Alithiasic cholecystitis

A three-year-old male child presented with erythematous maculopapular nonpruritic generalized rash, poor feeding, vomiting, and cramping generalized abdominal pain. He was previously healthy and there was no family history of immunologic or other diseases. On examination he was afebrile, hemodynamically stable, with painful palpation of the right upper quadrant and positive Murphy's sign. Laboratory tests revealed elevated inflammatory markers, elevated aminotransferase activity, and features of cholestasis...

INTRODUCTION: Acute acalculous cholecystitis (AAC) occurs more frequently in critically ill patients, in the immediate postoperative period, after trauma or extensive burns. It has a high rate of morbidity and mortality. Ischemia, infection and vesicular stasis are determinants in its pathogenesis. MATERIAL AND METHOD: Retrospective study including all cases of AAC diagnosed in our pediatric intensive care unit between January 1997 and December 2012. RESULTS: We included 7 patients, all associated with viral or bacterial infection...

Acalculous cholecystitis is a relatively rare form of cholecystitis appearing in severely ill patients. We chose the case of a young patient under chemotherapy for myeloid leukaemia who developed a severe septic shock secondary to an alithiasic cholecystitis. Because of hemodynamic instability needing high-dose of vasoactive amines, percutaneous gallbladder drainage was done. After this intervention, the septic shock could be controlled, but a bleeding liver laceration was observed, fortunately without morbidity consequences...

The authors present a clinical case of a 53 years old male admited in an ICU - DI (Intensive care Unit of Infectious Disease) with the diagnosis of severe malaria. He was treated with IV quinine di-hydrochloride and doxycycline and developed on the sixth day an acute alithiasic cholecystitis. Transhepatic percutaneous drainage was performed and the patient had good clinical outcome.

The gallbladder diaphragm is a very rare abnormality of the embryogenesis. It is an exceptional cause of biliary peritonitis. We report a 54-year-old man who presented with hepatic colic for the past 2 years. Imaging disclosed evidence of alithiasic cholecystitis on gallbladder diaphragm. The coelioscopic exploration confirmed the diagnosis and an associated presence of a biliary peritonitis. A cholecystectomy and a peritoneal washing were performed. The histological examination ruled in the diagnosis of cholecystitis on gallbladder diaphragm...

INTRODUCTION: The treatment of acutely obstructed carcinoma of the left colon and sigmoid still represents a matter of controversy. The aim of this study was to assess retrospectively the results of its management by emergency subtotal or total colectomy with primary anastomosis. MATERIALS AND RESULTS: Sixty-seven patients were reviewed. There were 42 males and 25 females. The mean age was 70.5 years (range: 26-87 years). Mean operative time was 210 minutes. There were five synchronous colon carcinomas (7...

Polyarteritis nodosa (PAN) is a necrotizing systemic vasculitis involving the wall of small and medium sized arteries. The histologic aspect is defined by the presence of fibrinoid necrosis and an infiltrate rich in neutrophil polynuclears in the artery wall and rare granulomas. Clinical manifestations are misleading, and more often the symptoms of the disease are retrospectively related to the PAN. The gastrointestinal involvement carries a poor prognosis. We report a clinical case of severe PAN concerning a 46-year-old woman revealed by an acute alithiasic cholecystitis, needing a cholecystectomy...

OBJECTIVE: To evaluate the diagnostic utility of sonography in cases of dengue hemorrhagic fever (DHF) and to describe the correlation grade existing between the most frequent clinical and sonographic findings in DHF. MATERIAL AND METHODS: Prospective, cross-sectional and descriptive study applied to 132 patients, 21 of them with typical dengue fever and 111 with DHF. They went through ultrasound, searching for thickening of the gallbladder wall, pleural effusion and ascites...

A 64-year-old man was admitted for alithiasic cholecystitis. Necrotizing vasculitis was detected in a gallbladder obtained at the cholecystectomy. Slight elevation of transaminases, HBe antigens and hepatitis B-DNA (HBV-DNA) were detected in the patient. Intrahepatic necrotizing vasculitis was also detected in the liver biopsy specimen, and he also suffered from peripheral neuropathy of suddenly onset. Based on the diagnosis of hepatitis B-related polyarteritis nodosa, lamivudine was initially administered, followed by plasmapheresis and glucocorticoid steroid therapy...

A bilioma is an encapsulated collection of bile outside the biliary tree, which, in general, appears after a laceration in the biliary tract secondary to traumatism or to an iatrogenic lesion. Rarely, it occurs without a traumatic factor. We present two cases of bilioma as a complication of acute alithiasic cholecystitis. A review of the literature and the role of the ultrasonography in the diagnosis and management of biliomas is performed.

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