Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Calculi”

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 127 records · Page 7Linked to original sources
PubMedDate not supplied

[Management of staghorn calculi].

OBJECTIVES: More than 200 articles about treatment of staghorn calculi have been published over the last 15 years; we observe a progressive tendency to the elective indication of a combination of therapeutic methods. Recent development of flexible ureteroscopy and endoscopical holmium-YAG laser lithotripsy has prompted the application of a new method of combined treatment for staghorn calculi: retrograde ureteroscopy and external shock wave lithotripsy. The objective of this work is to analyze indications and results of various therapeutic methods in relation to staghorn calculi complexity. METHODS AND RESULTS: We analyze the results of open surgery, extracorporeal shock wave lithotripsy, percutaneous nephrostomy and retrograde ureteroscopy in the treatment of staghorn calculi Group 1 (soft calculi < 700 mm2 of area and homogeneous pyelocalyceal distribution), Group 2 (calculi < 700 mm2 hard or with predominantly central pyelocalyceal distribution, wide infundibula and calyces with few branches), Group 3 (calculi > 700 mm2 with predominantly central or homogeneous distribution, absence of infundibular stenosis or excluded calyces) and Group 4 (great lithiasic mass predominantly homogeneous or peripheral, narrow infundibula or multiple infundibular stenosis and/or lithiasis within excluded calyces). CONCLUSIONS: In Group 1 staghorn calculi ESWL (JJ catheter + ESWL) has good results in 62.5% - 72.5% of the patients after an average of 3.2-3.6 sessions. The combination of contact lithotripsy by retrograde ureteroscopy and ESWL may be a therapeutic alternative. In group 2, percutaneous renal surgery may be considered the technique of choice; persisting residual fragments are treated by ESWL. Group 3 calculi are indication for combined therapy, percutaneous renal surgery and ESWL. ESWL therapy only is not indicated; open surgery through a sinus approach combined with intraoperative pyelocalyceal nephroscopy may be considered an option. Open surgery is recommended for Group 4 calculi--sinus approach is preferred--with mechanical extraction of caliceal fragments and/or pyelocalyceal nephroscopy support.

Clinical Trials as Topic↗
PubMed1988

Chronological variation in chemical composition of urinary calculi between 1965-68 and 1982-86 in north western India.

The chemical composition of 210 urinary calculi either spontaneously passed or surgically removed during January 1965-December 1968 was compared with the chemical composition of 1338 urinary calculi received during July 1982-June 86. The proportion of vesical calculi had significantly decreased from 30.48% (n = 64) during 1965-68 to 8.37% (n = 112), during 1982-86 (p less than 0.001). During 1965-68, magnesium was present in 16%, ammonium in 31% and urate in 33% of vesical calculi. But during 1982-86, the percentage of vesical calculi containing magnesium and ammonium was nil (p less than 0.001), but 76.8% of vesical calculi contained urate (p less than 0.001). Similarly, during 1965-68, 35.6% of renal calculi containing magnesium, 20% contained ammonium, 13.6% contained carbonate and urate was present in 32.2% of renal calculi. In contrast during 1982-86, magnesium was detected in only 0.24% of renal calculi (p less than 0.001), ammonium in 0.16% (p less than 0.001) and carbonate in 3.9% (p less than 0.001) but 57.4% of renal calculi contained urate (p less than 0.001).

Adolescent↗
PubMed1998

Treatment of biliary calculi using holmium: yttrium aluminum garnet laser.

