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Acute cholangitis

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https://www.readbyqxmd.com/read/29663264/no-association-of-timing-of-endoscopic-biliary-drainage-with-clinical-outcomes-in-patients-with-non-severe-acute-cholangitis
#1
Ryunosuke Hakuta, Tsuyoshi Hamada, Yousuke Nakai, Hirofumi Kogure, Rie Uchino, Naminatsu Takahara, Suguru Mizuno, Tatsunori Suzuki, Tatsuya Sato, Tsuyoshi Takeda, Kazunaga Ishigaki, Kei Saito, Tomotaka Saito, Minoru Tada, Hiroyuki Isayama, Kazuhiko Koike
BACKGROUND: Biliary drainage via endoscopic retrograde cholangiopancreatography (ERCP) is the first-line treatment for acute cholangitis. Despite the established effectiveness of urgent biliary drainage in patients with severe acute cholangitis, the indication of this procedure for non-severe acute cholangitis is controversial. AIMS: To assess the safety of elective drainage (≥ 12 h of admission) for non-severe acute cholangitis. METHODS: We retrospectively identified 461 patients with non-severe acute cholangitis who underwent endoscopic biliary drainage...
April 16, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29657606/early-biliary-drainage-is-associated-with-favourable-outcomes-in-critically-ill-patients-with-acute-cholangitis
#2
Mohammed Aboelsoud, Osama Siddique, Alexander Morales, Young Seol, Mazen Al-Qadi
Introduction: Acute cholangitis (AC) is a clinical condition that requires prompt medical management with IV fluids, antibiotics, and biliary drainage (BD). The optimal timing for BD remains unclear. Aim: To investigate the effect of biliary drainage timing on clinical outcomes in AC. Material and methods: We conducted a retrospective study of patients with AC admitted to the ICU using the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database...
2018: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/29649951/biliary-ascariasis-presenting-with-gangrenous-perforation-of-the-gall-bladder-report-of-a-case-and-brief-review-of-literature
#3
Ankush Sharma, Priyansh Jariwala, Navneet Kaur
The most common cause of gallbladder perforation is calculous cholecystitis. Rarer causes include trauma, iatrogenic injuries, biliary stasis and gall bladder ischemia. We report a case of gall bladder gangrene with perforation, secondary to extensive ascariasis. A 45-year-old woman presented with acute intestinal obstruction and jaundice. She had abdominal distension and right hypochondrial tenderness. Abdominal radiography showed dilated bowel loops and ultrasonogram showed worms in the small intestine and biliary tree...
January 1, 2018: Tropical Doctor
https://www.readbyqxmd.com/read/29610171/autoimmune-pancreatitis-and-ulcerative-rectocolitis-in-an-adolescent
#4
Elie Cousin, Ianis Cousin, Karim Aziz, Pascal Chailloux, Estelle Breton
Autoimmune pancreatitis (AIP) is rare in teenagers and difficult to diagnose. There are no clear and established diagnostic criteria in the pediatric population to distinguish subtype 1 and subtype 2. Here, we report the case of a 16-year-old white French teenager admitted to the pediatric emergency service with more than 1 year's history of pain originating from the epigastric and the right hypochondriac regions, with bloody diarrhea. After exclusion of pancreatic cancer and other common causes of acute pancreatitis, the diagnosis of AIP was suspected...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29607581/roux-en-y-enterolith-leading-to-obstruction-and-ischemic-necrosis-after-pediatric-orthotopic-liver-transplantation
#5
Ralph C Quillin, Advaith Bongu, Vania Kasper, Jennifer M Vittorio, Mercedes Martinez, Steven J Lobritto, Adam D Griesemer, James V Guarrera
Biliary complications are a common cause of morbidity after liver transplantation, with biliary stone formation being a known occurrence generally upstream of a stricture. A 12-year-old boy, who underwent an orthotopic liver transplantation at 11 months of age for biliary atresia, presented acutely with fever and abdominal pain. Cross-sectional imaging revealed Roux-en-Y limb dilatation and thickening. He was explored and was found to have an ischemic Roux limb secondary to an obstructing enterolith. A segmental bowel resection and revision of his hepaticojejunostomy was performed...
April 1, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29607537/gastrointestinal-unusual-cause-of-acute-cholangitis-in-a-chronic-pancreatitis-patient
#6
J W Choe, J J Lee, J J Hyun
No abstract text is available yet for this article.
April 1, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29607530/systematic-review-drug-induced-liver-injury-alternative-causes-in-case-series-as-confounding-variables
#7
REVIEW
Rolf Teschke, Gaby Danan
AIMS: Drug-induced liver injury (DILI) is rare as compared to the worldwide frequent acute or chronic liver diseases. Therefore, patients included in series of suspected DILI are at high risk of not having DILI, whereby alternative causes may confound the DILI diagnosis. The aim of this review is to evaluate published case series of DILI for alternative causes. METHODS: Pertinent studies were identified using a computerized search of the Medline database for publications from 1993 through 30 October 2017...
