scholarly journals Tomato peel: rare cause of biliary tract obstruction

2011 ◽  
Vol 152 (47) ◽  
pp. 1907-1910 ◽  
Author(s):  
Krisztina Hagymási ◽  
Zoltán Péter ◽  
Éva Csöregh ◽  
Emese Szabó ◽  
Zsolt Tulassay

Foreign bodies in the biliary tree are rare causes of obstructive jaundice. Food bezoars are infrequent as well. They can cause biliary obstruction after biliary tract interventions, or in the presence of biliary-bowel fistula or duodenum diverticulum. Food bezoars usually pass the gastrointestinal tract without any symptoms, but they can cause abdominal pain and obstructive jaundice in the case of biliary tract obstruction. Endoscopic retrograde cholangio-pancreatography has the major role in the diagnosis and the treatment of the disease. Authors summarize the medical history of a 91-year-old female patient, who developed vomiting and right subcostal pain due to the presence of tomato peel within the ductus choledochus. Orv. Hetil., 2011, 152, 1907–1910.

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Metin Şenol ◽  
Zehra Ünal Özdemir ◽  
İbrahim Tayfun Şahiner ◽  
Hakan Özdemir

Bezoar is defined as the accumulation of undigested foreign bodies or nutrients in the gastrointestinal tract. These foreign bodies can be hair (trichobezoar), fibers or seeds of vegetables and fruits (phytobezoar), or remnants of milk (lactobezoar) and stones (lithobezoar). Lithobezoar, the accumulation of stones in the digestive tract, is commonly seen in stomach. In this paper, a 7-year-old girl with colonic lithobezoar who presented with constipation, abdominal pain, and the history of pica was successfully treated by the extraction of the stones under general anesthesia.


2021 ◽  
Vol 25 (2) ◽  
pp. 135-139
Author(s):  
R. V. Bocharov ◽  
Ya. V. Shikunova ◽  
G. V. Slyzovsky ◽  
V. G. Pogorelko ◽  
M. A. Zykova ◽  
...  

Material and methods. A retrospective analysis of medical records of two children. Anamnestic, clinical, diagnostic and intraoperative findings were analyzed.Purpose. To describe cases of trichobezoars in children : occurrence, diagnostics and treatment.Results. In the first case, a girl, aged 5, often swallowed her own hair after a psychological trauma; and at the age of 15 she complained of hair loss and anemia. In the second case, a boy was chewing and swallowing his own hair for 6 months under the emotional stress. Two weeks before hospitalization he complained of abdominal pain. In both cases, there were no history of intestinal obstruction. At the fibroesophagogastroduodenoscopy, foreign bodies were visualized which were diagnosed as trichobezoars. X-ray diagnostics confirmed foreign bodies in both patients. Those bodies had the shape of the stomach and had an inhomogeneous porous structure. The patients were operated: laparotomy, gastrotomy with removal of dense hair formation. Postoperative course was uneventful.Conclusion. Psychological situations provoked in children the obsessive trichotillomania and trichophagia due to which large trichobezoars were formed in the stomach.


1991 ◽  
Vol 5 (5) ◽  
pp. 161-164
Author(s):  
Gary R May ◽  
David S Reid ◽  
Noel B Hershfield

Anatomic anomalies of the exrrahepatic biliary tree are common and often incidental findings at endoscopic retrograde cholangiopancreatography; however, they rarely complicate therapeutic procedures such as stone extraction. The cases of two patients with biliary obstruction due to stones are presented, who were found to have the cystic duct a rising almost directly from the ampulla. This rare anatomic variant posed problems both in terms of interpretation of the cholangiogram and removal of stones. Therapeutic endoscopists should be aware of this and other anomalies of the biliary tract and of the potential problems faced in both interpretation of the cholangiogram and in therapeutic procedures.


2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 336-336
Author(s):  
Satoshi Shimizu ◽  
Shuichi Mitsunaga ◽  
Izumi Ohno ◽  
Hideaki Takahashi ◽  
Hiroyuki Okuyama ◽  
...  