BACKGROUND: The holmium: yttrium aluminum garnet laser (Ho: YAG) has been shown to be effective and safe for the treatment of urinary calculi. Its effectiveness for the treatment of biliary calculi was investigated. METHODS: Endoscopic Ho: YAG lithotripsy of biliary stones was performed 7 times in 4 patients. Two patients had biliary duct calculi, and the other two patients had gall bladder calculi. All patients had multiple calculi that ranged in size from 4 mm to 5 cm. All procedures were performed percutaneously under intravenous sedation and local anesthesia. Rigid and flexible endoscopes were used to access the biliary calculi. Postoperative cholangiograms were performed on all patients. RESULTS: All calculi were successfully fragmented with the Ho: YAG laser. The most common settings on the laser were 1.0 J and 10 Hz. Average total laser energy used was 12.24 kJ. Two patients required multiple procedures for the resolution of the biliary calculi. No vascular or biliary injuries were encountered. Three patients were free of biliary calculi on their postoperative cholangiogram. One patient with multiple gallbladder stones refused further treatment after two percutaneous procedures. CONCLUSION: The holmium: yttrium aluminum garnet laser can be used safely and effectively in the endoscopic treatment of biliary calculi. This treatment maybe a suitable option in patients who are not candidates for more invasive procedures.

Adult↗
PubMed2005

[The treatment choice of solitary kidney complicated with complex calculi report of 42 cases].

OBJECTIVE: To investigate the therapeutics of complex calculi in solitary kidney, and to improve the effect and safety of treatment. METHODS: Experiences in the treatment of 42 patients were summarized. All patients were with mould or multiple calculi, 8 cases were complicated with ureter calculi, and 6 cases were hospitalized because of obstructive anuria. The patients with mould calculi received extracorporal shock wave lithotripsy (ESWL) prior to percutaneous nephrolithotomy (PCNL). While the patients with multiple calculi received PCNL prior to ESWL. Some cases were treated by lithotripsy. RESULTS: Thirty-six cases (86%) were cured by ESWL combined with PCNL. Eleven cases received lithotripsy during PCNL. The 6 cases with obstructive anuria recovered in 12 hours after emergent ESWL or lithotripsy; 6 cases (14%) underwent open operation because of deformity or obstruction in renal pelvis and ureter; 2 cases have to keep nephrostomy because of repeated infection. Followed up 6-18 months, 38 cases (86%) keep good kidney function; 5 cases (14%) had renal insufficiency; 4 cases (11%) reoccurred calculi. CONCLUSIONS: The therapeutics of ESWL combined with PCNL may clear complex calculi of solitary kidney effectively and safe. It is necessary to take emergent ESWL in renal obstructive calculi cases. And the patients with lower ureter obstructive calculi may take lithotripsy first. It is proper to choose open operation on the patients with deformity of renal pelvis or obstruction of ureter.

Adult↗
PubMed2006

Factors affecting the success rate of extracorporeal shock wave lithotripsy for renal calculi in children.

The aim of the study was to analyse factors affecting the success rate of extracorporeal shock wave lithotripsy (ESWL) in children with renal calculi. We performed a retrospective analysis reviewing records of 85 (40 female, 45 male) children (89 renal units) subjected to ESWL for treatment of renal calculi during 1990-2005 in our department. As 4 patients had bilateral calculi and 19 children (21 renal units) had renal stones at more than one different site, each location was analysed separately for convenience. The mean age of the patients was 10.3+/-4.6 (2-16) years. The stone-free rates for renal pelvis, lower, middle and upper caliceal calculi were 70, 62, 50 and 73%, respectively. A higher rate (33%) of insignificant fragments (< or = 4 mm) was noted for lower pole calculi. Increased stone diameter (P=0.0001) and burden (P=0.04) were found as the most significant factors that adversely affect the stone-free rate for pelvis renalis calculi, whereas an acutely oriented infundibulum and/or a long lower infundibulum (P=0.005) were unfavourable factors for clearance of lower caliceal stones. The stone-free rate in children with multiple calculi was 48%, while 29% of the renal units had retained fragments. ESWL is a good initial option for treatment of most of the renal calculi < 2 cm except in the presence of unfavourable lower caliceal anatomy. Increased stone burden, multiple stones, staghorn calculi, narrow lower infundibulopelvic angle and long lower infundibulum are factors that adversely affect the clearance rate.

Adolescent↗
PubMed1996

Urethral calculi in children.

