Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Lithiasis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed2006

Extracorporeal renal lithotripsy: evolution of residual lithiasis treated with thiazides.

OBJECTIVES: To analyze the evolution of residual lithiasis after renal extracorporeal shock wave lithotripsy (ESWL) and to show the prolonged efficacy of thiazides in the treatment of residual lithiasis in patients with calcium lithiasis. METHODS: We performed a longitudinal, analytical, 36-month study in 100 patients with residual calcium lithiasis after ESWL randomly distributed into two groups: 50 patients treated with placebo (controls, group 1) and 50 treated with hydrochlorothiazide, 50 mg/24 hr (group 2). All patients in both groups underwent imaging studies (simple radiography of the urinary tract and renal ultrasonography) and a metabolic urinary study. RESULTS: The percentage of global expulsion of lithiasis during the follow-up period was significantly greater (chi-square exponent = 19.938, P = 0.001) in the patients treated with thiazides (72%) than in the control group (36%), although a large number of patients in this group underwent new ESWL sessions. During the follow-up period, we performed ESWL on 42% of the patients in group 1 and 18% of group 2, a statistically significant difference (chi-square exponent = 6.881, P = 0.032). CONCLUSIONS: The results of our study have shown that residual lithiasis progresses in 58% of patients undergoing observation, and new ESWL sessions will be necessary in 42%. We observed a significant relationship between the presence of a urinary lithogenic pattern and the progression of the residual lithiasis. The administration of thiazides stabilizes or reduces the growth of residual lithiasis and favors its spontaneous elimination, thus reducing the need for new sessions of ESWL. This effect of thiazides is highly significant in patients presenting with hypercalciuria.

Adolescent↗
PubMed2002

[Extracorporeal lithotripsy in lumbar ureteral lithiasis. Is the ureteral catheter necessary?].

OBJECTIVES: To evaluate the efficacy of JJ catheter as urinary diversion in the treatment of lumbar ureteral lithiasis by ESWL. METHODS: Results obtained in our ESWL unit between january 1990 and October 2000 are compared. 680 cases of lithiasis are divided into 5 groups for analysis: Group A: Lumbar ureter non obstructive lithiasis. 200 cases. Group B: Lumbar ureter obstructive lithiasis without urinary diversion. 307 cases. Group C: Lumbar ureter obstructive lithiasis with JJ catheter. 90 cases. Group D: Lumbar ureter lithiasis with percutaneous nephrostomy. 32 cases. Group E: Lumbar ureter lithiasis pushed up to renal cavities by JJ catheter. 51 cases. RESULTS: Groups are compared for stone size, number of ESWL sessions and average number of shock waves. Repeated ESWL, complications and success rates are also analyzed. Statistical analysis of these results and its comparison by 2 proportion comparison tests show that groups B and C are homogeneous in size. We analyze these groups for complete success rate, partial success, and fragmentation index; it is derived from this analysis that Group C maintains the same level of fragmentation but not fragment expulsion, being this due to the only difference between groups B and C, which is the JJ catheter. CONCLUSIONS: In our series JJ catheter makes fragment expulsion difficult after treatment of the lumbar ureter lithiasis although it minimises the incidence of renal colic, the most frequent post-ESWL complication.

Humans↗
PubMed1984

[Monohydrate and dihydrate oxalic lithiasis. Calculi, their macroscopic structure (radiographic and therapeutic impact). Calciuria and oxaluria].

Calculi of pure calcium oxalate monohydroxide are hard, polish, dark brown stones, of a very tenuous crystalline structure. On the contrary, calculi of pure bihydroxide oxalate are clear irregular stones with a spiky surface. They are more friable and less hard than monohydroxide oxalate stones. Monohydroxide oxalate stones radiologically are regular and homogeneous, whereas bihydroxide oxalate stones have an irregular aspect. Monohydroxide oxalic lithiasis is less frequent than bihydroxide oxalic lithiasis. The proportion of monohydroxide lithiasis is the same in men and women whereas bihydroxide lithiasis is more frequent in men. Of a biologic point of view, in monohydroxide lithiasis, calciuria and oxaluria are often normal while proportion of hypercalciuria and hyperoxaluria is more important in bihydroxide lithiasis. Evolutivity is clearly inferior in monohydroxide lithiasis than in bihydroxide lithiasis.

