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1.
Rev. argent. cir ; 111(2): 107-110, jun. 2019. ilus
Article in English, Spanish | LILACS | ID: biblio-1013354

ABSTRACT

Los quistes congénitos de la vía biliar son infrecuentes y se definen por la dilatación quística del árbol biliar en cualquiera de sus porciones. Los quistes del conducto cístico son aún menos frecuentes. Su etiología permanece incierta y el tratamiento consiste en la resección debido a su potencial desarrollo de malignidad. Presentamos el caso de una paciente en la que se diagnosticó dilatación del conducto cístico y fue tratada por vía laparoscópica.


Congenital biliary duct cysts are rare and are defined as cystic dilatations of the biliary tree in any of its portions. Cystic duct cysts are more uncommon. Their etiology remains uncertain and they should be resected due to the possible development of malignancy. We report the case of a female patient with a diagnosis of dilation of the cystic duct that was treated with laparoscopic surgery.


Subject(s)
Humans , Female , Adult , Young Adult , Choledochal Cyst/diagnostic imaging , Laparoscopy/methods , Biliary Tract Diseases/diagnosis , Cholecystitis/diagnosis , Ultrasonography , Abdomen/diagnostic imaging
2.
Rev. Fac. Cienc. Méd. Univ. Cuenca ; 36(1): 75-80, Junio 2018. tab
Article in Spanish | LILACS | ID: biblio-998800

ABSTRACT

La pancreatitis necrotizante, una forma grave de la pancreatitis aguda, produce falla multiorgánica siendo la litiasis biliar su principal etiología. Se realiza la descripción de un caso clínico de una paciente de 16 años de edad con cuadro caracterizado por dolor abdominal de varios días de evolución, que junto a exámenes complementarios es indicativo de pancreatitis aguda, recibiendo tratamiento hospitalario sin mejoría es intervenida quirúrgicamente, encontrándose lesiones macroscópicas compatibles con pancreatitis necrotizante más litiasis biliar, se realiza resección del 60% de páncreas más colecistectomía por litiasis vesicular. Permanece en la unidad de cuidados intensivos para antibioticoterapia con posterior recuperación.


The necrotizing pancreatitis is a severe form of acute pancreatitis, which causes multiorgan failure, with biliary lithiasis being its main etiology.The description of a clinical case of a 16-year-old patient with abdominal pain of several days of evolution is made. This case and complementary tests are an indicative of acute pancreatitis. Despide of receiving hospital treatment without improvement, the patient is operated surgically. Macroscopic lesions compatible with necrotizing pancreatitis and biliary lithiasis were found. A resection of 60% of the pancreas and a cholecystectomy for vesicular lithiasis was performed. The patient stays in the intensive care unit for antibiotic therapy with a subsequent recovery.


Subject(s)
Humans , Female , Adolescent , Abdominal Pain , Pancreatitis, Acute Necrotizing , Lithiasis , Surgical Procedures, Operative , Cholecystitis/diagnosis
3.
Rev. méd. (La Paz) ; 24(1): 19-26, 2018. ilus
Article in Spanish | LILACS, LIBOCS | ID: biblio-961365

ABSTRACT

Las Guías de Tokio (TG-13) se utilizan para diagnosticar, evaluar la gravedad y guiar el manejo de la Colecistitis Aguda (CA). El objetivo de nuestro estudio fue aplicar las Guías de Tokio en el diagnóstico de CA de los servicios de emergencias y cirugía en el Hospital de Clínicas, durante abril a noviembre de 2017. La población estuvo constituida por 222 pacientes que ingresaron con síntomas de CA a los servicios de cirugía y emergencias; la edad promedio fue 40 ± 10 años y el 86% fueron mujeres (Grado I: 89.6%, Grado II: 9.4%, Grado III: 0%). Haciendo una correlación según TG-13 y los hallazgos quirúrgicos implicó que 14% tenían una colecistitis aguda edematosa, 5% colecistitis aguda necrotizante clasificados según la guía de Tokio como colecistitis aguda leve y 3% con diagnóstico de colecistitis aguda reagudizada con colecistitis aguda moderada. Se observó que la TG13 presentó una sensibilidad del 83% para el diagnóstico de CA, concluyendo que las TG-13 son aplicables en nuestro medio, permiten diagnosticar, clasificar adecuadamente y contar con una pauta de manejo para un tratamiento oportuno.