Sixty patients diagnosed to have urethral calculi in Diyarbakir State Hospital Department of Pediatric Surgery were evaluated retrospectively to determine factors influencing the clinical picture and treatment. All the patients were boys. Pain in the penis and retracting of the penis by the patient himself were most common symptoms. The patients with posterior urethral calculi had continuous urinary dribbling, and those with anterior urethral calculi had acute urinary retention. At the time of initial admittance, the calculi were posterior urethral in 10 cases, bulbous in 13, penile in 20, and external urethral meatal in 17. The 10 calculi located in the posterior urethra and four located in the bulbous urethra were manipulated retrogradely into the bladder. Forty-two calculi were extracted through the external urethral meatus. However, a calculus required urethrotomy, and other calculi required extraction trough a urethracutaneous fistula. The mode of clinical presentation and treatment in children with urinary calculi depends on localization. Localization is determined by the shape and diameter of the calculi.

Adolescent↗
PubMed1988

A modified algorithm for the management of ureteral calculi: 100 consecutive cases.

We treated 100 consecutive ureteral calculi requiring intervention with a previously described algorithm. There were 16 ureteropelvic junction, and 18 upper, 22 mid and 44 lower ureteral calculi. Treatment was by a stent and extracorporeal shock wave lithotripsy in 10 ureteropelvic junction, 10 upper ureteral and 3 mid ureteral calculi, ureteroscopy and extracorporeal shock wave lithotripsy in 6 upper and 6 mid ureteral calculi, and ureteroscopy alone in 5 ureteropelvic junction, 2 upper and 12 mid ureteral calculi. All 44 lower ureteral calculi were treated successfully by ureteroscopy. Of the 100 patients studied 98 were treated by endourological methods (extracorporeal shock wave lithotripsy or ureteroscopy), while 2 required an operation (1 with a ureteropelvic junction calculus and 1 with a mid ureteral calculus). Over-all, 100 patients required a total of 125 procedures to accomplish successful stone removal. An algorithm is developed in which lower ureteral calculi are treated by ureteroscopy, mid ureteral calculi (large and dense) by stent bypass and extracorporeal shock wave lithotripsy or (lucent and fragile) by ureteroscopy, upper ureteral calculi by stent bypass and extracorporeal shock wave lithotripsy without manipulation, and impacted ureteral stones initially by ureteroscopy and, if necessary, then by extracorporeal shock wave lithotripsy.

Algorithms↗
PubMed1995

A clinical study of upper urinary tract calculi treated with extracorporeal shock wave lithotripsy: association with bacteriuria before treatment.

To study the characteristics of upper urinary tract calculi associated with bacteriuria, we determined the relationships between the frequency of bacteriuria and some clinical factors such as location and size of calculi. Nine hundred and fifty-eight patients, 596 with renal calculi and 362 with ureteral calculi, were subjects in the present study. Bacteriuria was found in 75 patients, 57 with renal calculi (10%) and 18 with ureteral calculi (5%). The frequency of bacteriuria was significantly higher in patients with renal calculi than in those with ureteral stones (p < 0.05). In the patients with renal calculi, bacteriuria was most frequently associated with stones having a diameter of > 30 mm (19%), and secondarily with stones of 20-30 mm (12%). In contrast, the presence of bacteriuria was not related to the size of ureteral calculi. In conclusion, patients with renal stones of > 20 mm diameter have an increased risk of bacteriuria.

Adolescent↗
PubMed2000

Sensitivity of CT scout radiography and abdominal radiography for revealing ureteral calculi on helical CT: implications for radiologic follow-up.