336 Background: The aim of this study was to investigate the influences of obstructive jaundice (OJ) in unresectable biliary tract cancer (BTC) patients. Methods: Data of a total of 200 patients who were newly diagnosed as having unresectable BTC and received chemotherapy between July 2006 and December 2012 were retrospectively reviewed. Patients were divided into two groups according to whether or not they presented with OJ as the incipient chief complaint (Group 1, patients with OJ; Group 2, patients without OJ). Results: There were 81 patients in Group 1 and 119 patients in Group 2. In regard to the primary site (Group 1/Group 2), 29 had perihilar (27/2), 7 had distal (7/0), 68 had intrahepatic (15/53), 92 had gallbladder (31/61) and 4 had ampulla of vater (1/3) (p<0.01). The rate of distant metastasis was 60% in Group 1 and 76% in Group 2 (p=0.02). The performance status was good (0 or 1) in 96% of cases of both the groups. There were no significant differences in the median survival time between Group 1 and Group 2 (9.0 months vs. 9.0 months, p=0.42) or in the progression free survival of 1st line chemotherapy between the two groups (4.1 months vs. 3.7 months, p=0.08). The rate of development of biliary obstruction in Group 1 was significantly high during the first line chemotherapy (56% vs. 10%, p<0.01). Discontinuation of 1st line chemotherapy was necessitated due to biliary obstruction in 9 patients (10%) of Group 1 and none of the patients (0%) of Group 2. Multivariate analysis showed that absence of metastasis and use of a doublet chemotherapy regimen were significantly correlated with the overall survival, but not the presence of OJ as the incipient chief complaint (HR, 0.772; 95% CI, 0.532-1.119). Conclusions: Patients with OJ as the incipient chief complaint showed high rate of recurrent biliary obstruction and discontinuation chemotherapy due to biliary obstruction. However, OJ may not disadvantage for overall survival in BTC.


2019 ◽  
Vol 6 (3) ◽  
pp. 726
Author(s):  
Arshed Hussain Parry ◽  
Mohammad Saleem Dar ◽  
Abdul Haseeb Wani ◽  
Tariq Ahmad Gojwari ◽  
Irfan Robbani

Background: An accidently ingested foreign body may get lodged within the lumen of gastrointestinal tract, pass uneventfully with feces or may migrate extraluminally into the surrounding tissues in which case it may lead to suppurative or vascular complications. The aim of the endeavor was to study the spectrum of imaging findings in patients with accidental ingestion of foreign bodies with trans-gastric migration of metallic foreign bodies.Methods: Total 33 patients with history of accidental ingestion of foreign bodies were subjected to preliminary radiograph of neck, chest and abdomen followed by upper gastrointestinal endoscopy. Failure to retrieve/ localize foreign body endoscopically from upper gastrointestinal tract with check radiograph reiterating the presence of foreign body in upper abdomen were subjected to computed tomography of abdomen.Results: A total of 33 patients comprising of 27 females and 6 males with mean age of 23.76 years with history of foreign body ingestion were studied. Ingested foreign bodies were lodged in pharynx (n=7), esophagus (n=3), stomach (n=13) or duodenum (n=3).  In 7 patients in whom endoscopy failed to locate and/or retrieve foreign body, computed tomography confirmed the presence of trans-gastrically migrated foreign body in the surrounding structures. The location of migrated foreign bodies was in lesser sac (n = 2), greater omentum (n = 3), lesser omentum (n = 1) and transmural (n = 1). Two patients had evidence of collection formation around the migrated foreign bodies.Conclusions: Sharp or pointed metallic foreign bodies may migrate trans-luminally with various implications. Though radiography is the preliminary workhorse for the confirmation of ingested foreign bodies, computed tomography owing to its volumetric data acquisition helps in exact localization of migrated foreign bodies and should precede any therapeutic intervention for retrieval of migrated foreign bodies.


2020 ◽  
pp. 1-3
Author(s):  
Bhuvana Lakshmi Sundararajan ◽  
Siddartha Gowthaman ◽  
Arul Kumar ◽  
Ramanathan M

INTRODUCTION: Pica is common in patients with developmental disabilities and can be life-threatening. It is important to identify pica and manage it appropriately. CASE REPORT:A 19-year-old male presented with history of abdominal pain and vomiting for two days.On imaging he was found to have multiple foreign bodies within the small and large bowel.After trial of conservative management,he was taken up for exploratory laparotomy. He was found to have trichobezoar and lithobezoar obstructing the bowel at terminal ileum.Bezoars when removed via enterotomy. DISCUSSION: Bezoars are conglomerates of non-absorbable food or fibre formed in the alimentary tract.Trichobezoar forms following ingestion of hair and usually leads to gastric outlet obstruction.Lithobezoar refers to the accumulation of stones in the GIT. Reports of colonic lithobezoar are rare. Pica is the persistent ingestion of non-nutritive substances beyond a developmentally inappropriate age. Patients should be referred to a psychologist/behaviour analyst and caregivers should also be educated


2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Tyler McKechnie ◽  
Haroon Yousuf ◽  
Stephen Somerton

An 82-year-old female presented with a 4-week history of abdominal pain, weight loss, diarrhea, and nausea. A complete infectious workup was negative. Her computed tomography (CT) scan showed no pathologic changes and her esophagogastroduodenoscopy (EGD) showed erosive damage in the duodenum. Her duodenal biopsy showed inflammation with a marked increase in intra-epithelial lymphocytes and her immunohistochemistry was consistent with indolent T-cell lymphoproliferative disorder of the gastrointestinal tract. She was started on high dose steroids three months after the onset of her symptoms. She gradually improved with complete resolution of erosive changes on her repeat EGD.


