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PubMed2001

[Local and common humoral immunity in cholelithiasis and biliary sludge].

Analysis of local and systemic humoral immunity in 75 patients with cholelithiasis (36 patients) and biliary "sludge" (39 patients) are presented in this article. The bile of these patients were examined. The sIgA reduce in the bile, that testifies to the suppression of local humoral immunity but IgG and IgM increase due to inflammatory changes of gallbladder were revealed. Increase of all immunoglobulins, especially IgA, was revealed in blood serum. The both groups of the patients had demonstrated the same changes but with different expressiveness. This fact testifies to the similarity of pathological processes in these patients.

Adolescent↗
PubMedDate not supplied

[Pheochromocytoma associated with cholelithiasis].

OBJECTIVE: Pheochromocytoma is an adrenal or extra-adrenal tumor, which produces and secretes catecholamines. It is a rare cause of hypertension. Hypertension or hypertensive crises are most frequent clinical manifestations. Sometimes it can be associated with other diseases and conditions, such as cholelithiasis. CASE REPORT: We present a 37-year-old woman admitted to hospital with gastrointestinal complaints (right upper abdominal pain, nausea, vomiting) and hypertension with occasional hypertensive crises. Routine abdominal ultrasound revealed a gall-bladder stone, and enlargement of the right adrenal gland. The diagnosis of pheochromocytoma was confirmed by measurement of catecholamine levels in 24-hour urine collection and MIBG scan. After preoperative preparation, tumor extirpation was done. Histology confirmed the diagnosis of pheochromocytoma. Routine controls of catecholamine 24-hour urine levels showed no catecholamine excess, without hypertension and hypertensive crises as most frequent clinical manifestations. COMMENT: Physicians must consider pheochromocytomas in cases of drug resistant hypertension or hypertensive crises. Sometimes pheochromocytomas are associated with other diseases, such as gall-bladder stones, with mimicking and overlapping of clinical manifestations of pheochromocytomas with symptoms and signs of the associated disease.

Adrenal Gland Neoplasms↗
PubMed2001

The use of USG spatial reconstructions in diagnosing cholelithiasis and cholecystitis.

The aim of the paper is to determine diagnostic value of Spatial USG reconstructions in the diagnostics of cholelithiasis and inflammatory changes in the gallbladder. There was discussed the optimal way of examining the gallbladder in 3D USG presentation and advantages resulting from the use of the spatial option in diagnosing biliary deposits in selected inflammatory changes. USG spatial reconstructions which supplement the standard 2D USG examination in the diagnostics of difficult and doubtful cases of gallbladder pathology were found useful.

Cholecystitis↗
PubMed2002

[Intestinal obstruction due to cholelithiasis].

Medical histories of 22 patients operated for obturative intestinal obstruction due to cholelithiasis were analyzed, some specific features of this disease were defined. Surgical treatment consisted of enterotomy and cholelithoextraction with obligative decompression of higher intestinal parts. Sound stimulation of the intestine by Russian apparatus "Aropak-536" in combined treatment permitted to restore earlier motor function of gastrointestinal tract.

Aged↗
PubMedDate not supplied

Cholelithiasis in Ibadan: an update.

This study is to ascertain the present status of cholelithiasis in our environment. Six hundred and seventy (670) consecutive abdominal, ultrasounds done for various abdominal complaints at the University College HospitaL Ibadan from January 1977 to December 1998 were studied for gall stones in addition to other studies of the abdomen. Only twelve (12) gallstones were found, giving a prevalence of 1.79%. Only 25% were silent stones. The male:female ratio was 1:3. The mean age was 30 years (S.D = 2.8) and peak age was between 30 and 40 years. The average body mass index (B.M.I) was 23.49 kg/m2 (S.D = 3.9). The average parity among the women was four (4). Only one ultrasound was false (false negative). This study shows an increase. In prevalence over previous figures (1.79%) as against 0.007% in the sixties). The peak age is a decade lower and the anthropometric measurements in our patients do not support the typical caucassian model.

