scholarly journals Rare Presentation of Gall Bladder Adenomyomatosis

2021 ◽  
pp. 510-512
Author(s):  
M. Ishwarya ◽  
R. Anantharamakrishnan ◽  
K. Senthil Kumar ◽  
K. Pranay
Keyword(s):  
Gall Bladder ◽  
Bladder Wall ◽  
Young Male ◽  
Complete Disappearance ◽  
Rare Presentation ◽  
Contrast Enhanced ◽  
Gall Bladder Wall ◽  
History Of ◽  
The Right ◽  
Enhanced Computed Tomography

Introduction: Adenomyomatosis is a benign alterations of gall bladder wall that can be found in 9% of patients. We present a case of gall bladder adenomyomatosis of young male presented with right upper quadrant pain. Case Report: A 22 year old male admitted with a history of pain over right upper quadrant for 8 months. The patient’s physical examination revealed tenderness over the right hypochondrium region. Contrast enhanced computed tomography showed - gall bladder wall appeared diffusely thickened with multiple small cystic areas noted. Conclusion: Symptomatic gall bladder adenomyomatosis is an indicator for cholecystectomy, which results in complete disappearance of symptoms. Asymptomatic cases are not an indication for surgery, but the radiological diagnosis must be beyond any doubt. If there is a any diagnostic doubt about the possibility of gall bladder cancer, a cholecystectomy is justified.

scholarly journals Contrast-enhanced computed tomography of the liver, gall bladder and urogenital tract in female red-eared terrapins (Trachemys scripta elegans)

2017 ◽  
Vol 62 (No. 12) ◽  
pp. 674-680 ◽  
Author(s):  
V. Sochorcova ◽  
P. Proks ◽  
E. Cermakova ◽  
Z. Knotek
Keyword(s):  
Computed Tomography ◽  
Gall Bladder ◽  
Contrast Medium ◽  
Bladder Wall ◽  
Post Contrast ◽  
Contrast Medium Administration ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Contrast Studies

The aim of the present study was to evaluate the feasibility of contrast-enhanced computed tomography for organ morphology and perfusion in five captive terrapins. Native scans were performed and afterwards an iodinated non-ionic contrast media was manually administered through the jugular vein catheter. Post-contrast CT scans were taken 20 (T<sub>20</sub>), 60 (T<sub>60</sub>) and 180 (T<sub>180</sub>) seconds after the contrast medium administration. Maximum contrast enhancement of the kidneys and the liver was detected at T<sub>20</sub> and T<sub>60</sub>, respectively. The gall bladder content, the urinary bladder content and ovarian follicles were all without contrast enhancement in all five terrapins. Gall bladder wall thickness was 0.9 mm in all terrapins. Enhancement of the gall bladder wall in post-contrast studies was considered excellent, good or poor in two terrapins, two terrapins and one terrapin, respectively, with a mean score of 1.8 ± 0.84 over all contrast studies. Enhancement of the ureters in post-contrast studies was considered excellent in all terrapins in all contrast studies. Peak aortic enhancement was reached 20 seconds after contrast medium administration with the peak enhancement of 213.5 ± 41 HU in four terrapins and 560 HU in one terrapin. Peak hepatic vein enhancement after contrast medium administration was recorded 20 and 60 seconds in two and three terrapins, respectively. In conclusion, contrast-enhanced computed tomography proved to be a valuable method for clinical examination of the liver, gall bladder, kidneys, ureters, urinary bladder and ovarian follicles in red-eared terrapins.

scholarly journals Predicting difficult laparoscopic cholecystectomy

2018 ◽  
Vol 5 (3) ◽  
pp. 1094 ◽  
Author(s):  
Atul Kumar Gupta ◽  
Nitin Shiwach ◽  
Sonisha Gupta ◽  
Shalabh Gupta ◽  
Apoorv Goel ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Statistical Significance ◽  
Gallstone Disease ◽  
Bladder Wall ◽  
P Value ◽  
Clinical Predictors ◽  
Duration Of Symptoms ◽  
Gall Bladder Wall ◽  
History Of