Adult↗
PubMed1993

[The relationship between biliary lithiasis and lipoproteins isolated by ultracentrifugation].

BACKGROUND: The prevalence of biliary lithiasis was studied in a sample of rural female population by calculation of the risk factors associated and the correlation between biliary lithiasis and serum lipoprotein concentrations. METHODS: Two hundred forty-nine women between the ages of 20-75 years in whom complete anamnesis and calculation of the Quetelet index (QI) were performed, were the subjects of this study. The investigation of biliary lithiasis was carried out by echography. Serum lipoprotein concentrations were determined by sequential ultracentrifugation. RESULTS: The prevalence of biliary lithiasis in the population studied was of 10.4%. A tendency to increase by age was observed and a peak between 50-60 years of age (p < 0.05) was registered. Biliary lithiasis was more frequent among the obese population (p < 0.05). With respect to lipoprotein parameters, all the lipid values of the different fractions demonstrated to be higher in the lithiasic population, although only the differences in cholesterol vehicled by very low density lipoproteins (C-VLDL) achieved statistical significance) (p < 0.001). CONCLUSIONS: The prevalence of biliary lithiasis in the female population studied is similar to that reported in other Western populations, and an increasing tendency in the prevalence of biliary lithiasis with age and obesity was observed. The levels of C-VLDL are higher in women with biliary lithiasis than in those without.

Adult↗
PubMed1989

[Antilithogenic action of dehydroxymaleic, ketomalonic (mesoxalic) and tartronic acids in relation to experimental lithiasis in rats].

The authors study the effects of three acids, one with four carbon atoms, dihydroxymaleic acid, the two others with three carbon considered atoms, ketomalonic acid and tartronic acid. A first study considered the effects of these products on experimental lithiasis induced by oxalic acid, glyoxylic acid and ethylene-glycol. Dihydroxymaleic acid. Monohydrate calcium oxalate stones can be easily induced in the male rat, with in 24 hours, by an intraperitoneal injection of oxalic acid, at the rate of 8 mg per 100 g of body weight. If 25 mg of dihydroxymaleic acid are injected simultaneously via the intraperitoneal route, to a rat weighing 150 g, the lithiasis observed after 24 hours is just as severe. Experimental monohydrate calcium oxalate lithiasis is also induced by intraperitoneal injection of 8 to 9 mg of glyoxylic acid in a 100 mg rat. Dihydroxymaleic acid, injected at the same time as glyoxylic acid, also via the intraperitoneal route, at the rate of 50 mg for a rat weighing 150 g, results in total suppression of the lithiasis. Dihydroxymaleic acid also prevents lithiasis induced by the absorption by the rat, for several weeks, of a 1% ethylene-glycol solution if it is mixed to this solution at the rate of 5 mg per ml. A 12% ethylene-glycol solution given to the rat at the rate of 0.55 ml for 100 g of body weight induces the next day a comatose state and a diffuse parenchymatous monohydrate calcium oxalate lithiasis: coma and lithiasis are prevented by the simultaneous absorption of dihydroxymaleic acid at the rate of 65 to 70 mg. The ketomalonic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

[2,8-dihydroxyadenine lithiasis. 2 new pediatric cases of this misdiagnosed metabolic abnormality. The value of extracorporeal lithotripsy].

