scholarly journals Single Procedure Saline Lavage for Treatment of Inspissated Bile

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Nafisa Sideeka ◽  
Raja Shaikh ◽  
Gulraiz Chaudry
Keyword(s):  
Cholestatic Jaundice ◽  
Needle Puncture ◽  
Surgical Drainage ◽  
Single Procedure ◽  
Biliary Sludge ◽  
Biliary Ducts ◽  
The Common ◽  
Methods Of Treatment ◽  
Saline Lavage ◽  
Repeat Procedures

Inspissated bile syndrome is a rare cause of cholestatic jaundice in infancy, occurring due to obstruction of the biliary ducts and gallbladder by biliary sludge. Traditional methods of treatment include surgical drainage or cholecystostomy drain placement. Both can be associated with complications and prolonged admission. We present 2 cases treated with a single percutaneous needle puncture of the gallbladder followed by saline lavage. Two neonates presented with cholestatic jaundice and sonographic evidence of biliary sludge and dilation of the common bile duct. Single sonographic-guided needle puncture of the gallbladder was followed by irrigation with saline. Clearing of the biliary sludge was confirmed by sonography and cholecystocholangiography. There was resolution of the cholestatic jaundice, with no complications or repeat procedures.

scholarly journals Diagnostics and Treatment of Cervical Causes of Infertility

2019 ◽  
Vol 12 (1) ◽  
pp. 33-39
Author(s):  
Aleksandar K. Kunev
Keyword(s):  
Intrauterine Insemination ◽  
Treatment Options ◽  
Cervical Canal ◽  
Male Factor ◽  
Gynaecological Examination ◽  
The Common ◽  
Common Problems ◽  
Cervical Diseases ◽  
And Function ◽  
Methods Of Treatment

Summary Nowadays, infertility is a problem that affects an increasing number of people. The causes of infertility in a couple may be due to a variety of factors – female, male or unexplained. One of the common problems associated with infertility in women is related to uterine cervical diseases. The cervix is an essential part of the sperm passage, so various disorders in the cervix structure and function may be the cause of infertility. The study aimed to identify the leading cervical causes of female infertility, methods of treatment and their success. The most common problems of cervical origin are cervical polyps and stenosis of the cervical canal. They are easily diagnosed with a routine gynaecological examination and ultrasound examination. Polyps are removed through polypectomy, and after that, a natural pregnancy can be achieved. In the case of stenosis of the cervical canal, there are two treatment options – dilation or intrauterine insemination (IUI). In younger patients and lack of male factor in the couple, dilation is performed. Dilation is mechanical with classic Hegar dilatiors or with synthetic hygroscopic dilatiors (Dilapan). If, in addition to the stenosis of the cervical canal in a woman, there is a male factor, treatment with IUI is preferred. Methods for cervical factor treatment vary in their success rate but are generally characterised by good results.

Risk Factors Of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography – A Retrospective Cohort Study

2015 ◽  
Vol 87 (10) ◽  
Author(s):  
Stanisław Głuszek ◽  
Jarosław Matykiewicz ◽  
Dorota Kozieł ◽  
Dariusz Klimer ◽  
Iwona Wawrzycka ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Retrospective Cohort ◽  
Demographic Data ◽  
Young Patients ◽  
Duodenal Perforation ◽  
Endoscopic Retrograde ◽  
Valuable Procedure ◽  
Biliary Ducts ◽  
The Common ◽  
Procedure Type

AbstractEndoscopic retrograde cholangiopancreatography (ERCP) is the most important non-surgical procedure in serious pancreatic and biliary diseases, still burdened with the risk of severe complications. The objective of the study was to distinguish factors which could increase the risk of occurrence of ERCP complication in the form of pancreatitis.The study included 452 patients who had undergone ERCP. Patients’ records were retrospectively analyzed from the aspect of demographic data, indications for the procedure, type and course of the procedure, type and severity of complications, width of the common bile duct (CBD), concomitant diseases and administered medicines which might increase the risk of complications.In 35 patients (7.7%) a complication occurred in the form of pancreatitis (AP). A severe course was confirmed in 11 patients (31%). Cholelithiasis constituted approximately 2/3 of indications for ERCP. AP after ERCP was significantly more often observed in the group of patients aged under 40 (22.9% vs 8.6%; p<0.05). Narrow biliary ducts (3-8 mm) were the factor increasing the frequency of development of AP (25.9% vs 45%; p<0.05). Death occurred in 5 patients (1.1%), including 4 patients (0.96%) in the group without complications, and in 1 patient (2.85%) with complicated AP.ERCP is a very valuable procedure in clinical treatment; however, it is burdened with the risk of complications, such as AP, bleeding, or duodenal perforation. A group especially exposed to the risk of complications in the form of AP are young patients aged under 40 with a narrow CBD.