Background: Laparoscopic cholecystectomy (LC) has become the gold standard treatment for gallstone disease. Though mostly safe occasionally it can be difficult due to various problems faced during surgical procedure. Anticipation of likely difficulty can help in avoiding complications.Methods: With the aim of identifying various predictors of difficulty and their correlation with likely difficulty this prospective study on 50 adults undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis was undertaken. Various clinical, radiological and biochemical predictors and frequency and type of intraoperative difficulty was recorded.Results: In present study adverse clinical factors only showed significant predictive value (p value - 0.005). Adverse radiological predictors although showing trend towards, did not achieve statistical significance (p value 0.065). In clinical predictors duration of symptoms >1yr, History of acute cholecystitis and BMI >30 showed statistically significant association. Age >50yrs, Male gender, radiological predictors (Thickened gall bladder wall, small contracted gall bladder, Single large impacted stone) and deranged LFT did not show significant predictive value.Conclusions: Clinical predictors are most reliable factors. Use of good clinical judgement regarding possibility of and likely difficulty along with understanding of available resources is important in making decision in each case.

scholarly journals Gall Bladder Wall Thickness as a Predictor for Laparoscopic Cholecystectomy Difficulties in Gadarif, Eastern Sudan

2021 ◽  
Vol 2 (3) ◽  
pp. 158-163
Author(s):  
Sami E. E. Salah ◽  
Hawa Yahia
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wall Thickness ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Bladder Wall ◽  
Bladder Wall Thickness ◽  
Conversion To Open Cholecystectomy ◽  
Gall Bladder Wall ◽  
History Of

Background: Laparoscopic cholecystectomy is a revolutionary change in the treatment of patients with gallbladder stones. Multiple studies have identified factors that are predictive of surgical difficulties including preoperative ultra-sonographic findings. Objective: To determine the effectiveness of sonographic measurement of gall bladder wall thickness as a predictive factor for laparoscopic cholecystectomy difficulties in Gadarif Teaching Hospital, Sudan. Patients and methods: This are a prospective, observational, analytical cross-sectional hospital-based study in which all patients who underwent laparoscopic cholecystectomy for gall stones disease and had a pre-operative sonographic measurement for GBWT in GTH in the year 2019 were included. Results: 110 cases were studied. The male to female ratio was 0.2: 1, the mean age was 35±3.8 years. Past history of the acute attack reported in 54 (48.2%) of the patients, history of ERCP was reported in 2 (1.8%) and the majority of patients 71 (64.5%) has no associated medical condition. Abdominal examination was normal in 69 (62.7%) of the patients, 35 (31.8%) patients showed positive Murphy's sign or other signs. Gall bladder thickening, as a predictor of difficulty, was normal of ≤ 3 mm in 69 (62.7%), mild (4-5 mm) in 34 (30.9%), moderate (6-7 mm) in 5 (4.5%), and severe > 7 in 2 (1.8%) of the patients. A significant association was found between GBWT and: duration of symptoms, the number of attacks, operative time and hospital stay, postoperative complication, and conversion to open cholecystectomy. Operative time was found to be associated with the experience of the operator (P-value < 0.05). Conclusion: Pre-operative sonographic increasing gall bladder wall thickness is associated with difficult laparoscopic cholecystectomy in terms of postoperative complications, prolonged operative time, and conversion to open cholecystectomy even in expert hands.

scholarly journals Multifocal facial Rosai Dorfman disease with postsurgical recurrence

2021 ◽  
Vol 7 (8) ◽  
pp. 1377
Author(s):  
Ishita Sen ◽  
Subhadeep Chowdhury ◽  
Tithi Debnath
Keyword(s):  
Past History ◽  
Fatal Outcome ◽  
Nasal Mass ◽  
Contrast Enhanced ◽  
Rosai Dorfman Disease ◽  
History Of ◽  
Postsurgical Recurrence ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

<p class="abstract">Rosai Dorfman disease (RDD) is a histiocytic proliferative disorder with massive painless lymphadenopathy that though is rare yet has been reported more than seldom. Our report aimed to emphasis on a case with multifocal facial involvement with postsurgical recurrence, which had not yet been reported and an approach to alleviate the patient’s symptoms and avert a fatal outcome. This study was a case report and literature review. A 19 year old female presented with swelling involving right sided cheek, periorbital region and bilateral nasal cavity with palatal perforation for last 6 months. She had a past history of debulking of orbital RDD. Contrast enhanced computed tomography revealed an extraconal mass of the right orbit and left nasal mass extending to the nasopharynx. Biopsy taken from the nasal masses showed RDD on histopathology and immunohistochemistry. Though the disease was self-resolving, this patient required radiotherapy as debulking was not sufficient for its multifocal presentation and was followed by palatal reconstruction.</p>

scholarly journals Assessment of a Scoring System to Predict Difficult Laparoscopic Cholecystectomy

