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

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.

scholarly journals Torsion of Hydrosalpinx with Concurrent Acute Cholecystitis: Case Report and Review of Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Preeti R. John ◽  
Amelia M. Pasley
Keyword(s):  
Abdominal Pain ◽  
Acute Cholecystitis ◽  
Fallopian Tube ◽  
Bladder Wall ◽  
Age Groups ◽  
Lower Abdominal Pain ◽  
Abdominal Ultrasound ◽  
Acute Calculous Cholecystitis ◽  
Upper Abdominal ◽  
The Right

Introduction.Isolated torsion of the Fallopian tube is an uncommon cause of acute lower abdominal pain and can occur in women of all age groups. Cholecystitis is a frequent cause of upper abdominal pain. We present an unusual case with the presence of these two distinct pathological entities occurring concurrently in the same patient, causing simultaneously occurring symptoms. To our knowledge, this is the first reported presentation of such a case.Methods.We describe a 34-year-old premenopausal woman who presented with right sided upper and lower abdominal pain and nausea. Abdominal ultrasound (US) revealed acute cholecystitis. Vaginal US was suggestive of right hydrosalpinx. Intravenous antibiotics were administered and consent was obtained for operative intervention. During laparoscopy, the right Fallopian tube with hydrosalpinx was noted to be twisted three times. The right ovary appeared normal. The gall bladder wall was thickened and inflamed. Laparoscopic right salpingectomy and cholecystectomy were performed.Results.Surgical pathology revealed hydrosalpinx with torsion and acute calculous cholecystitis. The patient had an uneventful postoperative course and was discharged home on the first postoperative day. Her symptoms resolved after the procedure.Conclusions.In women with abdominal pain, both gynecologic and nongynecologic etiologies should be considered in the differential diagnoses. Concurrent presence of symptomatic gynecologic and nongynecologic intra-abdominal pathology is rare. Isolated Fallopian tube torsion is rare and is associated most often with hydrosalpinx. Some torqued Fallopian tubes can be salvaged. Laparoscopy is useful in management of both Fallopian tube torsion and cholecystitis.

scholarly journals A Rare Anomaly of Biliary System: MRCP Evidence of a Cystic Duct Cyst

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Cemil Goya ◽  
Mehmet Serif Arslan ◽  
Alpaslan Yavuz ◽  
Cihad Hamidi ◽  
Suzan Kuday ◽  
...  
Keyword(s):  
Cystic Duct ◽  
Clinical Symptoms ◽  
Rare Condition ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Colic ◽  
Cystic Dilatation ◽  
Duct Cyst ◽  
Abdominal Ultrasonography ◽  
Number Of Patients ◽  
The Right

Cystic duct cysts are a rare congenital anomaly. While the other bile duct cysts (choledochus and the intrahepatic bile ducts) are classified according to the classification described by Tadoni, there is no classification method described by the cystic duct cysts, although it is claimed that the cystic duct cysts may constitute a new “Type 6” category. Only a limited number of patients with cystic duct cysts have been reported in the literature. The diagnosis is usually made in the neonatal period or during childhood. The clinical symptoms are nonspecific and usually include pain in the right upper quadrant and jaundice. The condition may also present with biliary colic, cholangitis, cholelithiasis, or pancreatitis. In our case, the abdominal ultrasonography (US) performed on a 6-year-old female patient who presented with pain in the right upper quadrant pointed out an anechoic cyst at the neck of the gall bladder. Based on the magnetic resonance cholangiopancreatography (MRCP) results, a cystic dilatation was diagnosed in the cystic duct. The aim of this case-report presentation was to discuss the US and MRCP findings of the cystic dilatation of cystic duct, which is an extremely rare condition, in the light of the literature information.

scholarly journals Empyema with giant dilatation of the gallbladder

2008 ◽  
Vol 21 (2) ◽  
pp. 90-91 ◽  
Author(s):  
André Luiz Santos Rodrigues ◽  
Marcelino Ferreira Lobato ◽  
Carla Andrea Ribeiro Braga ◽  
Lucas Crociati Meguins ◽  
Daniel Felgueiras Rolo
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Acute Cholecystitis ◽  
Ultrasound Images ◽  
Early Cholecystectomy ◽  
Presenting Symptoms ◽  
Operative Complications ◽  
Mild Abdominal Pain ◽  
Clinical Consequences ◽  
The Right

INTRODUCTION: Gallbladder empyema is a serious complication of acute cholecystitis being peritonitis and sepsis it's main clinical consequences. Organ giant volume is rare specially with no relevant symptoms. CASE REPORT: Man 56-year-old with mild abdominal pain on the right hypochondrium, palpable gallbladder and ultrasound images revealing cholelithiasis. At surgery, there was a giant dilatation of the gallbladder with 580 mL of purulent bile. Cholecystectomy was carried out without post-operative complications. CONCLUSION: Early cholecystectomy should always be realized in patients presenting symptoms of gallbladder empyema no matter the size of it.