scholarly journals Direct Bare Metal Needle Puncture and Balloon Angioplasty in Calcified Plaques of the Common Femoral Artery Guided by Angiography (“BAMBOO SPEAR”)

2021 ◽  
Author(s):  
Naoki Hayakawa ◽  
Satoshi Kodera ◽  
Masataka Arakawa ◽  
Satoshi Hirano ◽  
Sandeep Shakya ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Balloon Angioplasty ◽  
Common Femoral Artery ◽  
Lower Limbs ◽  
Bare Metal ◽  
Needle Puncture ◽  
Total Occlusion ◽  
Calcified Plaque ◽  
The Common ◽  
Metal Needle

Abstract BackgroundSurgical endarterectomy for common femoral artery (CFA) disease is still considered the gold standard for treatment. Development of various techniques and devices has improved the clinical results of endovascular therapy (EVT) for CFA. However, severe conditions remain, especially for occlusive lesions owing to calcified plaque. We developed a useful technique for passing a lesion by directly penetrating the calcified plaque of the CFA using a bare metal needle and then passing through a balloon or dilating it. We named this technique “direct bare metal needle puncture and balloon angioplasty in calcified plaques of the common femoral artery guided by angiography” or “BAMBOO SPEAR.” Main textThis report describes our technique for crossing a lesion by directly penetrating the calcified plaque of the CFA using a needle. We report a case of a 73-year-old male with hemodialysis who presented with cyanosis and ischemic rest pain of both lower limbs. Control angiography showed total occlusion of the left CFA with a calcified plaque. We advanced a 21-G metal needle that was slightly curved into the blood vessel from where the lumen of the distal CFA was located. The needle was advanced into the center of the calcified plaque, while observing from multiple directions with a fluoroscopic guide. We succeeded in advancing the needle into the lumen of the distal external iliac artery. After guidewire crossing, intravascular ultrasound (IVUS) showed that guidewire was able to completely pass through the center of the calcified plaque. We could dilate the lesion by scoring balloon and drug-coated balloon. The final angiography showed sufficient results. We named this technique ‘‘direct BAre Metal needle puncture and BallOOn angioplaSty in calcified PlaquEs of the common femoral ARtery guided by angiography” (BAMBOO SPEAR).ConclusionsThe BAMBOO SPEAR technique may be considered a useful option in EVT for occlusive CFA with calcified plaques.

Tumefactive biliary sludge: A sonographic pseudotumour appearance in the common bile duct

1993 ◽  
Vol 47 (4) ◽  
pp. 251-254 ◽  
Author(s):  
I.M.G. Kelly ◽  
W.R. Lees ◽  
R.C.G. Russell
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Sludge ◽  
The Common

scholarly journals Direct bare metal needle puncture and balloon angioplasty in calcified plaques of the common femoral artery guided by angiography (“BAMBOO SPEAR”)

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Naoki Hayakawa ◽  
Satoshi Kodera ◽  
Masataka Arakawa ◽  
Satoshi Hirano ◽  
Sandeep Shakya ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Balloon Angioplasty ◽  
Common Femoral Artery ◽  
Lower Limbs ◽  
Bare Metal ◽  
Needle Puncture ◽  
Total Occlusion ◽  
Calcified Plaque ◽  
The Common ◽  
Metal Needle