OBJECTIVE: We compared the sensitivity of CT scout radiography with that of abdominal radiography in revealing ureteral calculi on unenhanced helical CT. MATERIALS AND METHODS: Over a 6-month period, patients presenting to the emergency department with acute flank pain were examined with standard abdominal radiography and unenhanced helical CT, which included CT scout radiography. In 60 patients in whom a diagnosis of ureteral calculus was made, CT scout radiographs and abdominal radiographs were examined by two interpreters who assessed whether stones could be visualized. All CT scout radiographs were viewed on a workstation using optimized window settings. RESULTS: CT scout radiography and abdominal radiography revealed 28 (47%) and 36 (60%) of 60 ureteral calculi, respectively. All ureteral calculi that appeared on CT scout radiography also appeared on abdominal radiography. However, eight calculi that were visible on abdominal radiography were not visible on CT scout radiography. CT scout radiography and abdominal radiography revealed 28% and 46% of 39 calculi less than or equal to 3 mm in diameter, respectively. For 21 calculi larger than 3 mm, the sensitivity of CT scout radiography and abdominal radiography was 81% and 86%, respectively. CONCLUSION: Abdominal radiography is more sensitive than CT scout radiography in revealing ureteral calculi; however, some calculi revealed on unenhanced helical CT cannot be seen on either abdominal radiography or CT scout radiography. Ureteral calculi not visible on either study can only be followed, when necessary, with unenhanced helical CT.

Adult↗
PubMed2002

[Treatment of 2019 cases with upper urinary tract calculi using a piezoelectric lithotriptor ESL-500A].

PURPOSE: We evaluated the results of extracorporeal shock wave lithotripsy (ESWL) in a large number of cases with upper urinary tract calculi, and reported the strategy how to improve the efficacy and safety of ESWL. PATIENTS AND METHOD: Eight hundred fifteen patients with renal calculi and 1,204 patients with ureteral calculi were treated using a piezoelectric ultrasound-guided lithotriptor, Toshiba ESL-500A. Auxiliary measures were needed in 51 cases (2.5%) and 1,968 cases (97.5%) were treated by in situ procedures. ESWL was performed with the optimal positioning of the patient and under the continuous monitoring by ultrasound system. The visibility of stones was improved by removal of abdominal gas and administration of diuretic agent to dilate the ureter. Cases with urinary tract infection were medicated by antibiotics and the obstruction of the urinary tract was cleared away as soon as possible. RESULTS: Including the cases with residual fragments less than 4 mm, the success rates at one month after the treatment were 97.7% and 98.7% for the renal and ureteral calculi, respectively. The mean numbers of sessions were 1.49 for renal calculi and 1.16 for ureteral calculi. Multiple sessions were required in 24.2% of renal calculi and 12.0% of ureteral calculi. No serious complication has been observed except for three cases, which were sepsis after ESWL, anuria in a solitary kidney, and pyonephrosis caused by Steinstrasse with urinary infection, respectively. CONCLUSION: ESWL using ESL-500A is an efficient treatment of upper urinary tract calculi which has higher pulverization rate and fewer complications in the adequate procedure.

Adolescent↗
PubMed2007

Value of 3-dimensional transrectal/transvaginal sonography in diagnosis of distal ureteral calculi.

OBJECTIVE: In a prospective study, the feasibility of 3-dimensional (3D) transrectal/transvaginal sonography in comparison with transabdominal sonography and intravenous urography (IVU) in identifying distal ureteral calculi was evaluated. METHODS: Sixty-two patients in the urologic clinic with clinical suspicion of distal ureteral calculi were included. The patients consisted of 44 men and 18 women with a mean age +/- SD of 44 +/- 17 years. These patients underwent 3D transrectal/transvaginal sonography, transabdominal sonography with IVU, and, finally, ureterorenoscopy. RESULTS: Fifty-nine patients were confirmed to have distal ureteral calculi on the basis of urologic intervention (ureterorenoscopy). Three patients had a spontaneous stone passage immediately after imaging completion. The median size of the calculi was 3.7 +/- 2.00 mm. Transabdominal sonography detected 34 of the 62 patients with calculi (sensitivity, 55%). The median size of the calculi was calculated as 5.0 +/- 2.4 mm. The examination time was 6.5 +/- 2.7 minutes. Intravenous urography detected 44 of the 62 patients with ureterolithiasis (sensitivity, 71%). Herein, the median stone size was measured as 3.9 +/- 1.9 mm, and the examination time was 38 +/- 17 minutes. The combination of transabdominal sonography and IVU in visualization of ureterolithiasis raised the sensitivity to 81% (50 of 62 patients). Three-dimensional transrectal/transvaginal sonography showed ureterolithiasis in all 62 patients confirmed to have distal ureteral calculi (sensitivity and specificity, 100%). The median size of the calculi was calculated as 4.4 +/- 2.2 mm, and the examination took 1.9 +/- 0.6 minutes. CONCLUSIONS: The data in our prospective study show that transrectal/transvaginal sonography with 3D image assessment is superior to IVU and abdominal sonography for diagnosing distal ureteral calculi.