2020 ◽  
Vol 42 (3) ◽  
pp. 71-75
Author(s):  
Prem R Sigdel ◽  
Nirajan Subedi ◽  
Suman Phuyal ◽  
Ashik Pokharel ◽  
Bikal Ghimire ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Surgery ◽  
Gall Bladder ◽  
Wall Thickness ◽  
Bladder Wall ◽  
Bladder Wall Thickness ◽  
Previous Abdominal Surgery ◽  
Gall Bladder Wall ◽  
History Of ◽  
Impacted Stone

Introduction Laparoscopic cholecystectomy (LC) has become the procedure of choice for management of symptomatic gallstone disease. It would be useful to have some reliable predictive factors for conversion in LC. Our aim is to predict difficult laparoscopic cholecystectomy preoperatively by using a scoring system. MethodsA total of 136 patients were included. The parameters considered for this study were old age, male sex, history of hospitalization, obesity, abdominal surgery scar, palpable gall bladder, gall bladder wall thickness, pericholecystic collection and impacted stone. ResultsAmong 136 cases, 70.6% were easy, 24.3% were difficult and 5.1% were very difficult intraoperatively. The factors like age >50 years, history of hospitalization for acute cholecystitis, previous abdominal surgery, palpable gall bladder, wall thickness >4mm and impacted stone were found statistically significant in predicting difficult LC. The preoperative scoring is statistically and clinically a good test for predicting the difficult LC (area under the curve = 0.824) with sensitivity of the test being 82.3% and specificity 72.7%. Conversion rate was 3.67%. ConclusionThe factors like age >50 years, history of hospitalization for acute cholecystitis, previous abdominal surgery, palpable gall bladder, wall thickness >4 mm and impacted stone are the preoperative predictors of difficult LC.

Pre-operative Prediction of Difficult Laparoscopic Cholecystectomy

2021 ◽  
Vol 15 (6) ◽  
pp. 1324-1327
Author(s):  
P. Lal ◽  
B. Shaikh ◽  
S. Athar ◽  
I. Baloch ◽  
A. A. Shah ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Surgery ◽  
Gall Bladder ◽  
Operative Time ◽  
Bladder Wall ◽  
Fluid Collection ◽  
Bladder Wall Thickness ◽  
Previous Abdominal Surgery ◽  
Gall Bladder Wall ◽  
History Of

Aim: To evaluate the factors for prediction of difficult laparoscopic cholecystectomy preoperatively. Methods: A Prospective Observational Study conducted at Surgical Unit II, Ghulam Muhammad Mahar Medical College Hospital Sukkur, from February 2020 to January 2021. Data was collected for 580 patients. All the patients fulfilling inclusion criteria were evaluated with following factors: age, gender, BMI, h/o previous GB disease, comorbids, h/o previous abdominal surgery, tender RHC, palpable gallbladder, ultrasonographic findings of gall bladder wall thickness, pericholecystic fluid collection & stone impaction at neck of gall bladder. Patients were assumed to be difficult on presence of one or more of above mentioned risk factors .laparoscopic cholecystectomy was performed by an experienced laparocopic surgeon. Peroperative findings and operative time was noted. Cases were considered difficult if operative time was >60 minutes or if the case was converted to open. All the information was recorded on predesigned proforma. Results: Age ranged from 23 to 70 years (mean age = 46.37 years). 456 patients were female while 124 patients were male. Majority of patients in our study (n=390) had normal BMI(BMI=18.5-24.9)and next majority (n=132) belonged to overweight group(BMI=25-29.9) . On inquiry, 93 patients had history of previous gall bladder disease in form of cholecystitis. Out of 580 patients, 161 patients had one or more comorbids. 39 out of 580 patients had history of previous abdominal surgery. 78 patients had tender right hypochonrium. 62 patients had palpable gall bladder. On ultrasound 73 patients had gall bladder wall thickness >4mm. In 39 patients pericholecystic fluid collection was found. In 33 patients, stone was impacted at the neck of gall bladder. 161 patients were preoperatively labeled as difficult. All the patients underwent laparoscopic cholecystectomy. Mean operative time was 42.56 minutes. 512 patients underwent uneventful laparoscopic cholecystectomy, in 68 patients difficulty was encountered 11 patients were converted to open procedure. Conclusion: We conclude that a careful insight in certain factors can predict the difficult laparoscopic cholecystectomy preoperatively. It acts as an important eye opener for surgeons to get an idea of the potential difficulty to be faced in that particular patient. Keywords: Laparoscopic cholecystectomy, Preoperative, Gall stones, Difficulty