Tokyo Guidelines (TG-13) are used to diagnose, assess severity and guide the management of Acute Cholecystitis (AC). The aim of our study was to apply Tokyo Guidelines in the diagnosis of AC in emergency and surgery services at Hospital de Clínicas, between April to November 2017. It was studied 222 patients who were admitted with AC symptoms to surgery and emergency services. 40 ± 10 was the average age, 86% were women, 89.6% corresponded to Grade I, 9.4% Grade II and grade III was not present. Performing a correlation according to TG-13 and surgical findings it was observed that 14% had an acute edematous cholecystitis, 5% acute necrotizing cholecystitis classified as mild acute cholecystitis according to Tokyo Guidelines, and 3% with diagnosis of exacerbated acute cholecystitis and with moderated acute cholecystitis. TG-13 showed a sensibility of 83% for AC diagnosis. It is concluded that TG-13 are applicable in our setting, they allow to diagnose, to classify adequately, and to have a management guideline for AC opportune treatment.


Subject(s)
Cholecystitis, Acute , Cholecystitis/diagnosis
4.
Rev. chil. cir ; 69(6): 479-482, dic. 2017. ilus
Article in Spanish | LILACS | ID: biblio-899640

ABSTRACT

Resumen Antecedentes: El vólvulo de la vesícula biliar se produce por el giro de la vesícula sobre su mesenterio a lo largo del eje del conducto y arteria císticos, con afectación de la irrigación vascular de forma completa o incompleta, pudiendo existir ciertas características anatómicas predisponentes. Caso clínico: Masculino de 87 años quien cursó con abdomen agudo; sospechando cuadro de piocolecisto, se realizó exploración quirúrgica encontrando como hallazgos triple torsión vesicular y múltiples litos color oscuro; se realizó colecistectomia abierta, cursando con una evolución satisfactoria. Discusión: Se trata de una entidad infrecuente que puede simular una colecistitis aguda; generalmente tiene buen pronóstico cuando el diagnóstico se realiza a tiempo. El tratamiento de elección es la colecistectomía laparoscópica.


Abstract Background: The gallbladder volvulus is produced by the rotation of the gallbladder over its mesentery along the axis of the cystic duct and artery, with involvement of vascular irrigation in a complete or incomplete way, and there may be certain predisposing anatomical characteristics. Clinical case: Male patient of 87 years who attended with acute abdomen, suspecting pyogenic cholecystitis, performs surgical exploration finding as vesicular triple twist, multiple stones dark. Open cholecystectomy is performed, following a satisfactory evolution. Discussion: It is an uncommon entity that can simulate acute cholecystitis, usually has a good prognosis, when the diagnosis is made on time. The treatment of choice is laparoscopic cholecystectomy.


Subject(s)
Humans , Male , Aged, 80 and over , Torsion Abnormality/surgery , Torsion Abnormality/complications , Gallbladder Diseases/surgery , Gallbladder Diseases/complications , Torsion Abnormality/diagnosis , Cholecystectomy/methods , Cholecystitis/diagnosis , Laparoscopy , Gallbladder Diseases/diagnosis , Abdomen, Acute/etiology
5.
Rev. méd. hondur ; 83(1/2): 18-22, ene.-jun. 2015. tab
Article in Spanish | LILACS | ID: biblio-933

ABSTRACT

Antecedentes: Colecistectomía Laparoscópica Ambulatoria (CLA) es el procedimiento donde el tiempo entre ingreso y egreso del paciente es <12 horas. En el Hospital de Especialidades (HE) del Instituto Hondureño de Seguridad Social (IHSS), Tegucigalpa, se implementó desde 2007. Objetivo: Determinar las características de CLA y de Colecistectomía Laparoscópica Hospitalaria (CLH), IHSS, 2012-2013. Métodos: Estudio descriptivo transversal en pacientes atendidos en Unidad de Cirugía Ambulatoria y HE IHSS, enero 2012­Enero 2013. Se identificaron características sociodemográficas y clínicas a partir de expedientes seleccionados aleatoriamente. Se estimó costo-beneficio en base a costo/intervención quirúrgica y días de hospitalización e incapacidad. Resultados se presentan como frecuencia y porcentaje, razones de disparidad (OR), intervalo de confianza 95% y valor de p<0.05. Resultados: Se analizaron 100 pacientes en cada grupo. Se asociaron a CLA edad ≤50 (3.8, 2.1

