scholarly journals Role of Cholecystectomy in Symptomatic Hyperkinetic Gallbladder Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Jai P. Singh
Keyword(s):  
Abdominal Pain ◽  
Complete Resolution ◽  
Biliary Colic ◽  
Quadrant Pain ◽  
Gallbladder Ejection Fraction ◽  
Hida Scan ◽  
Upper Abdominal ◽  
The Right ◽  
Upper Abdomen

Introduction. Biliary dyskinesia is defined by a gallbladder ejection fraction (EF) of less than 35% on HIDA scan, and these patients have shown a good response to cholecystectomy. Management of patients with biliary colic symptoms who have a hyperkinetic gallbladder ( EF > 80 % ) is not clearly defined. Herein, I report three cases of the symptomatic hyperkinetic gallbladder that were successfully managed with cholecystectomy. Case Report. Patient 1was a 56-year-old female presented with pain in the right upper abdomen for one month. Her workup was unremarkable except for the gallbladder EF of 86%. Patient 2 was a 33-year-old female with similar symptoms and workup with gallbladder EF of 97%. Patient 3 was a 20-year-old female with right upper abdominal pain and gallbladder EF of 91%. Patients 1 and 3 had the normal US, normal CT scan, and normal EGD. Patient 2 had normal US and CT but did not undergo EGD. All three patients underwent laparoscopic cholecystectomy and had complete resolution of their symptoms. Conclusion. The hyperkinetic gallbladder is a rare phenomenon, which can cause debilitating right upper quadrant pain. All three patients had an excellent response to cholecystectomy. Therefore, it is concluded that the patients with biliary colic and gallbladder EF of 80% or higher should be strongly considered for surgery.

Biliary pain in the structure of episodes of right upper abdominal pain

2020 ◽  
Vol 18 (6) ◽  
pp. 42-52
Author(s):  
Yu.O. Shulpekova ◽  
◽  
V.M. Nechaev ◽  
V.T. Ivashkin ◽  
◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Cholecystitis ◽  
Heart Diseases ◽  
Biliary Colic ◽  
Recurrent Pain ◽  
Biliary Pain ◽  
Abdominal Ultrasonography ◽  
Locomotor System ◽  
Upper Abdominal ◽  
The Right

Acute or recurrent pain in the right upper part of the abdomen is a common cause for visits to physicians. Not less than two thirds of episodes of pain in this area are conditioned by biliary colic and acute cholecystitis. Other most common causes include diseases of the liver, pancreas, prepyloric and pyloric parts of the stomach and the beginning portion of the small intestine, the right kidney, and also subhepatic appendicitis. Some cases of developing pain are associated with the right lung affection and involvement of the diaphragmatic pleura, with heart diseases, involvement of the locomotor system and nerves. Taking into account a high prevalence of cholelithiasis in Russia – around 10–12% – we can conclude that episodes of biliary colic develop every year in 1 of 500–1000 individuals. In Russia, approximately half a million cholecystectomies are performed annually. The prevalence of gall stones among the paediatric population amounts to 2%. As distinct from adults, who in 80% of cases have an asymptomatic course of disease, pain episodes in children manifest themselves in 60–67% of cases. The diiagnosis of acute cholecystitis might meet with considerable difficulties; a scale for assessment of the likelihood of acute cholecystitis has been developed. Unlike in adults, in children a significantly large proportion of cases occur due to acalculous cholecystitis. Differentiating the causes of pain might be difficult, therefore, its character and concomitant symptoms should be thoroughly analysed, and the findings of additional examinations should also be taken into consideration (at the first step – assessment of haematological and biochemical parameters, urinalysis, electrocardiogram and abdominal ultrasonography). Key words: right upper abdominal pain, biliary colic, biliary dyskinesia, cholelithiasis

Enterogastric Reflux: an Uncommon Diagnosis Analyzed by Hepatobiliary Imaging

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Peter Wang
Keyword(s):  
Abdominal Pain ◽  
Digestive Enzymes ◽  
Gallbladder Disease ◽  
Hepatobiliary Scintigraphy ◽  
Hepatobiliary Imaging ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Abdominal ◽  
Enterogastric Reflux