Inherited adenine phosphoribosyltransferase (APRT) has a recessive transmission. When it is very important, adenine can't be restored into nucleic acids pool and will changed into 2,8-dihydroxyadenine (2,8-DHA) by xanthine oxydase. To date in all countries but Japan, 2,8-DHA urolithiasis is observed only into homozygotic subjects with complete APRT deficiency. Commonly, its onset is observed in childhood often dramatically. The authors report two new pediatric cases in two new french families. First a 8 year old boy with spontaneous elimination of two lithiasis after right lumbar pain. Secondly an infant (nineteen months) who has presented an acute renal failure with anuria. Bilateral lithiasis incluted into pyeloureteral junctions have been pulled out by bilateral surgical pyelotomy. In each case, lithiasis were radioluscent and diagnosis made by ultrasonography. The uric acid metabolism was normal and it is the infra red spectrophotometric study of stones that had recogniseed the 2,8-DHA component. In the second case, bilateral residual lithiasis have been broken by piezoelectric extracorporeal lithotrypsy with good tolerance and favorable result. The two children received permanent preventive treatment. After 36 and 19 months they have no recurrence. In the literature, the frequency of 2,8-DHA lithiasis is very more low than the theorical incidence of homozygotics in population (1/100,000). The common confusion with uric lithiasis is one possible explanation. So spectorophotometric study of radioluscent stones was meant to be realised when uric metabolism is not disturbed. Prevention associates alimentary diet without purins and permanent treatment by allopurinol (10 mg/kg/day in a child). Not used to date, piezo-electric extracorporeal lithotrypsy seems to take a place for treatment of initial, residual or recurrent 2,8-DHA lithiasis like for our young patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenine↗
PubMed1984

An epidemiological study of renal lithiasis in gypsies and others in Spain.

A comparative epidemiological study was done on renal lithiasis in gypsies and nongypsies in Eastern Andalucía, Spain. A family history of lithiasis in gypsies was obtained 2 to 3 times less often compared to nongypsies (1.14 versus 4.34 per cent). The male-to-female ratio of gypsies with lithiasis was 0.59 per cent compared to 1.54 per cent in others. The inverse ratio in gypsies contrasted with those obtained by various authors in western countries of white and black populations. There was a predominance of immediate family history of lithiasis in gypsies with stones (p less than 0.001, 11.81 per cent), which was not observed among nongypsies (p equals 0.80). The incidence of consanguineous marriage among gypsies was high (26.95 per cent) compared to others (4.07 per cent). There was a dependent relationship in gypsies between family history of lithiasis and consumption of meat products (p equals 0.001), dairy products and food rich in oxalic acid (p equals 0.05). In nongypsies these differences were less significant statistically and were nonexistent in the incidence of consumption of food containing oxalic acid. We ascribe the difference in the incidence of lithiasis between gypsies and other subjects principally to hereditary and dietary factors.

Adolescent↗
PubMed2005

[Endoscopic treatment of pielo-uretheral lithiasis with Holmium-YAG laser. Two years of experience].

OBJECTIVE: To show the efficiency and safety of Holmium laser in the treatment of pyeloureteral lithiasis, based on our own experience since the introduction of this source of energy in our department. MATERIAL AND METHODS: From January 2002 to February 2004, we have carried out 198 ureterorenoscopies using Holmium laser to treat lithiasis located in the upper urinary tract. In all cases, a previous radiological study demonstrated the stone. Follow-up, where the efficacy of the treatment was assessed, was done with a scout x-ray after 3-4 weeks. We evaluated the localization and features of the lithiasis, technical aspects, results and complications of our series. RESULTS: The most common localization of the lithiasis was the pelvic ureter (59%), with the number of treated cases in both the iliac and lumbar ureter being similar (16%). 70% of the lithiasis had a size between 0.5 and 1.5 cm, and 15% showed a diameter bigger than 1.5 cm. In 61.8% of cases, laser lithotripsy was carried out under spinal anaesthesia, being the average of the pulses used 2532 (confidence interval 95%), using a working power of 1 J in all cases. The overall efficacy of the procedure in terms of size and localization was 95.5%. The complication rate was scarce (2.19%). CONCLUSIONS: Holmium laser lithotripsy is a very effective and safe procedure since in our experience it is 95.5% efficient for pyeloureteral lithiasis treatment and has a low rate of complications.

Adult↗
PubMedDate not supplied

[Bone abnormalities. Muscular dystrophy and lithiasis: lithogenic factors and therapeutic difficulties].

