate the associations between Foxo3a and stress hyperglycemia (SHG). Methods: PBMCs were obtained from AOSC patients (n=28) on admission (AP), from patients at 1 week after cure (RP) and from healthy volunteers (HV) (n=14) to evaluate the relationship between the protein levels of Foxo3a and the serum levels of glucose...
September 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/29093628/evidence-from-a-familial-case-suggests-maternal-inheritance-of-primary-biliary-cholangitis
#16
Saeam Shin, In Ho Moh, Young Sik Woo, Sung Won Jung, Jin Bae Kim, Ji Won Park, Ki Tae Suk, Hyoung Su Kim, Mineui Hong, Sang Hoon Park, Myung Seok Lee
Primary biliary cholangitis (PBC) is an idiopathic autoimmune liver disease characterized by chronic cholestasis and destruction of the intrahepatic bile ducts. Similar to other autoimmune diseases, the pathogenesis of PBC is considered to be a complex etiologic phenomenon involving the interaction of genetic and environmental factors. Although a number of common variants associated with PBC have been reported from genome-wide association studies, a precise genetic mechanism underlying PBC has yet to be identified...
October 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29090868/tokyo-guidelines-2018-management-bundles-for-acute-cholangitis-and-cholecystitis
#17
Toshihiko Mayumi, Kohji Okamoto, Tadahiro Takada, Steven M Strasberg, Joseph S Solomkin, David Schlossberg, Henry A Pitt, Masahiro Yoshida, Harumi Gomi, Fumihiko Miura, O James Garden, Seiki Kiriyama, Masamichi Yokoe, Itaru Endo, Horacio J Asbun, Yukio Iwashita, Taizo Hibi, Akiko Umezawa, Kenji Suzuki, Takao Itoi, Jiro Hata, Ho-Seong Han, Tsann-Long Hwang, Christos Dervenis, Koji Asai, Yasuhisa Mori, Wayne Shih-Wei Huang, Giulio Belli, Shuntaro Mukai, Palepu Jagannath, Daniel Cherqui, Kazuto Kozaka, Todd H Baron, Eduardo de Santibañes, Ryota Higuchi, Keita Wada, Dirk J Gouma, Daniel J Deziel, Kui-Hin Liau, Go Wakabayashi, Robert Padbury, Eduard Jonas, Avinash Nivritti Supe, Harjit Singh, Toshifumi Gabata, Angus C W Chan, Wan Yee Lau, Sheung Tat Fan, Miin-Fu Chen, Chen-Guo Ker, Yoo-Seok Yoon, In-Seok Choi, Myung-Hwan Kim, Dong-Sup Yoon, Seigo Kitano, Masafumi Inomata, Koichi Hirata, Kazuo Inui, Yoshinobu Sumiyama, Masakazu Yamamoto
Management bundles that define items or procedures strongly recommended in clinical practice have been used in many guidelines in recent years. Application of these bundles facilitates the adaptation of guidelines and helps improve the prognosis of target diseases. In Tokyo Guidelines 2013 (TG13), we proposed management bundles for acute cholangitis and cholecystitis. Here, in Tokyo Guidelines 2018 (TG18), we redefine the management bundles for acute cholangitis and cholecystitis. Critical parts of the bundles in TG18 include the diagnostic process, severity assessment, transfer of patients if necessary, and therapeutic approach at each time point...
November 1, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/29090866/tokyo-guidelines-2018-antimicrobial-therapy-for-acute-cholangitis-and-cholecystitis
#18
Harumi Gomi, Joseph S Solomkin, David Schlossberg, Kohji Okamoto, Tadahiro Takada, Steven M Strasberg, Tomohiko Ukai, Itaru Endo, Yukio Iwashita, Taizo Hibi, Henry A Pitt, Naohisa Matsunaga, Yoriyuki Takamori, Akiko Umezawa, Koji Asai, Kenji Suzuki, Ho-Seong Han, Tsann-Long Hwang, Yasuhisa Mori, Yoo-Seok Yoon, Wayne Shih-Wei Huang, Giulio Belli, Christos Dervenis, Masamichi Yokoe, Seiki Kiriyama, Takao Itoi, Palepu Jagannath, O James Garden, Fumihiko Miura, Eduardo de Santibañes, Satoru Shikata, Yoshinori Noguchi, Keita Wada, Goro Honda, Avinash Nivritti Supe, Masahiro Yoshida, Toshihiko Mayumi, Dirk J Gouma, Daniel J Deziel, Kui-Hin Liau, Miin-Fu Chen, Keng-Hao Liu, Cheng-Hsi Su, Angus C W Chan, Dong-Sup Yoon, In-Seok Choi, Eduard Jonas, Xiao-Ping Chen, Sheung Tat Fan, Chen-Guo Ker, Mariano Eduardo Giménez, Seigo Kitano, Masafumi Inomata, Shuntaro Mukai, Ryota Higuchi, Koichi Hirata, Kazuo Inui, Yoshinobu Sumiyama, Masakazu Yamamoto
Antimicrobial therapy is a mainstay of the management for patients with acute cholangitis and/or cholecystitis. Tokyo Guidelines 2018 (TG 18) provides recommendations for the appropriate for use of antimicrobials for community-acquired and healthcare-associated infections. The listed agents are for empirical therapy) provided before the infecting isolates are identified. Antimicrobial agents are listed by class-definitions and TG 18 Severity Grade I, II, and III subcategorized by clinical settings. In the era of emerging and increasing antimicrobial resistance, monitoring and updating local antibiograms is underscored...
November 1, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/29089703/evaluation-and-comparison-of-charcot-s-triad-and-tokyo-guidelines-for-the-diagnosis-of-acute-cholangitis
#19
Tolga Dinc, Selami Ilgaz Kayilioglu, Faruk Coskun
Reliability of Charcot's triad has long been questioned. Tokyo Guidelines committee published Tokyo Guidelines in 2007 and 2013. The aim of this study was to retrospectively examine the patients who had been treated with the diagnosis of acute cholangitis and evaluate 2007-2013 Tokyo criteria and Charcot's triad. The files of the patients with acute cholangitis in a referral center were examined retrospectively. All patients were classified and evaluated according to 2007 and 2013 Tokyo criteria and Charcot's triad; and results were compared...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29075173/case-report-biliary-pancreatitis-with-acute-cholangitis-in-a-patient-under-anticoagulant-treatment-with-dabigatran
#20
Franziska Baumann-Durchschein, Thomas Gary, R B Raggam
We report a case of acute onset of a biliary pancreatitis with cholangitis presented in our emergency department. The patient was under anticoagulant therapy with dabigatran due to persistent atrial fibrillation. Pancreatic enzymes including lipase were elevated above the linear measuring range and bilirubin together with cholestasis enzymes was also highly elevated. An ERCP with papillotomy was urgently indicated because postponing could lead to further deterioration of the patient's condition. Coagulation testing showed a prolonged thrombin time above 160sec which was followed by a diluted thrombin time (Haemoclot Test) resulted in a peak-level of dabigatran thus confirming full anticoagulation...
October 2017: EJIFCC
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