Abstract Background Surgical endarterectomy for common femoral artery (CFA) disease is still considered the gold standard for treatment. Development of various techniques and devices has improved the clinical results of endovascular therapy (EVT) for CFA. However, severe conditions remain, especially for occlusive lesions owing to calcified plaque. We developed a useful technique for passing a lesion by directly penetrating the calcified plaque of the CFA using a bare metal needle and then passing through a balloon or dilating it. We named this technique “direct bare metal needle puncture and balloon angioplasty in calcified plaques of the common femoral artery guided by angiography” or “BAMBOO SPEAR.” Main text This report describes our technique for crossing a lesion by directly penetrating the calcified plaque of the CFA using a needle. We report a case of a 73-year-old male with hemodialysis who presented with cyanosis and ischemic rest pain of both lower limbs. Control angiography showed total occlusion of the left CFA with a calcified plaque. We advanced a 21-G metal needle that was slightly curved into the blood vessel from where the lumen of the distal CFA was located. The needle was advanced into the center of the calcified plaque, while observing from multiple directions with a fluoroscopic guide. We succeeded in advancing the needle into the lumen of the distal external iliac artery. After guidewire crossing, intravascular ultrasound (IVUS) showed that guidewire was able to completely pass through the center of the calcified plaque. We could dilate the lesion by scoring balloon and drug-coated balloon. The final angiography showed sufficient results. We named this technique “direct BAre Metal needle puncture and BallOOn angioplaSty in calcified PlaquEs of the common femoral ARtery guided by angiography” (BAMBOO SPEAR). Conclusions The BAMBOO SPEAR technique may be considered a useful option in EVT for occlusive CFA with calcified plaques.

scholarly journals Calcium bilirubinate sludge causes early onset of congenital biliary dilatation: a report of two cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shoko Kato ◽  
Kenitiro Kaneko ◽  
Nozomi Matsushita ◽  
Shintaro Kurahashi ◽  
Takaaki Osawa ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Bile Duct ◽  
Absorption Spectrometry ◽  
Case Presentation ◽  
Congenital Biliary Dilatation ◽  
Biliary Dilatation ◽  
Calcium Bilirubinate ◽  
Biliary Sludge ◽  
The Common ◽  
Infrared Absorption Spectrometry

Abstract Background Symptomatic congenital biliary dilatation (CBD) during early infancy is always characterized by cystic dilation of the common bile duct with a narrow segment connecting the pancreatic duct. Case presentation In two consecutive infants with a prenatal diagnosis of CBD, we found that biliary sludge had formed in the cyst upon the appearance of symptoms including acholic stool and hypertransaminasemia. Infrared absorption spectrometry revealed that the sludge consisted of calcium bilirubinate. Conclusion We suggest that overproduction of bilirubin by neonatal hemolysis causes sedimentation of bilirubin calcium, resulting in obstruction of the narrow segment and development of symptoms.

scholarly journals The Morphometry Extrahepatic Bile Ducts

2018 ◽  
Vol 24 (4) ◽  
pp. 184-189
Author(s):  
Trantu Dina Elena ◽  
Bordei Petru ◽  
Ispas Viorel
Keyword(s):  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Hepatic Duct ◽  
Common Hepatic Duct ◽  
Ct Scanner ◽  
A Value ◽  
Extrahepatic Bile Ducts ◽  
Biliary Ducts ◽  
The Common ◽  
The Right

Abstract The extrahepatic bile duct morphometry was determined by the analysis of the colangiographies performed at Medimar Imaging Services SRL of the “St. Andrei “in Constanta on a General Electric Brightspeed Select CT scanner 16 slides. For the left liver duct found a caliber of 3.5-6.6 mm, its length ranging from 4.2-24.9 mm, and the right hepatic duct had a caliber ranging from 4.2-7.2 mm, the length being between 3.0-25.0 mm. At the confluence of the two hepatic ducts an angle of 35.0-124.1° was formed. In the common hepatic duct we found a caliber of 3.9-9.7 mm, in length between 20.2-52.9 mm. Cystic duct having a size of 2.4 to 5.5 mm, finding a length ranging from 24.6 to 66.4 mm. The angle formed at the end of the cystic duct in the hepatic duct had a value between 6.2-55.8°, and between the cystic and biliary ducts an angle of between 88.5-170.4° was formed. The coledoc duct had a caliber of 3.1-14.7 mm and a length of 19.8-57.3 mm.