UNLABELLED: Duchenne's muscular dystrophy with kypho-scoliosis, progressive muscle weakness and abnormal fatigue of the muscles results in an immobilisation syndrome with increased bone resorption and hypercalciuria. The accompanying chest deformity alters the respiratory capacity, causing pulmonary insufficiency, acidosis and acid urine. Dorso-lumbar kypho-scoliosis, occasionally very serious, alters the status of the upper urinary tract affecting urine transportation (stasis). Thus, hypercalciuria, urinary acidosis, stasis and infection will determine the formation of urinary lithiasis that can take place in these patients. MATERIAL AND METHODS: 15 patients with a variety of myopathies (Duchenne's disease, Myasthenia gravis,...) or serious skeletal deformities with metabolic renal lithiasis (pyelic or calyceal) were seen by our group. Other patients presented post-traumatic (paraplegia, hemiplegia,...) or poliomyelitic skeletal sequels or Pott's disease, with septic lithiasis. After evaluating all likely approaches including ESWL, the latter was chosen being the least aggressive. Conventional surgery, either percutaneous or endoscopic, foretells technical problems in terms of lithiasis approach. Both the case introducing the subject, Duchenne's muscular dystrophy, with bilateral renal lithiasis and the others are a reflection of complexity of finding the righ approach for these patients, including ESWL. RESULTS: Scoliosis was not a technical obstacle, since patients could be placed in lateral/oblique position to situate the stone in the right spot for lithotrity. Debris removal was easy, with no obstructive complications, in spite of the significant immobilisation of these patients. CONCLUSION: Immobilisation syndrome, acidosis, stasis and infection could jointly determine the lithogenesis mechanism in patients with muscle diseases or serious skeletal deformities and with renal lithiasis. ESWL has an opportunity in serious cases, where other techniques including surgery have major difficulties.

Adult↗
PubMedDate not supplied

[Study of the physical-chemical factors in patients with renal lithiasis].

OBJECTIVES: Urinary lithiasis has a multifactorial origin with participation of physical, chemical and anatomical factors. Physical-chemical factors of renal-prerenal origin are the consequence of exogenous or endogenous agents, which are integrated under the name of systemic diseases associated with urinary lithiasis. The objective of the urinary metabolic study is to know and to analyze the physical-chemical factors by which each of these diseases or clinical entities participate in the lithogenesis. METHODS: We performed a study on 320 cases distributed in two groups: Group A: 70 healthy subjects without past medical history or family history of urinary lithiasis. Group B: 250 patients with history of renal lithiasis who had passed calculi spontaneously, after extracorporeal shock wave lithotripsy or surgery. Computerized urinary metabolic study (EMUSYS) was performed in all cases. RESULTS: 24% of the patients in the control group presented one metabolic abnormality and 52% more than one; in group B, 17% of the patients presented one metabolic abnormality and 81% more than one. There were statistically significant differences in the percentage of hyperoxaluria, hipocitraturias and hyperalciurias. There were no differences in the subtypes of type III absorptive and excretory-resorptive hyperalciuria, hipomagnesiuria, and tubular acidosis, but these abnormalities were not detected in the control group. Moreover, some abnormalities were frequently observed in the control group, similarly to the patients group: enterorenal hyperuricosuria 34%, calcium supersaturation 13%, elevated excretion of sodium chloride 14%, type II absorptive hyperalciuria 8%, alimentary abnormalities, and low diuresis. CONCLUSIONS: People without lithiasis present biochemical urinary abnormalities in relation with life and alimentary habits similar to those found in patients, what concedes a role to the anatomical and hydrodynamical factors in lithogenesis. Patients with lithiasis present biochemical abnormalities such as calcium supersaturation, type II absorptive hyperalciuria, marginal absorptive hyperuricosuria, enterorenal hyperuricosuria, deficit of inhibitors, which may be controlled with adequate diet. Non dietetic hyperalciurias and hyperoxalurias, abnormalities of the urinary pH, and endogenous hyperuricosuria may be subject of diagnosis and treatment.

