Quiste de colédoco Todani Iva. Reporte de caso y revisión de la literatura

2021 ◽  
Vol 64 (3) ◽  
pp. 37-42
Author(s):  
Rodolfo Iván Lara-Ruiz ◽  
Mauricio de la Concha Tiznado ◽  
Oscar Mendoza-Valencia ◽  
Adrián Fernando Pérez-González ◽  
Edmundo Arias-Gómez
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Choledochal Cyst ◽  
Surgical Approach ◽  
Biliary Tree ◽  
Imaging Studies ◽  
High Clinical Suspicion ◽  
History Of ◽  
Open Surgical Approach

Biliary tree dilations are unusual congenital malformations that may involve the entire bile circulation and, they are common during the first life decade. Most cases initiate with jaundice and chronic abdominal pain which localizes in right upper quadrant. High clinical suspicion accompanied by imaging studies are essential for diagnosisHigh suggestive clinic associated with imaging studies are essential for diagnosis. Treatment has evolved until today complete cyst resection has become the treatment of choice, since it presents a good response, although without being free from long-term complicationsTreatment has been evolving being at the present time cyst complete resection the gold standard in treatment although without being exempt from long-term complications. We present the case of a 27-year-old male patient with a history of 3 months onset epigastric abdominal pain diagnosed as Todani IVa common bile duct choledochal cyst by magnetic resonance imaging. It is performed Open surgical management was performed with total resection of the cyst and biliodigestive Roux-en-Y diversiona total cyst resection with Roux-en-Y biliodigestive bypass by open surgical approach without any complications. He was discharged 7 days post-op. A review of the literatura focused on the surgical approach and management of similar cases was carried out. We carry out bibliography review focused on surgical approach and management of similar cases. Keywords: Bile duct dilation; choledochal cyst; Todani IVa; jaundice.

scholarly journals Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases

2019 ◽  
Vol 9 ◽  
pp. 23
Author(s):  
Giulia Frauenfelder ◽  
Annamaria Maraziti ◽  
Vincenzo Ciccone ◽  
Giuliano Maraziti ◽  
Oliviero Caleo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Abdominal Pain ◽  
Imaging Modality ◽  
Biliary Duct ◽  
History Of ◽  
The Common ◽  
Solid Lesions

Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.

scholarly journals Treatment of juvenile angiofibromas: 18-year experience of a single tertiary centre in Spain

2012 ◽  
Vol 50 (1) ◽  
pp. 95-103
Author(s):  
Fernando Lopez ◽  
Vanessa Suarez ◽  
Maria Costales ◽  
Carlos Suarez ◽  
Jose L. Llorente
Keyword(s):  
Surgical Approach ◽  
Early Stage ◽  
Tumour Size ◽  
Vascular Supply ◽  
Open Approach ◽  
Tertiary Centre ◽  
Preauricular Approach ◽  
Conventional Open Approach ◽  
Open Surgical Approach

Background: The management of juvenile angiofibroma (JA) has changed during the last decades but it still continues to be a challenge. The objective of this study was to review the used treatment and our outcomes. Methods: From 1992 to 2010, 48 cases of JA were treated at our department. Charts were reviewed for standard demographic, tumour size and location, vascular supply and results of embolization, surgical approach, operative results, adjuvant therapies, recurrence and postoperative follow-up. Results: Most tumours were Andrews-Fisch stages III and IV and surgery was used as the main treatment in all cases. We used an open surgical approach in 37 (77%) patients and 11 (23%) were treated endoscopically. The most common open approach used in this series was the subtemporal-preauricular approach. Until 1995, all tumours were operated on by a conventional open approach. Afterwards, early-stage tumours were operated on through an endoscopic approach. Ten patients were treated through surgery followed by radiosurgery. Two (4%) patients had recurrent disease. Conclusions: These tumours should be treated at centres with expertise in skull base surgery to achieve complete surgical resections with low morbidity. Radiosurgery after surgery seems to be a valuable option in the long-term control of some extended JAs.

scholarly journals Choledochal cyst of the proximal cystic duct: a taxonomical and therapeutic conundrum

2018 ◽  
Vol 100 (2) ◽  
pp. e34-e37 ◽  
Author(s):  
R Kilambi ◽  
AN Singh ◽  
KS Madhusudhan ◽  
P Das ◽  
S Pal
Keyword(s):  
Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Frozen Section ◽  
Type Ii ◽  
Choledochal Cysts ◽  
Duct Excision ◽  
Term Data