Subject(s)
Humans , Male , Female , Middle Aged , Ambulatory Surgical Procedures/methods , Cholecystectomy, Laparoscopic/trends , Cholecystitis/diagnosis , Health Care Costs , Health Services Administration/legislation & jurisprudence
6.
Article in English | IMSEAR | ID: sea-158699

ABSTRACT

Xanthogranulomatous cholecystitis [XGC] is an unusual focal or diffuse destructive inflammatory process of the gallbladder that may mimic a malignant neoplasm with associated complications. We present a rare case of Xanthogranulomatous cholecystitis with associated complications of liver abscess and enterobiliary fistula that was diagnosed radiologically and confirmed on histopathology.


Subject(s)
Adult , Cholecystitis/diagnosis , Cholecystitis/diagnostic imaging , Granuloma/diagnosis , Granuloma/diagnostic imaging , Humans , Male , Pathology , Xanthomatosis/diagnosis , Xanthomatosis/diagnostic imaging
7.
Ciudad de México; Centro Nacional de Excelencia Tecnológica en Salud; 2014. 48 p. tab.(Guías de Práctica Clínica de Enfermería). (IMSS-710-14).
Monography in Spanish | LILACS, BDENF | ID: biblio-1037663

ABSTRACT

Introducción. Los trastornos de la vía biliar afectan una proporción importante de la población mundial; más del 95% son atribuibles a la colecistitis aguda. La principal manifestación es el dolor agudo abdominal por lo que el 50% de los pacientes han tenido este síntoma al menos 48 horas antes de su ingreso.Método. Se realizaron cuatro búsquedas sistematizadas de información donde arrojo meta análisis, ensayos clínicos aleatorizados y/o estudios de cohorte publicados que dieron respuesta a las preguntas planteadas, de los cuales se seleccionaran las fuentes con mayor puntaje obtenido, en la evaluación de su metodología, las de mayor nivel en cuanto a gradación de evidencias y recomendaciones.Resultado. El signo de Murphy positivo en la colecistitis presenta una sensibilidad del 97%; el 95% de la colecistitis se asocia con la colelitiasis y aumenta riesgo de complicaciones, la Escala Visual Análoga (EVA) permite establecer una base de control y alivio del dolor y del 1 al 3% de las mujeres embarazadas presentan litios vesiculares.Conclusión. La colecistitis aguda ocurre entre los 30 y 80 años, siendo más frecuente en mujeres, es de importancia la valoración de los signos y síntomas, además de identificar complicaciones secundarias con la finalidad que el personal de enfermería elabore un plan de cuidados especifico ante los problemas reales del paciente, contemplando intervenciones en la ministración de medicamentos, preparación quirúrgica garantizando la seguridad del paciente y cuidados postquirúrgicos para minimizar factores de riesgo de infección y las recomendaciones del autocuidado para su egreso.


Introduction. The biliary disorders affect a significant proportion of the world population; more than 95% are attributable to acute cholecystitis. The main manifestation is abdominal pain so sharp 50% of patients have this symptom at least 48 hours before admission.Method. Four systematized information searches were performed which threw meta-analysis, randomized clinical trials and / or studies published cohort that provided answers to the questions, of which the sources were selected with the highest score obtained in the evaluation methodology ,the highest level as to grading evidence and recommendations.Result. The positive sign of cholecystitis Murphy has a sensitivity of 97%; 95% of cholecystitis and cholelithiasis associated with increased risk of complications, the Visual Analogue Scale (VAS) allows us to set a base control and pain relief and 1 to 3% of pregnant women have vesicular lithiums.Conclusion. Acute cholecystitis occurs between 30 and 80 years, being more common in women, it is important the assessment of signs and symptoms, and identify secondary complications in order that nurses develop a specific plan of care to actual problems of the patient, contemplating interventions in the ministration of medicines, surgical preparation ensuring patient safety and postoperative care to minimize infection risk factors and recommendations for self discharge.