Adolescent↗
PubMedDate not supplied

[Percutaneous treatment of intrahepatic lithiasis].

AIM: To present our experience with percutaneous intracorporeal electrohydrolic lithotripsy in the treatment of intrahepatic lithiasis. SUBJECTS AND METHODS: From January 1989 to November 1998, 53 patients with intrahepatic lithiasis were treated with percutaneous intracorporeal electrohydrolic lithotripsy. Twenty-six patients had primary intrahepatic lithiasis. Intrahepatic stones were associated with intrahepatic duct abnormalities in 11 patients, 9 had strictures and 2 had cystic dilatations. Twenty-seven patients had secondary intrahepatic lithiasis formed a biliodigestive bypass in 20 patients. Intracorporeal electrohydrolic lithotripsy was performed under cholangioscopic guidance in all patients. The endoscope was introduced into the biliary ducts through a cutaneobiliary tract in 51 patients, through a cutaneocholecystic tract in one and through a cutaneojejunal tract in one. These tracts were created and gradually dilated in two sessions three days apart. In twenty-two patients stenosis or sharp angulation prevented adequate positioning of the scope which was only successful after balloon dilation or insertion of a stiff wire. RESULTS: Complete clearance of stones was achieved in 49 patients (92%). Biliary or hepaticojejunostomy strictures were successfully dilated with an angioplasty balloon in all patients. Ten patients (19%) had early complications: four had bilomas treated by percutaneous drainage, three had resolutive onset of cholangitis, two had transient arterial hemobilia, and one had a pneumothorax. The mean duration of follow-up was five years. During this period, 5 patients (9%) had recurrent symptoms of biliary obstruction. Among these patients, three (5.7%) had recurrent symptomatic intrahepatic lithiasis, one had a recurrent biliary stricture and one had secondary sclerosing cholangitis. Treatment of recurrent stones was repeated intracorporeal electrohydrolic lithotripsy in two and left hepatectomy in one; recurrent biliary stricture was treated by hepaticojejunostomy and secondary sclerosing cholangitis by antibiotics. CONCLUSION: Intracorporeal electrohydrolic lithotripsy is effective and safe and should be proposed as the first line treatment of primary or secondary intrahepatic lithiasis.

Adult↗
PubMedDate not supplied

[Extracorporeal shock-wave lithotripsy as treatment of lithiasis in horseshoe kidney].

OBJECTIVES: Horseshoe kidney is the most frequent renal congenital anomaly, with an estimated general population prevalence of 1/400-500. This entity may be asymptomatic for the entire lifetime, or produce symptoms from associated complications such as lithiasis, hydronephrosis, or recurrent infections. The incidence of lithiasis varies between 20% and 80% of the patients. The treatment of lithiasis in this entity is controversial due to problems derived from the anatomy of the kidney and its drainage when stones are treated with external shock wave lithotripsy (ESWL). We tried to evaluate the efficacy of ESWL treatment and to establish the ideal conditions in which this technique may be considered treatment of choice. METHODS & RESULTS: A total of 25 patients were evaluated (17 males and 8 females). Patient age ranged from 8 to 75 year old. Three patients presented with bilateral lithiasis. 27 renal units were treated, 18 of which were left (66.7%) and 7 right. Stone size was measured in cm2 of surface. Lithiasis was located at the renal pelvis in 13 cases (48.1%), and lower calyx in 7 (25.9%). Four patients required JJ stent insertion. Mean number of shock waves per session was 3480 (range 1000-4000). Two Shock wave generators were used for treatment, the Dornier lithotripter S and the Dornier MFL-5000, with a range of 10-120 KV for the first one and 14-23 KV for the second. Follow up KUB X-rays were performed at 3, 6 and 12 months to evaluate fragmentation and elimination rates. In our series total fragmentation was 85.2%, and partial fragmentation (fragments > 6 mm) 14.8%. Elimination rates were satisfactory with 37.4% total elimination, and 48.1% partial elimination (Fragments < 6 mm). 14.8% of the patients had no elimination at all. CONCLUSIONS: We consider ESWL the first therapeutic option for cases of lithiasis with a mean area 4 cm2 or less and pelvic location. In case of great lithiasic areas other therapeutic options should be considered (open surgery or percutaneous nephrolithotomy) either in monotherapy or complementary to ESWL.

