ABSTRACT
Caroli's disease is an uncommon congenital malformation involving the intrahepatic bile ducts. This paper reports two cases presenting with biliary tract infection. Diagnosis was established by non-invasive imaging and cholangiography. The infecting organisms were cultured from bile obtained by percutaneous aspiration and the results were used to direct antimicrobial therapy. The role of antibiotics and other management options in preventing recurrent infection is discussed.
Subject(s)
Caroli Disease/diagnostic imaging , Adult , Amoxicillin/therapeutic use , Bile Ducts, Intrahepatic/abnormalities , Caroli Disease/complications , Cholangiopancreatography, Endoscopic Retrograde , Cholangitis/drug therapy , Cholangitis/etiology , Drug Therapy, Combination/therapeutic use , Escherichia coli Infections/drug therapy , Escherichia coli Infections/etiology , Humans , Klebsiella Infections/drug therapy , Klebsiella Infections/etiology , Male , Metronidazole/therapeutic use , Tomography, X-Ray ComputedABSTRACT
In a preliminary analysis of data from a community survey of psychiatric disorders in urban Christchurch, 157 of the 1018 adults interviewed met diagnostic criteria for alcohol abuse and/or dependence. The subjects who met the criteria for alcohol abuse and/or dependence were more likely to have used mental health services than the population at large, although 39% of those with an alcohol disorder had never used any form of mental health service. We examined the impact of severity of alcohol disorder, duration of disorder and gender on the use of services among those with an alcohol disorder. Duration of disorder was not related to use of mental health services. Women are more likely than men to use these services. However, the most important finding was that those with the most severe disorders were most likely to have used mental health services.