Enterogastric reflux (EGR) is the reflux of bile and digestive enzymes from the small bowel into the stomach. While it is a normal physiologic process in small amounts, excessive reflux and chronic EGR can cause upper GI symptoms often mimicking more common diseases such as gallbladder disease and GERD that often leads to its underdiagnosis. Identifying EGR is significant as it has been associated with the development of gastroesophogeal pathology including gastritis, esophagitis, ulcers, and mucosal metaplasia. This article presents a 22-year-old male with enterogastric reflux causing upper abdominal pain and will discuss the role of hepatobiliary scintigraphy in its diagnosis.

scholarly journals Resolution of group B streptococcal panspinal epidural abscess in a patient with diabetes after treatment with ceftriaxone and linezolid

2019 ◽  
Vol 12 (11) ◽  
pp. e232243
Author(s):  
David Wen ◽  
James Norman ◽  
Pooja Dassan ◽  
Gurjinder Sandhu
Keyword(s):  
Abdominal Pain ◽  
Back Pain ◽  
Urinary Retention ◽  
Conservative Management ◽  
Complete Resolution ◽  
Epidural Abscess ◽  
Radicular Pain ◽  
Group B ◽  
The Right ◽  
New Onset

Panspinal epidural abscesses are an extremely rare yet potentially fatal condition. Whether cases are best managed surgically or medically is currently controversial. A 63-year-old patient with diabetes presented initially with abdominal pain, back pain, urinary retention and constipation. He subsequently developed fevers, radicular pain and new-onset weakness in the right leg. MRI confirmed a panspinal epidural abscess extending from C7 to L5, with group B Streptococcus (GBS) cultured on sampling. Due to the significant risks of surgery he was managed conservatively, initially with ceftriaxone, and subsequently in combination with linezolid. Repeat MRI 3 months after presentation revealed complete resolution of the abscess. This case illustrates how conservative management is a valid option for patients with this condition, and supports the use of synergistic linezolid in this scenario. It also highlights how some cases may not initially present with the classically described triad of fever, back pain and loss of neurological function.

Enterogastric Reflux: An Uncommon Diagnosis Analyzed by Hepatobiliary Imaging

2019 ◽  
Vol 8 (3) ◽  
Author(s):  
Peter Wang
Keyword(s):  
Abdominal Pain ◽  
Digestive Enzymes ◽  
Gallbladder Disease ◽  
Hepatobiliary Scintigraphy ◽  
Hepatobiliary Imaging ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Abdominal ◽  
Enterogastric Reflux

Enterogastric reflux (EGR) is the reflux of bile and digestive enzymes from the small bowel into the stomach. While it is a normal physiologic process in small amounts, excessive reflux and chronic EGR can cause upper GI symptoms often mimicking more common diseases such as gallbladder disease and GERD that often leads to its underdiagnosis. Identifying EGR is significant as it has been associated with the development of gastroesophogeal pathology including gastritis, esophagitis, ulcers, and mucosal metaplasia. This article presents a 22-year-old male with enterogastric reflux causing upper abdominal pain and will discuss the role of hepatobiliary scintigraphy in its diagnosis.

scholarly journals Unusual Differential Diagnosis of Upper Abdominal Pain

2009 ◽  
Vol 2009 ◽  
pp. 1-3
Author(s):  
Lanthaler Monika ◽  
Grissmann Thomas ◽  
Schwentner Lukas ◽  
Nehoda Hermann
Keyword(s):  
Abdominal Pain ◽  
Liver Abscess ◽  
Unusual Case ◽  
Foreign Bodies ◽  
Gastric Perforation ◽  
Gastric Wall ◽  
Endoscopic Removal ◽  
Quadrant Pain ◽  
Anterior Gastric Wall ◽  
Upper Abdominal

We here present an interesting unusual case of upper abdominal pain. The patient was a 38-year-old man, who was admitted to our hospital complaining of right upper quadrant pain caused by a toothpick that perforated the anterior gastric wall and penetrated segment I of the liver. After endoscopic removal and an initially uneventful course, computed tomography revealed a perigastric abscess that was treated by repeated gastroscopic rinsing via an endoscopically placed catheter. After another three uneventful weeks, a liver abscess with minor tendency to constrict the portal vein was diagnosed, and a segment I liver resection together with abscess drainage was performed. The peculiarity of this case is the rarity of toothpick ingestion and gastric perforation in a young and healthy white Caucasian followed by development of a liver abscess after primary uneventful endoscopic removal. In light of this case, gastric perforation due to ingested foreign bodies such as toothpicks can be considered a rare cause of upper abdominal pain.