Adolescent↗
PubMed2003

[Soft lithiasis ("mous")].

OBJECTIVES: To describe the most relevant features of matrix lithiasis, an infrequent type of lithiasis seldom reported since the generalization of extracorporeal shock wave lithotripsy. METHODS: We report a clinical case and analyze the most important bibliography found by MEDLINE search (1950-1999). We will focus on the physiopathology and etiology of these stones to understand its development and the clinical presentation showed by these patients. RESULTS: Matrix lithiasis is a very rare entity, described almost one century ago. It is mainly composed of lithiasis matrix, and the percentage of mineral content is really low in comparison with usual stones. Persistent urinary tract infection is another constant in these patients, which to some extent conditions the modification of the usual urinary components, creating a series of the disturbances within the urinary tract that favour the aggregation of the components of the lithiasis matrix up to the formation of a stone, without need of aggregation of mineralized crystals. CONCLUSIONS: A high degree of suspicion is necessary for the diagnosis of matrix lithiasis, because it does not show the usual clinical picture of a renal stone. Exhaustive lavage of caliceal cavities and elimination of bacteriuria are essential elements for treatment, in order to avoid recurrence of the disease.

Female↗
PubMed2001

[Bladder lithiasis].

OBJECTIVE: to study the particularities of the bladder lithiasis in our countries. This was a retrospective study of 94 cases (62 men and 32 women) of bladder lithiasis over a period of 13 years. The lithogenic factors; clinic, paraclinic and therapeutic aspects have been studied. Morphoconstitutional analysis has been carded out in collaboration with Cristal Laboratory (St Cloud hospital center in France). RESULTS: mean age was 24.2+/-20.7 years old. The principals mains of consultation were: dysuria (n =36), mictionnal pain (n = 28), hematuria (n = 15). Facilitating factors have been found in 27% of cases. In 10 cases, there was an association bladdder lithiasis and bladdder-vaginal fistula. Radiologic test was dominated by intraveinous urographic (53.19 of cases). The metabolic test showed hypercalcemia and cristalluria in 2 cases. In 7,45 % of cases, we have founding a renal failure. An urinary tract infection have been noticed in 42 % of cases. Open surgery has been the main treatement (96 %) associating in 15 % of cases the treatement of an uropathy. In one case the bladder lithiasis weighed 1120 g. The morphologic and spectrophotometric analysis of the lithiasis have been achieved in 13 % of cases showing the predominance of struvite. CONCLUSION: the bladder lithiasis is still common in our countries; it could be good for us to access endoorporeals and extracorporeals therapeutic equipements in orderto reduce the indications of open surgery.

Adolescent↗
PubMed1990

[2,8-dihydroxyadenine lithiasis. 2 new pediatric cases of an unknown metabolic deficit. The use of extracorporal lithotripsy].

Inherited adenine phosphoribosyltransferase (APRT) has a recessive transmission. When it is very important, adenine can't be restored into nucleic acids pool and will changed into 2,8-dihydroxyadenine (2,8-DHA) by xanthine oxidase. To date in all countries but Japan, 2,8-DHA urolithiasis is observed only into homozygotic subjects with complete APRT deficiency Commonly, its onset is observed in childhood often dramatically. The authors report two new pediatric cases into new french families. First a 8 years old boy with spontaneous elimination of two lithiasis after right lumbar pain. Secondly an infant (nineteen months) who has presented an acute renal failure with anuria. Bilateral lithiasis included into pyelourectal junctions have been pulled out by bilateral surgical pyelotomy. In each case, lithiasis were radiolucent and diagnosis made by ultrasonography. The uric acid metabolism was normal and it is the infra red spectrophotometric study of stones that had recognised the 2,8-DHA component. In the second case, bilateral residual lithiasis have been broken by piezoelectric extra-corporeal lithotripsy with good tolerance and favorable result. The two children received preventive treatment. After 36 and 19 months they have no recurrence. In the literature, the frequency of 2,8-DHA lithiasis is very more low than the theoretical of homozygotics in population (1/100,000). The common confusion with uric lithiasis is one possible explanation. So spectrophotometric study of radiolucent stones was meant to be realised when uric metabolism is not disturbed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenine↗
PubMed1980

[Effect of chenodeoxycholic acid in cholesterol lithiasis].