Introdução. Os distúrbios biliares afetar uma proporção significativa da população mundial; mais de 95% são atribuíveis a colecistite aguda. A principal manifestação é a dor abdominal tão acentuada de 50% dos pacientes apresentam este síntoma pelo menos 48 horas antes da admissão.Método. quatro informações sistematizadas pesquisas onde eu jogo meta-análise, ensaios clínicos randomizados e / ou estudos publicados coorte que forneceram respostas para as perguntas, das quais as fontes foram selecionados com a maior pontuação obtida na metodologia de avaliação foram feitas, maior nível de evidências e recomendações de classificação.Resultado. O sinal positivo de colecistite Murphy tem uma sensibilidade de 97%; 95% de colecistite e colelitíase associada ao aumento do risco de complicações, a Escala Analógica Visual (VAS) permite que você defina um controle base e alívio da dor e 1 a 3% das mulheres grávidas têm lithiums vesiculares.Conclusão. colecistite aguda ocorre entre 30 e 80 anos, sendo mais comum em mulheres, é importante a avaliação de sinais e sintomas, e identificar complicações secundárias com as enfermeiras objectivo q desenvolver um plano específico de atendimento a problemas paciente real, contemplando intervenções no ministério de medicamentos, preparo cirúrgico, garantindo a segurança do paciente e cuidados pós-operatórios para minimizar os fatores de risco de infecção e recomendações para a auto descarga.


Subject(s)
Adult , Cholelithiasis/complications , Cholelithiasis/diagnosis , Cholelithiasis/mortality , Cholelithiasis/prevention & control , Cholelithiasis/rehabilitation , Cholelithiasis/therapy , Cholecystitis/diagnosis , Cholecystitis/mortality , Cholecystitis/prevention & control , Cholecystitis/therapy
8.
Rev. chil. cir ; 65(4): 307-314, ago. 2013. tab
Article in Spanish | LILACS | ID: lil-684350

ABSTRACT

Introduction: CA 19-9 has been identified as a derivative of sialic Lewis blood group A and is expressed in 95 percent of the population. Several studies have documented an overproduction of CA 19-9 in malignant pancreatic and biliary tree diseases. The objective of this study is to determine the accuracy of the tumor marker CA 19-9 differentiating benign and malignant bilio-pancreatic diseases. Material and Methods: diagnostic test study. We reviewed the records of all patients with malignant bilio-pancreatic diseases and benign biliary calculous diseases evaluated in Hospital Base Osorno between august 2007 and december 2011, with CA 19-9 as part of their study. Results: 71 patients met the inclusion criteria, 17 men and 54 women, with a mean age of 60.7 +/- 15.3 years old. Twenty nine (40.8 percent) cases were benign and 42 (59.2 percent) cases malignant. For a cutoff level of 37 U/ml the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) to differentiate benign from malignant disease was 81 percent, 72.4 percent, 81 percent and 72.4 percent, respectively. For a cut off level of 130 U/ml specificity and PPV increased to 96.6 percent and 96.4 percent, respectively. Conclusions: the use of CA 19-9 is useful in the diagnosis of patients with suspected bilio-pancreatic malignant disease. The optimization of the normal published value can help to improve accuracy.


Introducción: El CA 19-9 se ha identificado como un derivado siálico del grupo sanguíneo Lewis A y se expresa en el 95 por ciento de la población. Numerosos estudios han documentado una sobreproducción de CA 19-9 en tumores malignos del árbol biliar y páncreas. El objetivo de este estudio es determinar la utilidad del marcador tumoral CA 19-9 en la diferenciación de patología bilio-pancreática benigna y maligna. Material y Métodos: estudio de pruebas diagnósticas. Se revisaron los antecedentes de todos los pacientes con patología bilio-pancreática maligna y enfermedad litiásica biliar benigna, evaluados en el Hospital Base de Osorno entre agosto de 2007 y diciembre de 2011, a los que se les haya solicitado CA 19-9 como parte de su estudio. Resultados: 71 pacientes cumplieron los criterios de inclusión, 17 hombres y 54 mujeres, con una media de 60,7 +/- 15,3 años de edad. Veintinueve (40,8 por ciento) casos correspondieron patología benigna y 42 (59,2 por ciento) casos a patología maligna. Para un valor de corte de 37 U/ml la sensibilidad, especificidad, valor predictivo positivo (VPP) y valor predictivo negativo (VPN) para diferenciar enfermedad benigna de maligna fue de 81 por ciento, 72,4 por ciento, 81 por ciento y 72,4 por ciento, respectivamente. Para un valor de corte de 130 U/ ml la especificidad y el VPP aumentaron a 96,6 por ciento y 96,4 por ciento, respectivamente. Conclusiones: el uso del Ca 19-9 es útil en el proceso diagnóstico de pacientes con sospecha de patología bilio-pancreática maligna. La optimización de los valores sobre el valor de normalidad publicado puede ayudar a mejorar su rendimiento.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged, 80 and over , /blood , Cholangiocarcinoma/diagnosis , Cholecystitis/diagnosis , Choledocholithiasis/diagnosis , Pancreatic Neoplasms/diagnosis , Gallstones/diagnosis , Diagnosis, Differential , Pancreatic Diseases/diagnosis , Biliary Tract Diseases/diagnosis , Linear Models , Biomarkers/blood , Predictive Value of Tests , ROC Curve , Sensitivity and Specificity
9.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2013; 23 (11): 826-827
in English | IMEMR | ID: emr-132883