Adult↗
PubMed1990

Minimal invasive therapy of ureteral calculi using modern techniques.

In a one year period from July 1985 to July 1986, 224 upper and 62 distal ureteric calculi were treated. In situ ESWL represents the therapy of first choice for upper and distal ureteric calculi with a success rate of 81% and 76%, respectively. Retrograde mobilization of the calculus was used only in cases where in situ ESWL was impossible because of localization difficulties (obesity, stone close to the spine, skeleton deformation). Although ESWL after successful mobilization succeeded in 95%, retrograde mobilization was possible only in 80%. Antegrade ureterorenoscopy via percutaneous nephrostomy was performed to avoid open surgery after impossible retrograde mobilization and succeeded in 90%. Two second generation lithotripters suitable for treatments without invasive forms of anesthesia, the modified Dornier HM3+ and the Wolf Piezolith 2200, were compared in terms of efficacy for ureteric calculi. In situ ESWL was successful for upper ureter calculi in 70.7% with the HM3+ and 37.9% with the Piezolith 2200. In situ ESWL of middle ureteric calculi was successful in 81.8% with the modified HM3+, while in situ treatment of middle ureteric calculi was impossible with the piezolith 2200 due to insufficient localization of middle ureteric calculi with ultrasound. Distal ureteric calculi were treated successfully in 71.4% with the modified Dornier HM3+ and in 64% with the Piezolith 2200. Our initial clinical experience with ESWL in the prone position for iliac ureteric calculi is reported. Eight of 10 cases were treated successfully in situ.

Humans↗
PubMed1994

Primary in situ extracorporeal shock wave lithotripsy for ureteral calculi.

The use of a second generation lithotriptor (Siemens Lithostar) for ESWL treatment of 199 consecutively referred patients with ureteral calculi is evaluated. Follow up data were available in all patients. In 79 patients the calculus was located in the upper third of the ureter, in 43 patients in the middle third and in 77 patients in the lower third of the ureter. In situ ESWL was performed in 187 patients (94%) under local infiltration analgesia, if invasive procedures in conjunction with ESWL were not planned. The overall stone free rates for all patients after 1, 3 and 6 months were 62.3%, 82.4% and 89.9% respectively. The size of the calculus influenced the outcome of treatment, the number of treatments and number of shock waves given. The stone free rates 3 and 6 months after ESWL in patients with upper ureteral calculi were 86.1% and 91.1%; the number of treatments per patient was 1.2. The corresponding rates for patients with mid or lower ureteral calculi were 76.7%, 86.0% (1.0 treatment) and 81.8%, 90.9% (1.2 treatment) respectively. ESWL alone failed to clear calculi in 4 patients with upper ureteral stones, 6 patients with mid-ureteral calculi and 14 patients with lower ureteral calculi. The number of additional procedures post-ESWL was significantly higher among patients with calculi in the lower third of the ureter. It is concluded, that ESWL in situ with a second generation lithotriptor using X-ray localization is an effective and noninvasive method to treat ureteral calculi. In situ ESWL is recommended as first line treatment for ureteral calculi in the upper and mid-thirds.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1996

Ultrastructure of selected struvite-containing urinary calculi from dogs.