2020 ◽  
pp. 28-38
Author(s):  
T. E. Polunina

Irritable bowel syndrome (IBS) – a recurrent functional disorder of the gastrointestinal tract (GIT), the main symptom of which is abdominal pain necessarily associated with a change in intestinal function. IBS is a functional intestinal disorder in which recurrent abdominal pain is associated with a defecation act and a change in the frequency or shape of the stool. The diagnosis of IBS remains exclusively clinical. The difficulty in studying IBS, especially from the perspective of its epidemiology, is that there is still no universal and specific biological marker. Very often patients complain about symptoms typical for several functional disorders, in particular, biliary tract pathology and IBS. The article discusses the multi-component causes and mechanisms of IBS formation, which are also present in other functional gastrointestinal tract diseases. Patients with IBS often have functional disorders of the biliary tract (FDBT) that are not associated with organic pathology. There are no reliable differences in the frequency and nature of FDBT in patients with IBS, depending on its current variant - with constipation or diarrhea prevalence. As a result, the treatment of patients with IBS remains a challenge, and the recurrence of the disease depends on the state of psycho-emotional health, the presence of overlap syndrome in most cases. The article presents the main international criteria for diagnostics of IBS. The main approaches to the treatment of IBS are considered. Good results in the treatment of IBS are observed when using drugs that affect the complex of pathophysiological mechanisms of the disease. This is confirmed in the article by a clinical case study. The prescription of the Sparex drug for pain relief in a patient with IBS and FDBT is justified by the fact that it not only eliminates pain, but also improves the rheological properties of bile, typical for overlap “IBS-FDBT” syndrome.


1988 ◽  
Vol 74 (5) ◽  
pp. 593-597 ◽  
Author(s):  
Saverio Di Palo ◽  
Agostino Faravelli ◽  
Edoardo Beretta ◽  
Gian Luca Taccagni

A 43 year-old man with a 15-year history of disseminated Langerhans histiocytosis (LH) in complete clinical remission was admitted with jaundice and abdominal pain. Pathological examination demonstrated LH in the choledochus associated with sclerosing cholangitis in the liver. Immunohistochemistry for S-100 protein and electron microscopy of the choledochus tissue showed Langerhans cell-like elements in the infiltrate. Our findings suggest that, in patients with disseminated Langerhans histiocytosis, liver function should be monitored, particularly, for signs of biliary obstruction, and demonstrate that such a finding is possible in adults.


2012 ◽  
Vol 78 (10) ◽  
pp. 1182-1186 ◽  
Author(s):  
Jason F. Richardson ◽  
John G. Lee ◽  
Brian R. Smith ◽  
Brian Nguyen ◽  
Kathleen P. Pham ◽  
...  

Endoscopic access to the gastric remnant and pancreatobiliary tree is technically difficult after Roux-en-Y gastric bypass even when facilitated by the use of specialized techniques such as balloon enteroscopy and the use of overtubes. Furthermore, such techniques are not universally available at all medical centers. We describe a case series of 13 patients with a history of Roux-en-Y gastric bypass for the treatment of morbid obesity who underwent laparoscopic transgastric endoscopy through the gastric remnant to access the duodenum or biliary tree. Charts of these patients were reviewed for demographics, indications for procedure, length of stay, morbidity, and mortality. Four of the patients had failed prior attempts to access the excluded anatomy through traditional transoral endoscopy. Two patients underwent transgastric endoscopy for evaluation of gastrointestinal bleeding. Of the 11 patients for whom endoscopic retrograde cholangiopancreatography was planned, all underwent successful biliary cannulation and sphincterotomy. There were no conversions to an open procedure or complications during the follow-up period. Laparoscopic transgastric endoscopy is a safe and reliable method to access the excluded stomach and biliary tree in patients with a history of Roux-en-Y gastric bypass.


Sign in / Sign up

Export Citation Format

Share Document