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

scholarly journals Heterotopic Pancreas in the Gallbladder: Case Report and Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Emad Aborajooh ◽  
Ibrahim Khalil Khairi Ghayada ◽  
Yasser Mustafa Issa Lafi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Literature Review ◽  
Acute Cholecystitis ◽  
Gallbladder Wall ◽  
Pancreatic Tissue ◽  
Heterotopic Pancreas ◽  
Abdominal Ultrasonography ◽  
Pancreatic Acini ◽  
Case Presentation ◽  
Upper Abdominal

Introduction. Heterotopic pancreas (HP) is the congenital presence of pancreatic tissue outside its normal location in the absence of vascular and anatomical connection with the main pancreas. HP can affect any part of the gastrointestinal tract, and it is mostly encountered in the stomach. The gallbladder is a rare site of HP, and our literature review revealed that only 38 cases were reported. We present a case of HP in the gallbladder that was presented with a picture of acute cholecystitis. After the case presentation, we will discuss HP in the gallbladder by reviewing the literature. Case Presentation. A 49-year-old male presented to the emergency department complaining of progressively worsening right upper abdominal pain for the last 24 hours. After thorough history and physical examination, a provisional diagnosis of acute cholecystitis was made. Abdominal ultrasonography revealed a rim of edema surrounding the gallbladder wall with two stones impacted at the gallbladder neck. Laparoscopic cholecystectomy was performed with an uneventful postoperative course, and the patient was discharged the next day. Microscopic examination of the gallbladder showed that a heterotopic pancreatic tissue, composed of a large number of pancreatic acini and few ducts with the absence of islets of Langerhans, was found around the cystic duct. The patient was asymptomatic at the regular follow-up six months postoperatively. Conclusion. HP in the gallbladder is an extremely rare finding. Its clinical presentation is not different from other cholecystopathic diseases. Most cases were accompanied by cholelithiasis. Preoperative laboratory and imaging modalities are usually not helpful in the diagnosis of HP in the gallbladder. The definitive diagnosis is made by histological examination of the gallbladder specimen. Laparoscopic cholecystectomy is sufficing treatment.

scholarly journals Corrective surgery using a gridiron incision for abdominal pain caused by a folded ovary in the third trimester of pregnancy

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199774
Author(s):  
A Mi Kim ◽  
Jong Woon Kim ◽  
Yoon Ha Kim ◽  
Tae Young Kim ◽  
Hyun Kyung Ryu ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Laparoscopic Surgery ◽  
Tender Point ◽  
Sudden Onset ◽  
Third Trimester ◽  
Normal Appendix ◽  
Abdominal Ultrasonography ◽  
Lower Quadrant ◽  
The Third ◽  
The Right

Introduction Sonography and magnetic resonance imaging (MRI) may be helpful to obtain an accurate diagnosis of acute abdominal pain in pregnancy. Adnexal torsion presenting in the first or second trimester can be confirmed and treated through laparoscopic surgery; however laparoscopic surgery in the third trimester can be difficult owing to the large uterus, and a gridiron incision can be useful. Case Report/Case presentation An 18-year-old gravida 1, para 0 (G1P0) woman at 30 + 4 weeks of gestation presented with sudden-onset cyclic pain in the right lower quadrant. Abdominal ultrasonography showed a normal appendix, and MRI showed a normal appendix and normal ovaries. The patient’s prominent tender point was marked and compared with the MR images, which confirmed the mark as the position of the right ovary. Laparotomy was performed through a gridiron incision, and a folded right ovary was identified. The ovary was unfolded, and TachoSil® and Surgicel® were used to maintain the unfolded position. The patient’s pain resolved, and her postoperative course was uneventful. She delivered a healthy, 2540-g male baby at 35 weeks’ gestation. Discussion/Conclusions A gridiron incision was useful to treat a folded ovary in the third trimester and to evaluate the adnexa and minimize uterine manipulation.

scholarly journals An Unusual Case of Monolobar Caroli’s Disease

1994 ◽  
Vol 8 (3) ◽  
pp. 185-188
Author(s):  
Anthony J Gomez ◽  
Robert J Bailey
Keyword(s):  
Abdominal Pain ◽  
Unusual Case ◽  
Pathological Examination ◽  
Right Hepatectomy ◽  
Radiological Evaluation ◽  
Caroli's Disease ◽  
Caroli’S Disease ◽  
Hepatic Lobe ◽  
Upper Abdominal ◽  
The Right

A 27-year-old male with recurrent upper abdominal pain was found to have a suspicious mass in the right hepatic lobe. Right hepatectomy was performed. Pathological examination and further radiological evaluation proved this to be a focal form of Caroli’s disease.

scholarly journals Signal Intensity of Superb Microvascular Imaging Correlates with the Severity of Acute Cholecystitis

2016 ◽  
Vol 10 (2) ◽  
pp. 452-458 ◽  
Author(s):  
Minoru Tomizawa ◽  
Fuminobu Shinozaki ◽  
Yasufumi Motoyoshi ◽  
Takao Sugiyama ◽  
Shigenori Yamamoto ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Signal Intensity ◽  
Gallbladder Wall ◽  
Abdominal Ultrasonography ◽  
Small Vessels ◽  
Protein Levels ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Superb Microvascular Imaging ◽  
Upper Abdominal ◽  
Microvascular Imaging

Evaluation of the severity of acute cholecystitis is critical for the management of this condition. Superb microvascular imaging (SMI) enables the assessment of slow blood flow of small vessels without any contrast medium. An 84-year-old man visited our hospital with right upper abdominal pain. Computed tomography and abdominal ultrasonography showed a slight thickening of the gallbladder. White blood cell count and C-reactive protein levels were elevated. He was diagnosed with acute cholecystitis and treated conservatively with antibiotics. Two days later, his condition worsened and percutaneous transhepatic gallbladder drainage (PTGBD) was performed. The patient recovered and was discharged, and his drainage was withdrawn 7 days later. On admission, color-coded SMI (cSMI) showed pulsatory signals on the slightly thickened gallbladder wall. On the day of PTGBD, the intensity of the signal on cSMI had increased. Once the patient was cured, no further signal was observed on the gallbladder wall with either cSMI or mSMI. In conclusion, the strong pulsatory signal correlated with the severity of acute cholecystitis observed with cSMI and mSMI. Illustrating the signal intensity is useful for the evaluation of the severity of acute cholecystitis.

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