Chenodesoxycholic acid (CDCA) was administered to 60 patients with radiolucent lithiasis and also to 2 patients with functioning gallbladder and radiopaque stone. The lithiasis disappeared completely in 27 patients while in 14 patients there was a decrease in the size of the stones from 30 to 70% as compared to the size of the previous ones. Treatment was successful in about 68,33% of cases. Only one patient had severe diarrhea which led to interruption of treatment. A transient increase of SGOT and SGPT was observed in 7 patients (11,29%) and there was an increase of GT in 4 patients (6,45%). These enzymes returned to normal with no change of treatment. 48 patients had hepatic biopsy before and during treatment, but no histologic abnormalities were found. Two patients were operated upon at 9 and 17 months after starting treatment due to bile-pancreatic crisis. Of the 27 patients who had complete remission of lithiasis, 12 of them were given 500 mg/day CDCA and another twelve 500 mg every other day. None of the two groups revealed recurrence of lithiasis. Two of the patients who were given only 500 mg twice a week revealed multiple small-sized lithiasis 7 and 9 months after dissolution. A patient who had interrupted treatment completely revealed a recurrence of lithiasis after 10 months.

Adult↗
PubMedDate not supplied

[Details of diagnosis and surgical treatment in terminal choledochal lithiasis].

Lithiasis of the terminal choledocus raises problems of pre- and intraoperative diagnosis, especially when the evolution is complicated by sclero-inflammatory of the Oddi, chronic pancreatitis, or acute pancreatitis, or with angiocholitis and hepato-renal failure. The high frequency of the lithiasis of the terminal choledocus (37.72% of all cases of biliary lithiasis) makes necessary an improvement of the methods used for the exploration, and evacuation of this type of lithiasis, and for the recovery of the biliary flow. The clinical syndrome in this biliary lithiasis was predominantly of the painful type (in 20.63% of the patients), of the icteric type (58.75%), of the angiocholitic type (8.75%), or it was dominated by pancreatitis (5.95%) or peritonitis (3.06%). In the 126 cases of lithiasis of the terminal choledocus the authors have applied the following procedures: external biliary drainage (50 cases with one death), choledochduodenostomy (42 cases with 4 deaths), papillosplincterotomy of the Oddi (34 cases with 6 deaths). The high postoperative death rate (8.75%) may be related to the fact that surgery was performed in late stages in patients aged over 50 years, with severe anatomoclinical forms (icterocholangitis), with increased anesthetic and surgical risks, as well as that of postoperative complications.

Adolescent↗
PubMedDate not supplied

[Cystine-lysinuric lithiasis].

Cistin-lisinuria is not a unfrequent etiology of lithiasis in children. Six patients have been studied as well as their families, being a total of 45 patients. Lithiasis was present in ten of our patients, and hyperaminoaciduria, without lithiasis in ten, affecting in both cases (with or without litiasis) either all the four amynoacide (cystine, lysine, arginine and ornithine) or only one or two of them. Authors have not found any correlation between clearance of cystine and the presence or absence of lithiasis; on the other hand the best index to correlate the presence of lithiasis is to reach a value, equal or superior to 300 mgr of cystine excreted in the urine per 1 gr of creatinine excreted in urine. The correct treatment in cystinuric patients with lithiasis is to alcalize the urine maintaining a constant urinary pH between 7-8, giving a sufficient dose of sodium bicarbonate per os. In case of resistance to this treatment or if a great calculi is present, D-penicillamine would be an efficient treatment to disolve the calculi. These treatment when carried out under analytical control presents no problems or complications in their experience.

Adolescent↗