OBJECTIVE: To elucidate the ultrastructural details of struvite-containing urinary calculi from dogs. SAMPLE POPULATION: 38 specimens were selected from a collection of approximately 13,000 canine urinary calculi: 18 of these were composed entirely of struvite, and 20 consisted of struvite and calcium phosphate (apatite). PROCEDURE: Qualitative and quantitative analyses of specimens included use of plain and polarized light microscopy, x-ray diffractometry, scanning electron microscopy with backscattered electron imagery, x-ray fluorescence scans, and electron microprobe analysis. RESULTS: 4 textural types were recognized among struvite calculi, and 4 textural types of struvite-apatite calculi were described. Evidences of calculus dissolution were described from 4 calculi studied. CONCLUSIONS: The presence of small, well interconnected primary pores in struvite-containing urinary calculi from dogs appears to be a significant factor in determining the possible interaction of calculi with changes in the urine composition. The progress of dissolution from the calculus surface to the calculus interior appears to be largely affected by the primary porosity originally present between crystals forming the calculus framework. Apatite was observed to be more resistant to dissolution than struvite. CLINICAL RELEVANCE: The prevalence of fine concentric laminations having low porosity, and the common occurrence of apatite among struvite-containing urinary calculi from dogs may be 2 reasons why the efficacy of dietary and medicinal manipulations in dissolving urinary calculi is greater among cats than it is among dogs.

Animals↗
PubMed1998

Ureteroscopic management of intrarenal calculi.

PURPOSE: To determine its potential role in stone therapy, we evaluated our experience with the ureteroscopic removal of intrarenal calculi in 100 patients. We review the indications, techniques, stone-free and overall success rates, and complications. MATERIALS AND METHODS: From July 1994 to December 1996 ureteroscopic stone removal was attempted in 100 patients a mean of 52 years old who had renal calculi. Indications for treatment included concurrent ureteral stones in 56 cases, and failed extracorporeal shock wave lithotripsy, medical or percutaneous management as well as obesity and anatomical anomalies. There were 2 or more calculi in the affected kidney in 68 patients and stones greater than 6 mm. in 67. Treatment of intrarenal calculi was performed with flexible ureteroscopes, a laser or electrohydraulic lithotriptor and endoscopic graspers. The number and size of calculi were noted in each patient. Stone-free and overall success rates defined as 1 residual fragment less than 3 mm. were noted at 1 and 3-month followup visits. RESULTS: The overall success rate was 89%. Ureteroscopic treatment of intrarenal calculi resulted in a 77% stone-free rate. Of the 23 patients with residual calculi 12 (52%) had a single residual fragment less than 3 mm. The targeted stone was removed or fragmented in 98 patients (98%) and no ureteral calculi remained postoperatively. As expected, the number and size of the original stones inversely correlated with the success rate. There were no intraoperative complications, and only 3 urinary tract infections and 3 fevers were noted postoperatively. CONCLUSIONS: The use of smaller diameter ureteroscopes, better working instruments and more effective lithotriptors allow calculi in all parts of the collecting system to be engaged and treated. Success rates throughout the whole collecting system are comparable to if not better than those of extracorporeal shock wave lithotripsy and percutaneous approaches.

Adolescent↗
PubMed2000

Routine vs "on demand" postoperative ERCP for small bile duct calculi detected at intraoperative cholangiography. Clinical evaluation and cost analysis.