Isolated choledochal cysts involving the cystic duct are rare. We present a case of a choledochal cyst involving only the proximal cystic duct, and discuss the taxonomic and therapeutic challenges. There is a need for a clearly defined classification system for these cysts as they may be categorised as either type II or type VI cysts. The optimal treatment remains debatable, with some authors recommending a bilioenteric reconstruction owing to the wide cystic duct–bile duct junction. However, we suggest that a cholecystectomy should be performed with examination of the specimen and frozen section in case of any abnormality rather than upfront bile duct excision. In addition, given the rarity of this condition and the paucity of long-term data, we recommend meticulous follow-up for development of any malignancy.

scholarly journals A rare cause of neutropenic enterocolitis: Propylthiouracil-induced agranulocytosis

2018 ◽  
Vol 25 (5) ◽  
pp. 286-289 ◽  
Author(s):  
Vermi Degerli ◽  
Fulya Yilmaz Duran ◽  
Mustafa Kucuk ◽  
Ibrahim Atasoy
Keyword(s):  
Abdominal Pain ◽  
Complete Blood Count ◽  
Multiple Organ ◽  
Antithyroid Drugs ◽  
Gastrointestinal Complication ◽  
Emergency Physicians ◽  
Neutropenic Enterocolitis ◽  
High Clinical Suspicion ◽  
Life Threatening ◽  
History Of

Introduction: Neutropenic enterocolitis is a life-threatening gastrointestinal complication of neutropenia that is rarely seen in adults. Neutropenic enterocolitis is more common in oncology patients, especially in those with leukemia. Antithyroid drugs are widely used to treat hyperthyroidism, but they can rarely cause agranulocytosis. Although the pathophysiology is not well understood, high clinical suspicion and immediate and appropriate treatment responses are essential to reduce the mortality rate of neutropenic enterocolitis. Case presentation: We present a case of a 57-year-old male patient who developed neutropenic enterocolitis as a result of agranulocytosis caused by the use of propylthiouracil. He had history of hyperthyroidism and was on propylthiouracil. He presented to the emergency department with abdominal pain but eventually died due to rapid deterioration of sepsis and multiple organ failure despite medical and surgical treatment. Discussion: Thioamides can cause agranulocytosis which can result in serious complication including neutropenic enterocolitis. Complete blood count must be monitored in patients receiving thioamides, and these patients should be educated on symptoms of agranulocytosis. Conclusion: Since patients with neutropenic enterocolitis are often evaluated first by emergency physicians, emergency physicians must be vigilant for neutropenic enterocolitis in patients with neutropenia and abdominal pain.

scholarly journals Case Report: Isolated Cystic Dilatation of the Cystic Duct: A Misdiagnosed Case Preoperatively

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiankang Zhang ◽  
Zeming Hu ◽  
Xuan Lin ◽  
Dongliang Zhang ◽  
Hao Wang ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Cystic Dilatation ◽  
Liver Transaminase ◽  
Caudal Portion ◽  
The Common

A 33-year-old female with a mild elevation of liver transaminase was sent to the general surgery department for medical services due to upper-right abdominal pain for 2 weeks. A liquid dark area ~4 × 3 × 3 cm in size in the theoretical location of the pancreatic segment of the common bile duct was detected by abdominal CT with no enhancement of the cystic wall found in the enhanced CT scan. The patient was then diagnosed with a choledochal cyst based on the results of the radiological images preoperatively. During the operation, the isolated cystic dilatation was found in the middle part of the cystic duct, and its caudal portion was found behind the head of the pancreas and converged into the common bile duct at an acute angle and low insertion. According to the intraoperative evaluation, the female was then diagnosed with a cystic duct cyst (CDC). The surgery was converted to a laparotomy for the unclear structure and the possibility of anatomic variation of the bile duct. The caudal portion of the cystic duct was found communicated with the common bile duct with a narrow base, and the extrahepatic bile duct was not cystic. The CDC was removed in the surgery. One week later, the patient was discharged from the hospital for the disappearance of abdominal pain and normal liver transaminase and did not report any discomfort in the 1-month-long follow-up. The lessons drawn from this case were as follows: (1) the distinction between the relatively frequent choledochal cyst and the isolated CDC should always be taken in mind; (2) a surgical strategy should be given priority for an intraoperatively confirmed CDC; (3) a common bile duct exploration is recommended for patients with choledocholithiasis or jaundice.

scholarly journals Annular pancreas with choledocholithiasis in an adult male patient: a case report

2019 ◽  
Vol 6 (10) ◽  
pp. 3834
Author(s):  
Ilija Milev ◽  
Panche Karagjozov ◽  
Aleksandar Mitevski ◽  
Marjan Mihailov
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Male Patient ◽  
Duodenal Bulb ◽  
Biliary Tree ◽  
Pancreatic Tissue ◽  
Annular Pancreas ◽  
Papilla Vateri ◽  
History Of ◽  
And Control