Adult↗
PubMed2002

Cholelithiasis in thalassaemia major.

The incidence of gall stones in thalassaemia is less than that in sickle cell anaemia or hereditary spherocytosis. With adequate blood transfusions, the incidence is as low as 2%. There are not many reports on cholelithiasis in thalassaemia. A case of 24-year-old female with thalassaemia major and gall stone is reported here.

Adult↗
PubMed1975

Cholelithiasis--areview of 130 cases.

One hundred and thirty cases of cholelithiasis were studied in the surgical wards of the Institute of Postgraduate Medicine and Research, Dacca. Geographical distribution, pattern of clinical features, results of biochemical, microbiolgical, histopathological and other investigations have been recorded.

Adolescent↗
PubMed2002

[Surgical treatment of cholelithiasis in elderly and aged patients].

Surgical treatment of cholelithiasis in 485 elderly and aged patients operated from 1991 to 2000 are analyzed. Patients with acute inflammation in the biliary tract underwent surgery after standard conservative therapy during 12-48 hours after hospitalization. Methods of completion of surgery on the biliary tract are proposed: treatment of the bile cyst bed after cholecystectomy associated with lesion of hepatic tissue; methods of external and internal drainage of the major bile ducts and drainage of infrahepatic space through loin. Epidural blocking was used as the main component of combined anesthesia. These methods of surgical treatment in elderly and aged patients reduce number of postoperative complications and shorten hospital stay.

Acute Disease↗
PubMed2002

[New aspects of the pathogenesis of cholesterol cholelithiasis].

During the last few years our knowledge of the pathogenesis of cholesterol gallstone disease has dramatically changed. Only a decade ago this topic was considered as already explored and scientifically not very interesting. However, with the progress in the field of lipid metabolism, the views on the aetiopathogenesis of cholelithiasis and particularly on its genetic aspects appear to be revolutionary. The predominant pathogenetic factor turned up to be the biliary cholesterol supersaturation, which is influenced by biliary secretion of the three major components of bile--cholesterol, phospholipids and bile salts. During the last years biliary secretion of these biliary lipids has been studied thoroughly and genetic mechanisms leading to the disorder of the biliary lipids homeostasis have been described. These novel aspects are discussed in the review article presented.

Bile Acids and Salts↗
PubMed2003

[Cholelithiasis in children: a clinical and morphological study].

BACKGROUND: The use of ultrasonography increased the frequency of diagnosis of cholelithiasis in childhood. AIM: To determine the clinical and laboratory features and follow up of children with biliary stones. PATIENTS AND METHODS: Twenty six children (13 male, aged 1 month to 14 years) were prospectively enrolled. RESULTS: Nine children had a past medical history of factors potentially predisposing to stones. A clinical presentation with vomiting (50%), abdominal pain (46%) and jaundice (23%) was the most common indication for surgery. The diagnosis was based on abdominal ultrasound in all children. Cholecystectomy was performed in 15 children (laparoscopy in 13 and open surgery in 2). Children who underwent surgery were older than those who did not undergo surgery (p < 0.001), but they did not have differences in liver function tests. Eight children had pigmented stones and seven had cholesterol stones. CONCLUSIONS: In our patients, neither family history nor laboratory tests were useful in the diagnosis as well as in the clinical decision of surgery, which was based on symptoms. The presence of cholesterol stones in a high proportion of these children may be a unique situation in Chile, considering the high prevalence of this disease in the adult population.

Adolescent↗
PubMed2003

[Biophysical properties of bile and urine in patients with cholelithiasis].