Mo1144 Efficacy of Diagnosis for Acute Cholecystitis With Contrast Enhanced Ultrasonography: Evaluation for Blood Flow of the Gall Bladder Wall

2012 ◽  
Vol 142 (5) ◽  
pp. S-606
Author(s):  
Hiroki Utsunomiya ◽  
Atsushi Hiraoka ◽  
Miki Kan ◽  
Yusuke Imai ◽  
Haruka Tatsukawa ◽  
...  
Keyword(s):  
Blood Flow ◽  
Gall Bladder ◽  
Acute Cholecystitis ◽  
Bladder Wall ◽  
Contrast Enhanced ◽  
Gall Bladder Wall ◽  
Contrast Enhanced Ultrasonography

scholarly journals Venipuncture Induced Complex Regional Pain Syndrome Presenting as Inflammatory Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Punit Pruthi ◽  
Pramod Arora ◽  
Manoj Mittal ◽  
Anugrah Nair ◽  
Waqia Sultana
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Inflammatory Arthritis ◽  
Young Male ◽  
Pain Syndrome ◽  
Poor Response ◽  
History Of ◽  
Diagnostic Modalities ◽  
Musculoskeletal Ultrasonography ◽  
The Right

Venipuncture is one of the most commonly done medical procedures. We report a unique case of a 23-year-old young male who presented with features suggestive of inflammatory arthritis. The symptoms, which initially started on the right side, also involved the other side after a few weeks. Although the patient’s symptoms and signs were simulating inflammatory arthritis, he had atypical features like poor response to anti-inflammatory medicines and normal laboratory parameters. His musculoskeletal ultrasonography was also not suggestive of arthritis. His history was reviewed and on direct questioning he revealed a history of venipuncture for blood sample withdrawal, done from right antecubital region for routine health check on the day prior to the onset of symptoms. Complex regional pain syndrome was suspected and triple-phase radioisotope bone scan was done which was highly suggestive of this diagnosis. The patient was managed with multidimensional approach and responded very well to the treatment. Complex regional pain syndrome is usually not thought of in the initial differential diagnosis of inflammatory arthritis. In this report we highlight the need to elicit the often overlooked history of trivial trauma like venipuncture, especially in atypical cases of arthritis. Also the role of newer diagnostic modalities in such cases is emphasized.

scholarly journals Patterns of Gall Bladder Wall Thickening in Dengue Fever: A Mirror of the Severity of Disease

2017 ◽  
Vol 03 (02) ◽  
pp. E76-E81 ◽  
Author(s):  
Jitendra Parmar ◽  
Chander Mohan ◽  
Maulik Vora
Keyword(s):  
Gall Bladder ◽  
Dengue Fever ◽  
Bladder Wall ◽  
Warning Signs ◽  
Severe Dengue ◽  
Wall Thickening ◽  
Severity Of Disease ◽  
Gall Bladder Wall ◽  
Track Pattern ◽  
Honeycomb Pattern

Abstract Background Dengue fever is a major public health problem with an increased incidence in recent years. Gall bladder wall thickening has been reported as one of the most common findings in dengue fever. There is a paucity of literature regarding the various patterns of gall bladder wall thickening in dengue fever and their significance in predicting the severity of disease. Methodology and Significant Findings Out of 93 seropositive patients included in the study, 54 patients with dengue fever had gall bladder wall thickening. 4 patterns of gall bladder wall thickening are demonstrated in this study. A uniform echogenic pattern in 20 patients, striated or tram track pattern in 11 patients, an asymmetric pattern in 2 patients and a honeycombing pattern in 21 patients. The range of patterns of wall thickening included normal wall thickening or uniform echogenic wall thickening in DF without warning signs, a striated or tram track pattern, and a honeycomb pattern in severe DF. Serial ultrasound done on consecutive alternate days revealed a change in the pattern of gall bladder wall thickening according to the severity of disease. Conclusion The present study revealed 4 distinct patterns of gall bladder wall thickening. The uniform echogenic pattern was found to be more prevalent in dengue fever without warning signs, while the honeycomb pattern was found to be more prevalent in severe dengue fever. A change in the pattern of gall bladder wall thickening on subsequent serial ultrasound can predict the severity of the disease.

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