Annular pancreas is very rarely presented with a clinical picture of obstructive jaundice, usually due to some biliopancreatic malignancy rather than choledocholithiasis which make our case unique. We are presenting a 60-year-old male patient with a 6 mounts old medical history of right upper quadrant pain and intermittent jaundice. On ultrasonography a common bile duct stone was detected with dilatation of the biliary tree and gallstones with edematous wall of the gallbladder. On gastroscopy narrowing of the duodenum was registered. On ERCP the papilla Vateri could not be cannulated and there was a substantial amount of retained food in the duodenal bulb and antral part of the stomach. MRCP showed extensive dilatation of the whole biliary tree from several stones in the distal part of the common bile duct. At the operation there was a ring of pancreatic tissue about 2 cm wide that surrounded the second portion of the duodenum. The operation proceeded with choledochotomy, choledocholythotomy, L-L choledocho-duodenostomy and partial resection of the pancreatic ring. After three mounts the patient had gain weight, had no pain or any other symptoms and control gastroscopy showed normal finding.

Dislocations of the hip and femoral head fractures

2011 ◽  
Author(s):  
A. Pohl
Keyword(s):  
Femoral Head ◽  
Surgical Approach ◽  
Early Treatment ◽  
Closed Reduction ◽  
Open Reduction ◽  
Injury Pattern ◽  
General Anaesthetic ◽  
Associated Injuries ◽  
Imaging Studies

♦ Most injuries are high violence, so look for associated injuries♦ Immediate closed reduction usually best under general anaesthetic♦ Do not proceed to open reduction without appropriate imaging studies♦ Surgical approach depends on injury pattern♦ Some long term complications can be minimized/avoided by appropriate early treatment (e.g. avascular necrosis).

scholarly journals Sump Syndrome: A Rare Long-Term Complication of Choledochoduodenostomy

2017 ◽  
Vol 11 (2) ◽  
pp. 428-433 ◽  
Author(s):  
Hrudya Abraham ◽  
Sajan Thomas ◽  
Amit Srivastava
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Clinical Manifestations ◽  
Rare Condition ◽  
Endoscopic Retrograde ◽  
Distal Common Bile Duct ◽  
History Of ◽  
The Common

Biliary sump syndrome is a rare condition. It is seen as a rare long-term complication in patients with a history of a side-to-side choledochoduodenostomy. In the era before endoscopic retrograde cholangiopancreatography, side-to-side choledochoduodenostomy was a common surgical procedure for the management of biliary obstruction. In the setting of a side-to-side choledochoduodenostomy, the bile does not drain through the distal common bile duct anymore. Therefore, the part of the common bile duct distal from the choledochoduodenostomy anastomosis consequently transforms into a poorly drained reservoir, making this so-called “sump” prone to accumulation of debris. These patients are prone to cholangitis. We present a 64-year-old man with a history of side-to-side choledochoduodenostomy who presented with manifestations of cholangitis. An endoscopic retrograde cholangiopancreatography confirmed a diagnosis of sump syndrome. The etiology, clinical manifestations, and treatment of biliary sump syndrome are discussed in this article.

scholarly journals Intraductal papillary neoplasm of the bile duct: two case reports and review of the literature

2019 ◽  
Vol 6 (2) ◽  
pp. 25
Author(s):  
Vishal Kaila ◽  
Siddharth B Javia ◽  
Nirav Thosani ◽  
Isaac Raijman
Keyword(s):  
Bile Duct ◽  
Case Reports ◽  
Biliary Tree ◽  
Imaging Studies ◽  
Intraductal Papillary Neoplasm ◽  
Single Operator ◽  
Papillary Lesions ◽  
Extrahepatic Biliary Tree ◽  
Papillary Neoplasm ◽  
Made In

Background: Intraductal Papillary Neoplasm of the Bile Duct (IPNB) is a rare disease that is characterized by papillary lesions in the intra and extrahepatic biliary tree. Traditional imaging studies may show biliary dilation and/or filling defects. Endoscopic retrograde cholangiopancreatography can demonstrate diffuse bile duct dilatation as well as amorphous filling defects, however visualization of the biliary system can be limited by obstruction by the papillary lesions or mucin. Digital single operator cholangioscopy can be used to aid in diagnosis.Case Presentation: We report two elderly Caucasian males that presented with fatigue and obstructive jaundice. In both cases, the diagnosis of IPNB of was made. In one case, digital single operator cholangioscopy was used successfully to make the diagnosis.Conclusions: We present two cases of IPNB as well as a review of the clinical characteristics of IPNB and the utility of digital single operator cholangioscopy to aid in diagnosis. In IPNB, timely diagnosis is paramount. Traditional imaging studies can be inadequate, digital single operator cholangioscopy allows for quick diagnosis and, if indicated, further intervention. 

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