Bilious mask: parasite masquerading as malignant gall bladder polyp

2021 ◽  
Vol 14 (6) ◽  
pp. e241712
Author(s):  
Chinnu Mariam Philip ◽  
Malini Eapen ◽  
Sudhindran S
Keyword(s):  
Bile Duct ◽  
Gall Bladder ◽  
Young Woman ◽  
Major Surgery ◽  
Bile Duct Wall ◽  
Positron Emission ◽  
Significant Impairment ◽  
Pet Scans ◽  
Bladder Polyp

A 31-year-old woman, presenting with right upper quadrant pain, was suspected to have malignant gall bladder polyp based on MRI and CT scan findings. She underwent radical cholecystectomy with excision of bile duct and hepaticojejunostomy. Surprisingly, histology revealed parasitic remnants within the bile duct wall with no evidence of malignancy. A year later, this young woman suffers significant impairment of quality of life, perhaps an aftermath to the radicality of the surgery. Our case demonstrates a masquerade of ‘malignant biliary polyp’ by a parasite. This raises the need for extensive investigations such as endoscopic ultrasound guided biopsies, parasitic serology and positron emission tomography (PET) scans when patients present with probable malignant biliary lesions, even in difficult-to-access areas. A preoperative diagnosis might have averted an unnecessary major surgery in this young woman.

Gallbladder polyp

2018 ◽  
Vol 1 (1) ◽  
pp. 23-24
Author(s):  
Watcharasak Chotiyaputta
Keyword(s):  
Gall Bladder ◽  
Gallbladder Polyp ◽  
Gallbladder Polyps ◽  
Upper Abdomen ◽  
Bladder Polyp

Gall bladder polyp เป็นภาวะที่พบได้บ่อย คาดว่าพบได้ประมาณร้อยละ 5 ของประชากรทั่วไป การวินิจฉัยที่สำคัญคือการตรวจด้วยอัลตร้าซาวนด์บริเวณถุงน้ำดีซึ่งต้องแยกให้ดีระหว่าง gall bladder polyp และ gallstone การรักษาที่สำคัญคือการผ่าตัดถุงน้ำดีออกเมื่อติ่งเนื้อมีขนาดเกิน 1 ซม ถ้าขนาดไม่เกินควรทำการติดตามดุว่าติ่งเนื้อมีขนาดใหญ่ขึ้นหรือไม่ โดยเฉพาะในช่วง 2 ปีแรก Figure 4 CT of upper abdomen แสดง multiple gallbladder polyps และ gallstones โดยลักษณะของ gallstones เป็น densed hyperdensity มากกว่า gallbladder polyps

ДИАГНОСТИКА ХРОНИЧЕСКИХ ИНДУЦИРОВАННЫХ КРАПИВНИЦ

2019 ◽  
pp. 5-13
Author(s):  
E.Yu. Borzova
Keyword(s):  
Quality Of Life ◽  
Biological Therapy ◽  
Treatment Algorithm ◽  
The Novel ◽  
International Guidelines ◽  
Systemic Reactions ◽  
Significant Impairment ◽  
Challenge Tests

Хронические индуцированные крапивницы имеют важное социальноэкономическое значение вследствие риска развития системных реакций и значительного снижения качества жизни пациентов. Диагностика хронических индуцированных крапивниц основывается на анамнестических данных и проведении провокационных тестов. Современный протокол ведения больных хронической крапивницей включает применение неседативных антигистаминных препаратов. Международные согласительные документы по лечению крапивницы рекомендуют 4кратное увеличение суточной дозы неседативных антигистаминных препаратов при их неэффективности в стандартных дозах. Данные метаанализа указывают на эффективность омализумаба при хронических индуцированных крапивницах. В перспективе ожидается расширение арсенала генноинженерной биологической терапии хронических индуцированных крапивниц.Chronic inducible urticarias are characterized by the risks of systemic reactions and a significant impairment of patients quality of life. The diagnosis of chronic inducible urticarias relies on the patients history and the challenge tests. A treatment algorithm for the management of chronic inducible urticarias includes nonsedating antihistamines as a firstline treatment. The international guidelines for the management of chronic inducible urticarias recommend updosing of nonsedating antihistamines up to four fold if standard doses are not effective. The metaanalysis suggests the efficacy of omalizumab in chronic inducible urticarias. In the prospect, the novel options of biological therapy for chronic inducible urticarias are expected.

ДИАГНОСТИКА ХРОНИЧЕСКИХ ИНДУЦИРОВАННЫХ КРАПИВНИЦ

2019 ◽  
Author(s):  
E.Yu. Borzova
Keyword(s):  
Biological Therapy ◽  
Meta Analysis ◽  
Treatment Algorithm ◽  
The Novel ◽  
First Line ◽  
Systemic Reactions ◽  
Significant Impairment ◽  
Challenge Tests ◽  
First Line Treatment