Treating Sibling Incest Using a Family Systems Approach

2003 ◽  
Vol 25 (4) ◽  
pp. 337-350 ◽  
Author(s):  
Cora Haskins
Keyword(s):  
Mental Health ◽  
Systems Theory ◽  
Family Systems ◽  
Systems Approach ◽  
Family Systems Theory ◽  
Mental Health Counselors ◽  
Sibling Abuse ◽  
Sibling Incest ◽  
The Common ◽  
Methods Of Treatment

Mental health counselors are becoming more aware of sibling abuse in all of its forms. The literature addressing the nature of sibling abuse is increasing; however, there is little written about methods of treatment. Family systems theory as a framework for understanding the common family dynamics observed in families where there is sibling abuse is discussed. Lastly this paper presents a case example using family systems theory as a framework for conceptualizing and developing treatment.

Choledochal cyst with secondary cholangitis, choledochitis, duodenal papillitis, and pancreatitis in a young domestic shorthair cat

2021 ◽  
pp. 104063872110171
Author(s):  
Megan E. Schreeg ◽  
Sybille A. Miller ◽  
John M. Cullen
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Duodenal Papilla ◽  
Choledochal Cysts ◽  
Chronic Antigenic Stimulation ◽  
Bile Drainage ◽  
Biliary Ducts ◽  
The Common ◽  
Duodenal Papillitis

Choledochal cysts, congenital segmental dilations of the common bile duct, have been reported in few cats, and histologic characterization is lacking. A 20-mo-old spayed female domestic shorthair cat was presented because of vomiting and weight loss. There was progressive elevation of liver enzyme activity (ALT > ALP, GGT) and hyperbilirubinemia. Diagnostic imaging identified focal cystic dilation of the common bile duct, dilation and tortuosity of adjacent hepatic ducts, and a prominent duodenal papilla. A choledochal cyst was suspected, and the animal was euthanized. On postmortem examination, there was a 2-cm, firm, thickened, cystic dilation of the common bile duct, patent with adjacent ducts. Histologically, the cyst wall was expanded by fibroblasts, collagen, and lymphoplasmacytic inflammation. Adjacent bile ducts were markedly dilated and tortuous, with lymphoplasmacytic inflammation and papillary mucosal hyperplasia that extended to the major duodenal papilla. There was chronic neutrophilic cholangitis, suggesting bacterial infection and/or disturbed bile drainage, extrahepatic obstruction, and lymphoplasmacytic pancreatitis with ductular metaplasia. Prominent lymphoid follicles within biliary ducts and duodenum suggested chronic antigenic stimulation. Choledochal cysts can be associated with chronic neutrophilic cholangitis, extrahepatic obstruction, choledochitis, duodenal papillitis, and pancreatitis, and should be a differential for increased hepatic enzymes and hyperbilirubinemia in young cats.

The Use of Minimally Invasive Methods of Treatment of Obstructive Jaundice with Calculous Etiology

2015 ◽  
Vol 22 (3) ◽  
pp. 127-133
Author(s):  
Курманбаев ◽  
A. Kurmanbaev
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Minimally Invasive ◽  
Surgical Methods ◽  
The Common ◽  
Methods Of Treatment ◽  
Combined Interventions ◽  
Minimally Invasive Methods ◽  
Surgical Operations

The effectiveness of isolated retrograde endoscopic interventions and combined manipulations by the method «Randevu», also surgical operations for the purpose of elimination of choledocholithiasis, complicated by mechanical jaundice was defined on a large clinical material. It was identified a significant decline in hyperbilirubinemia in all used methods of treatment. Liver enzymes alanineaminotransferase and aspartate aminotransferase significantly reduced in the application of minimally invasive retrograde endoscopic and combined manipulations by the method «Randevu». There was a significant decrease in the diameter of the common bile duct by ultrasound only at the use of combined interventions by the method «Randevu». There was the greatest number of complications at the use of surgical methods of treatment of choledocholithiasis, complicated by mechanical jaundice, reaching 20% of cases. The rate of complications at the use of minimally invasive retrograde resolution methods of choledocholithiasis averaged 3% of cases. Postoperative complications are not observed at the use of the combined manipulations by the method &#34;Randevu&#34;. Based on the analysis of the above data, the author determines the best treatment outcomes in patients with concomitant minimally invasive operations on the method of «Randevu», manifested a significant decrease in indicators of bilirubi-nemia, hepatic enzymes, diameter of the common bile duct. Also, this two-step tactic can be recommended for the extreme severity of the patient´s state, complicated by obstructive jaundice.

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