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Results for “CHOLELITHIASIS”

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PubMed1980

[Cholelithiasis in a previously not described case of congenital erythropoietic porphyria (author's transl)].

The signs of congenital erythropoietic porphyria (Günther) had their onset at the age of two in a male patient born in 1934: there were blisters and scars after exposure to sunlight, red urine, marked cutaneous pigmentation, acral mutilation, lanugo and erythrodontia. Porphyrin levels in red blood cells and urine confirmed the diagnosis. Splenectomy was performed in 1966 for hypersplenism and haemolysis. No transfusion has been necessary since and the haemolysis has completely disappeared, but signs of ineffective erythropoiesis have continued. Cholecystectomy with choledochal revision was performed because of right upper abdominal colics, fever and biliary stasis in 1977: five partly pigmented, partly mixed gall-stones were removed. The latter had a black, friable centre with high porphyrin content and a cholesterol coating. Thus, as in other chronic haemolyses, pigmented gall-stones may also occur in congenital erythropoetic porphyria.

Adult↗
PubMed2002

Delay of diagnosis in pancreatic cancer due to suspected symptomatic cholelithiasis.

BACKGROUND: A single centre study was conducted to examine the frequency of cholecystectomies, both open and laparoscopic, up to 2 years prior to the diagnosis of pancreatic cancer. In particular, it was of interest to investigate whether there is a diagnostic delay in a significant number of pancreatic cancer patients and if these patients already have symptoms or findings at the time of cholecystectomy that might have been indicative of the underlying malignant disease. METHODS: It is demonstrated that 17 out of 186 pancreatic cancer patients (9%) underwent a cholecystectomy within the 2 years prior to cancer diagnosis. RESULTS: A significant number of these patients showed a considerable weight loss at the time of the cholecystectomy. It is hypothesized that symptoms which led to cholecystectomies in these patients were most likely related to the pancreatic cancer. Owing to the resulting delay of pancreatic cancer diagnosis the resection rate with curative intent decreases to 35% from 44% in the whole series. CONCLUSION: Patients suffering from cholecystolithiasis and showing atypical symptoms or other notable findings such as considerable weight loss might be assessed in more detail pre- as well as postoperatively in order to minimize the diagnostic delay in pancreatic cancer and to avoid unnecessary operations.

Adenocarcinoma↗
PubMed2004

Endoscopic ultrasonography in detection of cholelithiasis in patients with biliary pain and negative transabdominal ultrasonography.

BACKGROUND: The aim of the study was to evaluate endoscopic ultrasonography (EUS) as a single method for diagnosing cholecystolithiasis in patients with a clinical suspicion of cholecystolithiasis, but with a normal transabdominal ultrasonography (TUS). METHODS: A prospective study was performed on patients with biliary type of colic and normal US of the gallbladder. All patients had at least one normal TUS examination (mean 2.1, range 1-5) performed by an experienced radiologist. All patients were subsequently examined with EUS. EUS examination was performed with either a mechanical radial scanning echo-endoscope (Olympus GF-UM20) or a linear echo-endoscope (Pentax FG32-UA or FG34-UA). Patients in whom EUS demonstrated cholecystolithiasis were offered laparoscopic cholecystectomy within 2 weeks. RESULTS: A total of 35 patients (31 F and 4 M) were included. In 18 out of 35 (52.4%) patients cholecystolithiasis was diagnosed by EUS. In 15 out of 17 patients the EUS diagnosis was verified by surgery. At follow-up after 12 months, 13 of the 15 patients (87%) with verified gallbladder stones had no abdominal discomfort, whereas 2 patients (13%) complained of persistent and unchanged abdominal pain. CONCLUSION: EUS seems to be a promising imaging method in the detection of microlithiasis in the gallbladder in patients with clear biliary colic and normal transabdominal US.

Abdomen↗
PubMed1995

Epidemiology of gallstone disease in Italy: prevalence data of the Multicenter Italian Study on Cholelithiasis (M.I.COL.)

This study was designed to obtain a general overview of gallstone disease in Italy. A total of 18 cohorts in 10 Italian regions were enrolled in this survey. Four cohorts were excluded from analysis because of a participation rate of less than 50 percent. Field activities started in December 1984 and terminated in April 1987. A precoded questionnaire was administered to each subject by a trained member of the medical staff. Participants underwent an ultrasonographic examination of the upper abdomen and blood sampling. Each research group was provided with an identical ultrasonographic machine. Standardized criteria were established for both the examination and diagnosis. The inter- and intraobserver variation in the ultrasonographic procedure was assessed using a reliability study. The overall kappa score for interobserver agreement was good (0.649), while intraobserver agreement was good or excellent (kappa scores > 0.60) in 75 percent of the observers. A total of 29,739 of the 46,139 (64.4 percent) enrolled subjects were examined. Among those with a clear-cut definition of the gallbladder status, 6.5 percent of the males and 10.5 percent of the females had gallstones. Additional 3.0 and 8.4 percents, respectively, had already undergone cholecystectomy. Prevalence of gallstone disease (gallstones plus cholecystectomy) increased linearly with age in both sexes. Among subjects with gallstones, 76.7 percent of men and 72 percent of women were not aware of having gallstones; 87.0 percent of men and 84.9 percent of women were asymptomatic. This study confirms that gallstone disease is a highly prevalent condition. Gallstones rarely cause symptoms, and subjects are mostly unaware of their presence.

Adult↗
PubMedDate not supplied

Cholelithiasis in sickle cell anemia: a case for elective cholecystectomy.

Ten patients with sickle cell anemia over the age of 10 who had cholecystectomy are reported. All had symptomatic cholecystitis; three had biliary tract obstruction. Transfusions were given preoperatively and with attention to oxygenation and fluid and electrolyte balance. There were few complications, none serious. Based upon the frequency of gallstones over the age of 10, the likelihood of symptoms or serious complications and the apparent ease with which the properly prepared sickle cell patient comes through surgery, we recommend routine cholecystograms in all adolescent and adult sickle cell anemia patients with elective cholecystectomy for those who have stones.

Adult↗