Хронические индуцированные крапивницы имеют важное социально-экономическое значение вследствие риска развития системных реакций и значительного снижения качества жизни пациентов. Диагностика хронических индуцированных крапивниц основывается на анамнестических данных и проведении провокационных тестов. Современный протокол ведения больных хронической крапивницей включает применение неседативных антигистаминных препаратов. Международные согласительные документы по лечению крапивницы рекомендуют 4-кратное увеличение суточной дозы неседативных антигистаминных препаратов при их неэффективности в стандартных дозах. Данные мета-анализа указывают на эффективность омализумаба при хронических индуцированных крапивницах. В перспективе ожидается расширение арсенала генно-инженерной биологической терапии хронических индуцированных крапивниц.Chronic inducible urticarias are characterized by the risks of systemic reactions and a significant impairment of patients quality of life. The diagnosis of chronic inducible urticarias relies on the patients history and the challenge tests. A treatment algorithm for the management of chronic inducible urticarias includes nonsedating antihistamines as a first-line treatment. The international guidelines for the management of chronic inducible urticarias recommend updosing of nonsedating antihistamines up to four fold if standard doses are not effective. The meta-analysis suggests the efficacy of omalizumab in chronic inducible urticarias. In the prospect, the novel options of biological therapy for chronic inducible urticarias are expected.

The effectiveness of a digital pelvic floor training program in thetreatment of urinary incontinence – a real-world evaluation (Preprint)

2019 ◽  
Author(s):  
Sabine Keim ◽  
Alexandra von Au ◽  
Lina Maria Matthies ◽  
Stephanie Wallwiener ◽  
Sarah Brugger ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Floor ◽  
University Hospital ◽  
First Line ◽  
First Line Therapy ◽  
A Value ◽  
Pelvic Floor Training ◽  
Significant Impairment ◽  
Pelvic Floor Weakness

BACKGROUND Background: Many women experience urinary incontinence (UI) during andafter pregnancy due to pelvic floor weakness. First-line therapy is conservative treatment, which nowadays can be facilitated by using digitalsolutions. OBJECTIVE The aim ofthe present study was to investigate the efficacy and effectiveness of pelvinain patients with existing UI. METHODS Methods: In the present observational study we analyzed the effectivenessof pelvina, a certified digital pelvic floor training course, in reducing UI symptoms by regularly applying “The Questionnaire for Urinary Incontinence Diagnosis” (QUID) and furthermore examining quality of life (QoL) by conducting the SF-6D. RESULTS Results: In this prospective study, 373 patients with a median age of 36 years (IQR 33 - 47 years) were included. At baseline the patients had a median QUID of 11 (IQR 11 - 15). During the course, incontinence improved significantly to a QUID of 5 (IQR 2 – 11; p<0.001). Additionally, the patients had also shown a significant impairment in their QoL at baseline with a value of 19 (IQR 16 - 22) in SF-6D. After completing the course, the QoL had risen to 24 (IQR 20 - 26). CONCLUSIONS Conclusion: Use of the certified digital pelvic floor course pelvinasignificantly reduces existing UI due to pelvic floor weakness over the timespan of the course. At the same time QoL is significantly improved. CLINICALTRIAL The present study was approved by the ethics committee of the Heidelberg University Hospital (S-392/2019)

Quality-of-life assessment in the treatment of iatrogenic bile duct injuries: hepaticojejunostomy versus end-to-end biliary reconstructions

2012 ◽  
Vol 82 (12) ◽  
pp. 923-927 ◽  
Author(s):  
Beata Jabłońska ◽  
Marek Olakowski ◽  
Paweł Lampe ◽  
Zygmunt Górka ◽  
Łukasz Bułdak
Keyword(s):  
Quality Of Life ◽  
Bile Duct ◽  
Life Assessment ◽  
Quality Of Life Assessment ◽  
Bile Duct Injuries ◽  
End To End

scholarly journals PET Scan Perfusion Imaging in the Prader–Willi Syndrome: New Insights into the Psychiatric and Social Disturbances

2010 ◽  
Vol 31 (1) ◽  
pp. 275-282 ◽  
Author(s):  
Carine Mantoulan ◽  
Pierre Payoux ◽  
Gwenaëlle Diene ◽  
Mélanie Glattard ◽  
Bernadette Rogé ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Severe Disabilities ◽  
Brain Regions ◽  
Pet Scan ◽  
Prader Willi Syndrome ◽  
Behavioral Skills ◽  
Positron Emission ◽  
Functional Consequences ◽  
Magnetic Resonance Imaging Mri ◽  
Pet Scans

The Prader–Willi syndrome (PWS), a rare multisystem genetic disease, leads to severe disabilities, such as morbid obesity, endocrine dysfunctions, psychiatric disorders, and social disturbances. We explored the whole brain of patients with PWS to detect abnormalities that might explain the behavioral and social disturbances, as well as the psychiatric disorders of these patients. Nine patients with PWS (six males, three females; mean age 16.4 years) underwent a positron emission tomography (PET) scan with H215O as a tracer to measure regional cerebral blood flow (rCBF). The images were compared with those acquired from nine controls (six males, three females; mean age 21.2 years). A morphologic magnetic resonance imaging (MRI) was also performed in PWS patients, and their cognitive and behavioral skills were assessed with Wechsler Intelligence Scale for Children III and the Child Behavior Check List (CBCL). The MRI images showed no evident anatomic abnormalities, whereas PET scans revealed hypoperfused brain regions in PWS patients compared with controls, particularly in the anterior cingulum and superior temporal regions. We observed a significant relationship ( P<0.05) between rCBF in the hypoperfused regions and CBCL scores. The functional consequences of these perfusion abnormalities in specific brain regions might explain the behavioral and social problems observed in these individuals.

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