The electric conductivity of the hepatic bile received during and 24 hours after surgery from the drainage introduced into the common hepatic duct was studied in 94 patients with cholelithiasis. It is demonstrated that conductivity increases in cholestasis, inflammatory process in the biliary tract and depends on the hepatic morphofunctional status. The specific electric conductivity of intraoperative bile that is more than 192 S/m is considered to be criteria for the diagnosis of cholangitis. The electric conductivity of urine before and in first 4 days after surgery decreases in inflammation of the biliary tract and depends on the degree of concomitant renal dysfunction and electrolyte disturbances. There was a decrease in the conductivity of bile and urine in all studied groups. Detection of biophysical parameters of biological fluids may objectively control the postoperative period and correct treatment policy.

Bile↗
PubMed2003

[Experience of the 7th Central Military Clinical Aviation Hospital in early diagnostics, treatment, rehabilitation, and expert evaluation of cholelithiasis in flying personnel].

The Seventh Central military clinical aviation hospital is experienced in performing laparocholecystectomy (LCE) in pilots afflicted with cholelithiasis (CL). In the period from 1990 to 2001, 92 operations were carried out after which 80 patients (87%) were permitted to fly. Medical discharge of 12 patients (13%) was associated not with CL but with some morphofunctional shifts caused by concomitant diseases. Seven to five-yr. follow-up of the 80 pilots who had returned their flying status after LCE showed their good tolerance for the flight loads.

Aerospace Medicine↗
PubMed1992

[The use of decompressive endoscopic operations in the complicated course of cholelithiasis].

The article is based on an analysis of observation of 853 patients with complicated forms of cholelithiasis. The average age of patients was 73.5 years, two thirds of them had critical coexistent diseases. The system of treatment proposed by the authors allowed achievement of good results (lethality is less than 5%) while the methods of treatment generally accepted in surgical practice is followed by higher lethality achieving 40%. The work analyzes errors and complications of endoscopic decompressing operations and gives recommendations for their prevention.

Acute Disease↗
PubMed1992

Biochemical assessment of cholelithiasis.

Bile and serum were analysed in 45 cases of cholelithiasis and 25 control subjects for cholesterol, phospholipids, bilirubin, alkaline phosphatase and LCAT activity. Serum phospholipids were found to be elevated in sixty percent of cases, whereas phospholipids in bile were found to be decreased. Serum alkaline phosphatase and alanine aminotransferase were normal. Serum and bile LCAT activity was found to be significantly depressed.

Alanine Transaminase↗
PubMedDate not supplied

[The effect of soy bran on the bile acid spectrum of patients with cholelithiasis].

Thirty females aged 21-57 with cholelithiasis in the physicochemical stage were put on a diet including soya bran. Bile acids were assayed in the duodenal portion B by gas-liquid chromatography. A pre- and posttreatment bile spectrum analysis indicated that before the dietetics chenodeoxycholic acid concentration and mean total of bile acids were markedly lower than control values. The diet enriched with food fibers promoted normalization of the above parameters.

Adult↗
PubMed1992

Studies on intrahepatic cholelithiasis in west China.

Intrahepatic cholelithiasis is widespread in Asia and brings much suffering to the Chinese people. This paper presents a brief sketch of our clinical observations, research and some related views.

Bile Ducts, Intrahepatic↗
PubMedDate not supplied

[A complex x-ray endoscopic study in complicated cholelithiasis].

Recurrent or residual choledocholithiasis was diagnosed in 202 patients with a history of cholecystectomy, in 148 cases this condition was combined with papillostenosis. Transfistula extraction of the concrements and endoscopic papillosphyncterotomy helped achieve cure of 186 (92%) patients without relaparotomy. The authors discuss the role of roentgenology in such combined x-ray and endoscopic diapedetic examinations and emphasize its role in identification of the diagnostic details that are so important for the choice of the optimal treatment strategy. They come to a conclusion that the results of treatment of complicated cholelithiasis by 'minor surgery' means depend not only on the manipulations and skills of the surgeon endoscopist, but on the full-value employment of roentgenology as well.

Adolescent↗