April 1, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29593631/acute-hemorrhagic-encephalitis-responding-to-combined-decompressive-craniectomy-intravenous-immunoglobulin-and-corticosteroid-therapies-association-with-novel-ranbp2-variant
#8
Abdulla Alawadhi, Christine Saint-Martin, Farhan Bhanji, Myriam Srour, Jeffrey Atkinson, Guillaume Sébire
Background: Acute hemorrhagic encephalomyelitis (AHEM) is considered as a rare form of acute disseminated encephalomyelitis characterized by fulminant encephalopathy with hemorrhagic necrosis and most often fatal outcome. Objective: To report the association with Ran Binding Protein ( RANBP2) gene variant and the response to decompressive craniectomy and high-dose intravenous methylprednisolone (IVMP) in life-threatening AHEM. Design: Single case study...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29575243/a-direct-cholangioscopic-perspective-on-cholecystitis
#9
Vincent Zimmer, Ernst-Peter Mues
Putrid drainage during endoscopic retrograde cholangiography (ERC) is usually considered equivalent to ongoing cholangitis, however, acute cholecystitis representing a viable alternative diagnosis ("not all that drains pus is cholangitis"). Endoscopic high-quality visualization by direct cholangioscopy (DC) of acute cholecystitis has not been been reported so far, while mimimal information is available in such context pertaining to therapeutic single-operator cholangioscopy (SOC)-assisted gallbladder drainage...
March 25, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29532602/pantoprazole-induced-autoimmune-chronic-hepatitis
#10
Lucy Meunier, Jose Ursic-Bedoya, Georges-Philippe Pageaux, Dominique Larrey
BACKGROUND: Although very rare, pantoprazole can result in acute hepatitis. It has yet to be reported, however, that it can also cause chronic autoimmune hepatitis. AIM, METHOD, AND RESULTS: We report the case of a patient in whom pantoprazole administration for two months was followed by acute liver injury with severe jaundice and features of autoimmunity. A liver biopsy revealed acute hepatocellular lesions associated with cholestasis, acute cholangitis, and polymorphous inflammatory infiltration suggestive of drug-induced liver injury...
March 12, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29528732/current-and-future-perspectives-in-autoimmune-hepatitis
#11
Eleni Theocharidou, Michael A Heneghan
Autoimmune hepatitis occurs in genetically susceptible individuals as a result of loss of immunological tolerance to hepatic autoantigens that can be precipitated by environmental triggers. The clinical manifestation is usually insidious but can be also acute with liver failure. The diagnosis is made on the basis of antibody positivity, elevated immunoglobulin G levels and interface hepatitis on liver histology. Induction of remission is achieved with high-dose steroids in the majority of cases, and maintenance of remission with azathioprine...
March 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29517637/early-endoscopic-retrograde-cholangiopancreatography-versus-conservative-treatment-in-patients-with-acute-biliary-pancreatitis-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
Lara M de A Coutinho, Wanderley M Bernardo, Rodrigo S Rocha, Fabio R Marinho, Aureo Delgado, Eduardo T H Moura, Sergio E Matuguma, Dalton Chaves, Tomazo A P Franzini, Paulo Sakai, Eduardo G H de Moura
OBJECTIVES: The aim of the study was to evaluate the role of early endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of acute biliary pancreatitis, in comparison with conservative treatment. METHODS: Systematic review via databases (MEDLINE [PubMed], Latin-American and Caribbean Health Sciences Literature database, Embase, Cochrane Central, and the [Brazilian] Regional Library of Medicine) is conducted. We analyzed 10 randomized controlled trials (1091 patients)...
April 2018: Pancreas
https://www.readbyqxmd.com/read/29511408/worsening-of-acute-cholangitis-caused-by-a-bile-duct-stone-after-hospitalization-a-case-series
#13
Tetsuro Akashi, Yuichi Tachibana, Susumu Matsuo, Junya Gibo
Acute cholangitis is a fatal condition if inadequately treated. It is possible to underestimate the severity of the condition because bacterial cultures are not immediately available. We evaluated the clinical features of patients with cholangitis due to bile duct stones who were diagnosed with severe bacteremia at the time of hospitalization, but not at the time of the initial visit. We conducted a retrospective analysis of cases of endoscopic retrograde cholangiopancreatography performed between January 2007 and October 2011 in patients with bile duct stones complicated by cholangitis...
February 2018: Gastroenterology Research
https://www.readbyqxmd.com/read/29487761/acute-cholangitis-an-update
#14
REVIEW
Monjur Ahmed
Acute cholangitis is bacterial infection of the extra-hepatic biliary system. As it is caused by gallstones blocking the common bile duct in most of the cases, its prevalence is greater in ethnicities with high prevalence of gallstones. Biliary obstruction of any cause is the main predisposing factor. Diagnosis is established by the presence of clinical features, laboratory results and imaging studies. The treatment modalities include administration of intravenous fluid, antibiotics, and drainage of the bile duct...