HIDA Scan with Ejection Fraction is over Utilized in the Management of Biliary Dyskinesia

2015 ◽  
Vol 81 (7) ◽  
pp. 669-673 ◽  
Author(s):  
Amanda H. Eckenrode ◽  
Joseph A. Ewing ◽  
Jennifer Kotrady ◽  
Allyson L. Hale ◽  
Dane E. Smith
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Ejection Fraction ◽  
Iminodiacetic Acid ◽  
Biliary Colic ◽  
Symptom Improvement ◽  
Symptom Resolution ◽  
Atypical Symptoms ◽  
Hida Scan ◽  
Normal Ultrasound ◽  
Upper Abdominal

Patients with upper abdominal pain, nausea, and vomiting are often evaluated with ultrasound to diagnose symptomatic cholelithiasis or cholecystitis. With a normal ultrasound, a hepatobiliary iminodiacetic acid (HIDA) scan with ejection fraction (EF) is recommended to evaluate gallbladder function. The purpose of this study was to evaluate whether the HIDA scan with EF was appropriately utilized in considering cholecystectomy. Over 18 months, we performed 1533 HIDA scans with EF. After exclusion, 1501 were analyzable, 438 of whom underwent laparoscopic cholecystectomy. Patients were divided into two groups: those with typical and atypical symptoms of biliary colic. Our primary endpoint was symptom resolution of those who underwent laparoscopic cholecystectomy. Symptom resolution was assessed by chart review of postop visits or readmissions. In patients with typical symptoms, resolution occurred in 66 per cent of patients with positive HIDA and 77 per cent with negative HIDA ( P = 0.292). In patients with atypical symptoms, resolution occurred in 64 per cent of patients with positive HIDA and 43 per cent with negative HIDA ( P = 0.013). A HIDA scan with EF was not useful in patients with typical symptoms of biliary colic and negative ultrasounds, and should not be used to make a decision for cholecystectomy. However, this test can be helpful in patients with atypical symptoms, as it does predict symptom improvement in this group.

Myositis ossificans in the right inferior thoracic wall as an unusual cause of lower thoracic-upper abdominal pain: Report of a case

Surgery Today ◽  
2008 ◽  
Vol 38 (10) ◽  
pp. 962-964 ◽  
Author(s):  
Tarkan Ergun ◽  
Hatice Lakadamyali ◽  
Huseyin Lakadamyali ◽  
Ertan Gokay
Keyword(s):  
Abdominal Pain ◽  
Myositis Ossificans ◽  
Thoracic Wall ◽  
Pain Report ◽  
Upper Abdominal ◽  
The Right

Recurrent Pyogenic Cholangitis: ‘Sump Syndrome’ following Choledochoduodenostomy

1997 ◽  
Vol 27 (1) ◽  
pp. 51-52 ◽  
Author(s):  
T F Toufeeq Khan ◽  
Zaheer A Sherazi ◽  
Suseela Muniandy ◽  
Malik Mumtaz
Keyword(s):  
Abdominal Pain ◽  
Hospital Admissions ◽  
Late Complication ◽  
Iminodiacetic Acid ◽  
Endoscopic Retrograde ◽  
Percutaneous Access ◽  
Intrahepatic Calculi ◽  
Hida Scan ◽  
Recurrent Pyogenic Cholangitis ◽  
Upper Abdominal

An uncommon and late complication of side-to-side choledochoduodenostomy (CDD), the ‘sump syndrome’, developed in a patient 4 years after surgery. Recurrent right upper abdominal pain, fever with chills and rigors and latterly, mild jaundice made her seek repeated hospital admissions which were treated successfully with antibiotics. During the last admission, ultrasonography, endoscopic retrograde cholangiography (ERC), computerized scanning (CT) and hepatic iminodiacetic acid (HIDA) scan using Tc99m confirmed multiple intrahepatic calculi with proximal dilatation, debris in the distal blind segment and delayed excretion through the CDD. At surgery, the choledochoduodenostomy was taken down and a Rouxen-Y hepaticojejunostomy (RHJ) was fashioned after ductal clearance. The closed end of the Roux loop was placed subcutaneously for subsequent percutaneous access for cholangiography and removal of calculi. She is asymptomatic and well 28 months after surgery.

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