BACKGROUND: The detection of small and often asymptomatic gallbladder calculi within the bile duct at intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) frequently poses a management dilemma. Therefore, we set out to compare the outcomes and costs of two management strategies for small stones that remain in the bile duct after LC-routine postoperative endoscopic retrograde cholangiopancreatography (ERCP) vs observation alone with "on-demand" ERCP. METHODS: We studied 70 patients with bile duct stones among 922 consecutive patients who underwent LC between 1990 and 1997. Data were collected prospectively. Bile duct calculi were detected in 70 of 705 patients (9.9%) with successful IOC. Of these, 44 patients had large calculi (> or =5 mm in diameter) and were subjected to a laparoscopic common bile duct exploration. The remaining 26 patients had small calculi (<5 mm in diameter); four of them had undergone preoperative endoscopic sphincterotomy and duct clearance and were therefore excluded from analysis. Patients with small duct calculi were assigned, according to individual surgeon policy, to either routine postoperative ERCP (group A, n = 8) or observation (group B, n = 14). ERCP was reserved for those who become symptomatic. The two groups were comparable for age and sex distribution. RESULTS: No complications developed during the follow-up period in patients assigned to observation, although four became symptomatic and underwent ERCP. In group A, ERCP demonstrated a clear biliary tree in four patients and bile duct calculi in three patients; it failed in one patient. In group B, ERCP demonstrated a clear bile duct in one patient and bile duct calculi in two patients; it also failed in one patient. Endoscopic sphincterotomy and duct clearance were achieved in all patients with demonstrable bile duct calculi at ERCP. There was no morbidity or mortality associated with ERCP. The overall hospital stay was significantly longer in group A than in group B (median 5 vs 1.5 days; p = 0.011); however, the number of outpatient clinic visits was significantly greater in group b (median 3 vs 5.5, p = 0.011). The mean hospital costs, including the costs of hospital stay, readmissions, ERCP, and follow-up, were significantly greater in group A than in group B (mean pound2669 vs pound1508, p = 0.008). CONCLUSION: A "wait and see" policy of observation alone for patients with small bile duct calculi detected at IOC during LC appears to be safe, and it is more cost-effective than routine postoperative ERCP. ERCP should be reserved for post-LC patients who become symptomatic.

Adult↗
PubMed1997

Bile duct calculi in patients with primary sclerosing cholangitis.

PURPOSE: To determine the imaging appearance and frequency of detection of bile duct calculi in patients with primary sclerosing cholangitis. MATERIALS AND METHODS: Images (169 computed tomographic [CT] scans, 155 sonograms, and 109 cholangiograms) of 189 patients with primary sclerosing cholangitis, five of whom were prospectively included, were reviewed. Pathologic records were reviewed for proof of the presence of calculi. RESULTS: Bile duct calculi were visualized on images in 14 (7.6%) of the 184 retrospective patients and in all five of the prospective patients. The presence of calculi was confirmed with pathologic or imaging findings in 19 patients, in whom calculi were visible on 16 of 18 CT scans, 15 of 19 sonograms, and 14 of 17 cholangiograms. Calculi were in the intrahepatic ducts in 11 patients and in the intra- and extrahepatic bile ducts in eight patients. At CT, calculi appeared as foci of faint high attenuation or as coarse calcifications in nondilated or variably dilated ducts. At sonography, they appeared as unique echogenic casts with variable posterior acoustic shadowing or as discrete, echogenic, variably shadowing foci in variably dilated ducts. Calculi were depicted at cholangiography as rounded filling defects. CONCLUSION: Intrahepatic bile duct calculi are present in approximately 8% of patients and can have a unique imaging appearance.

Adult↗
PubMed2005

Possible etiology of calculi formation in salivary glands: biophysical analysis of calculus.

Sialolithiasis is one of the common diseases of the salivary glands. It was speculated that, in the process of calculi formation, degenerative substances are emitted by saliva and calcification then occurs around these substances, and finally calculi are formed. However, the exact mechanism of the formation of calculi is still unclear. In this study, we identify some possible etiologies of calculi formation in salivary glands through biophysical analysis. Calculi from 13 patients with submandibular sialolithiasis were investigated by transmission electron microscopy, scanning electron microscopy, X-ray microanalyzer, and electron diffraction. Transmission electron microscopic observation of calculi was performed in the submandibular gland (n = 13). In 3 of the 13 cases, a number of mitochondria-like structures and lysosomes were found near calcified materials. Scanning electron microscopic examination of these materials revealed that there were lamellar and concentric structures and that the degree of calcification was different among the calculi. X-ray microanalysis disclosed the component elements in the calculi to be Ca, P, S, Na, etc., and the main constituents were Ca and P. The calcium-to-phosphorus ratio was 1.60-1.89. Analysis of the area including mitochondria-like structures, lysosomes, and the fibrous structures by electron diffraction revealed the presence of hydroxyapatite and calcified materials. It is speculated that mitochondria and lysosomal bodies from the ductal system of the submandibular gland are an etiological source for calcification in the salivary gland.

Electron Probe Microanalysis↗