February 15, 2018: World Journal of Gastrointestinal Pathophysiology
https://www.readbyqxmd.com/read/29480416/procalcitonin-as-a-decision-supporting-marker-of-urgent-biliary-decompression-in-acute-cholangitis
#15
Yoon Suk Lee, Kwang Bum Cho, Kyung Sik Park, Ju Yup Lee, Yoo Jin Lee
BACKGROUND AND AIM: This study aimed to evaluate the association of serum procalcitonin (PCT) at hospital presentation with disease severity and clinical deterioration to septic shock in acute cholangitis. METHODS: This study included consecutive patients with a diagnosis of acute cholangitis who presented to the emergency department and underwent biliary drainage. PCT and blood culture tests were conducted at the time of initial presentation. Patients were categorized into three groups based on disease severity...
February 26, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29468407/intravenous-immunoglobulin-for-the-treatment-of-intractable-cholangitis-after-kasai-portoenterostomy-in-biliary-atresia-patients
#16
Dandan Li, Pei Wang, Ying He, Chunlei Jiao, Didi Zhuansun, Nannan Wei, Jixin Yang, Jiexiong Feng
OBJECTIVE: To assess the efficacy of intravenous immunoglobulin (IVIG) as add-on treatment for intractable cholangitis (IC) after Kasai portoenterostomy (KPE) in biliary atresia (BA) patients. METHODS: 113 BA patients who had one or more episodes of cholangitis after KPE were recruited in this study. According to whether response to routine conservative treatment, all patients were divided into IC group and simple cholangitis (SC) group. Meanwhile, patients with IC subdivided into IVIG group and control group according to whether application of IVIG...
April 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29425886/ercp-performed-through-previously-placed-duodenal-stents-a-multicenter-retrospective-study-of-outcomes-and-adverse-events
#17
Judith Staub, Ali Siddiqui, Linda Jo Taylor, David Loren, Tom Kowalski, Douglas G Adler
BACKGROUND AND AIMS: ERCP (endoscopic retrograde cholangiopancreatography) performed through previously placed enteral stents is an uncommon procedure without a significant amount of supporting literature, and with a wide reported range of technical success. The purpose of this study was to evaluate and better define the technical feasibility and safety of performing ERCP through enteral stents in patients with combined malignant biliary and gastric outlet obstruction (GOO). METHODS: We conducted a multicenter, retrospective study on 71 patients with combined gastric outlet and biliary obstruction who underwent ERCP through a previously placed enteral stent at 2 tertiary care centers...
February 6, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29409310/electrohydraulic-lithotripsy-for-difficult-bile-duct-stones-under-endoscopic-retrograde-cholangiopancreatography-and-peroral-transluminal-cholangioscopy-guidance
#18
Rieko Kamiyama, Takeshi Ogura, Atsushi Okuda, Akira Miyano, Nobu Nishioka, Miyuki Imanishi, Wataru Takagi, Kazuhide Higuchi
Background/Aims: Electrohydraulic lithotripsy (EHL) under endoscopic retrograde cholangiopancreatography (ERCP) guidance can be an option to treat difficult stones. Recently, a digital, single-operator cholangioscope (SPY-DS) has become available. Peroral transluminal cholangioscopy (PTLC) using SPY-DS has also been reported. In this retrospective study, the technical feasibility and clinical effectiveness of EHL for difficult bile duct stones under ERCP guidance and under PTLC guidance was examined...
February 8, 2018: Gut and Liver
https://www.readbyqxmd.com/read/29408612/shorter-duration-of-antibiotic-treatment-for-acute-bacteraemic-cholangitis-with-successful-biliary-drainage-a-retrospective-cohort-study
#19
Asako Doi, Takeshi Morimoto, Kentaro Iwata
OBJECTIVES: To assess the effectiveness of short duration antimicrobial therapy for acute cholangitis with bacteraemia. METHODS: We conducted a retrospective cohort study of patients with acute bacteraemic cholangitis with successful biliary duct drainage at a single centre in Japan. We compared short-course antimicrobial therapy (SCT, ≤7 days) and long-course therapy (LCT, ≥8 days), with a primary outcome of 30-day mortality. We constructed logistic regression models for mortality and a composite outcome, including mortality, recurrence, recrudescence, new bacteraemia, liver abscess or other complications related to cholangitis...
February 2, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29401491/urgent-endoscopic-retrograde-cholangiopancreatography-is-not-superior-to-early-ercp-in-acute-biliary-pancreatitis-with-biliary-obstruction-without-cholangitis
#20
Hee Seung Lee, Moon Jae Chung, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Si Young Song, Jae Bock Chung
Acute pancreatitis is a common diagnosis worldwide, with gallstone disease being the most prevalent cause (50%). The American College of Gastroenterology recommends urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 h) for patients with biliary pancreatitis accompanied by cholangitis. Most international guidelines recommend that ERCP be performed within 72 h in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, but the optimal timing for endoscopy is controversial...
2018: PloS One
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