ABSTRACT

Salmonella cholecystitis is a rare but important complication of Salmonella typhi infection. We are reporting an 11 years old female child who presented with complaints of high-grade fever, jaundice and right sided abdominal pain [Charcot's triad]. Her examination showed tender hepatomegaly. Initial blood results revealed high white cell counts with left shift, deranged liver function tests. Abdominal ultrasonography revealed distended gallbladder with minimal layer of sludge seen within its lumen along with streak of pericholecystic fluid. Blood culture grew Salmonella typhi. She was successfully treated with intravenous ceftriaxone.


Subject(s)
Humans , Female , Child , Salmonella typhi , Cholecystitis/diagnosis
10.
Rev. argent. ultrason ; 11(2): 90-94, jun. 2012. ilus
Article in Spanish | LILACS | ID: lil-653188

ABSTRACT

La colecistitis aguda es la causa más frecuente de engrosamiento parietal vesicular. No obstante no es la única entidad que puede presentar esta característica ecográfica. Se presentan entidades no biliares que producen por diversos mecanismos engrosamientos parietales focales o difusos de la vesícula biliar. En contadas ocasiones el diagnóstico puede ser complementado con un procedimiento tomográfico abdominal.


Subject(s)
Cholecystitis/diagnosis , Cholecystitis , Ultrasonography , Gallbladder/abnormalities , Gallbladder
11.
Article in Korean | WPRIM | ID: wpr-84301

ABSTRACT

Xanthogranulomatous cholecystitis is an unusual inflammatory disease of the gallbladder characterized by severe proliferative fibrosis and the accumulation of lipid-laden macrophages in areas of destructive inflammation. Its macroscopic appearance may occasionally be confused with gallbladder carcinoma. We present a case of perforated xanthogranulomatous cholecystitis presenting as biloma. An 80-year-old woman was referred to our hospital with a 1-week history of abdominal pain and febrile sensation. Abdominal CT showed a biloma in the subhepatic area. The follow-up CT showed that the biloma increased in size. Therefore, ultrasonography-guided aspiration was performed. The aspirated fluid/serum bilirubin ratio was greater than 5, which was strongly suggestive of bile leakage complicated by perforated cholecystitis. She underwent a laparoscopic cholecystectomy with cyst aspiration and adhesiolysis. A histological diagnosis of perforated xanthogranulomatous cholecystitis was made.


Subject(s)
Aged, 80 and over , Female , Humans , Bilirubin/blood , Cholecystectomy , Cholecystitis/diagnosis , Drainage , Gallbladder Neoplasms/diagnosis , Granuloma/diagnosis , Tomography, X-Ray Computed , Xanthomatosis/diagnosis
12.
Managua; Nicaragua. Ministerio de Salud; sept. 2010. 69 p. tab, graf.
Monography in Spanish | LILACS | ID: lil-593059

ABSTRACT

El Gobierno de Reconciliación y Unidad Nacional a través del Ministerio de Salud, presente el siguiente documento Protocolos de atención de enfermedades quirúrgicas más frecuentes en adultos, que es una recopilación de los servicios de los Hospitales Alemán Nicaraguense y Antonio Lenin Fonseca quienes iniciaron revisión, actualización y elaboración de guías clínicas de las principales patologías atendidas en los servicios. Este trabajo se base en la búsqueda de la unificación de criterios y la mejor utilización de recursos en función de brindar un servicio eficaz y de calidad para nuestros usuarios y usuarias...


Subject(s)
Choledocholithiasis , Disease Management , Abdominal Pain/surgery , Abdominal Pain/classification , Hernia, Inguinal/classification , Hernia, Inguinal/diagnosis , Patient Care Management/standards , Case Management/standards , Pathology, Surgical/classification , Pathology, Surgical/standards , Appendicitis/surgery , Appendicitis/classification , Appendicitis/pathology , Cholecystitis/surgery , Cholecystitis/diagnosis , Cholecystitis/pathology
14.
Femina ; 37(3): 123-129, mar. 2009. tab
Article in Portuguese | LILACS | ID: lil-526931

ABSTRACT

O abdome agudo na gravidez é entidade rara, cujo diagnóstico é dificultado devido às alterações fisiológicas típicas da gravidez que tornam os achados menos evidentes. Embora o abdome agudo obstétrico seja mais comum, a dor abdominal não obstétrica apresenta considerável impacto na morbimortalidade materno-fetal. Sua etiologia inclui, principalmente, apendicite aguda, doença biliar, obstrução intestinal, pancreatite e trauma abdominal. O diagnóstico e o tratamento devem ser instituídos precocemente com o intuito de reduzir complicações para mãe e feto. Diante da importância do tema, o presente artigo tem por objetivo realizar atualização sobre os aspectos etiológicos, diagnósticos e de manejo do abdome cirúrgico não obstétrico.


Acute abdomen in pregnancy is a rare condition with a difficult diagnosis because of the typical physiological alterations of pregnancy that make the findings less evident. Although obstetric acute abdomen is more common, non-obstetric abdominal pain has a marked impact on the morbidity and mortality of the mother and fetus. The etiology of non-obstetric acute abdomen includes mainly: acute appendicitis, biliary disease, intestinal obstruction, pancreatitis, and abdominal trauma. The diagnosis and treatment should be established early to reduce complications for the mother and fetus. Considering the importance of the subject, the objective of the present paper was to report an update on the etiological aspects, diagnosis and management of non-obstetric surgical abdomen.


Subject(s)
Female , Pregnancy , Abdomen, Acute/diagnosis , Abdomen, Acute/etiology , Abdomen, Acute/therapy , Abdomen, Acute , Appendicitis/diagnosis , Cholecystitis/diagnosis , Laparoscopy , Magnetic Resonance Imaging , Intestinal Obstruction/diagnosis , Pancreatitis/diagnosis , Maternal Mortality , Pregnancy Complications
15.
Article in English | WPRIM | ID: wpr-8091

ABSTRACT

We report a case of tension pneumothorax after an endoscopic sphincterotomy. A 78-yr-old woman presented with progressing dyspnea. She had undergone an endoscopic retrograde cholangiopancreatogram three days before due to acute cholecystitis. She underwent endoscopic sphincterotomy for stone extraction, but the procedure failed. On arrival to our hospital, she complained about severe dyspnea and she had subcutaneous emphysema. A computed tomogram scan revealed severe subcutaneous emphysema, right-side tension pneumothorax, and pneumoretroperitoneum. Contrast media injected through a transnasal biliary drainage catheter spilled from the second portion of the duodenum. A second abdominal computed tomogram showed multiple air densities in the retroperitoneum and peritoneal cavity, which were consistent with panperitonitis. We recommended an emergent laparotomic exploration, but the patient's guardians refused. She died eventually due to septic shock. Endoscopic retrograde cholangiopancreatogram is a popular procedure for biliary and pancreatic diseases, but it can cause severe complications such as intestinal perforation. Besides perforations, air can spread through the abdominal cavity, retroperitoneum, mediastinum, and the neck soft tissue, eventually causing pneumothorax. Early recognition and appropriate management is crucial to an optimal output of gastrointestinal perforation and pneumothorax.


Subject(s)
Aged , Female , Humans , Acute Disease , Cholangiopancreatography, Endoscopic Retrograde/adverse effects , Cholecystitis/diagnosis , Intestinal Perforation/etiology , Pneumothorax/diagnosis , Retropneumoperitoneum/diagnosis , Sphincterotomy, Endoscopic , Tomography, X-Ray Computed
16.
Rev. argent. ultrason ; 7(4): 240-242, dic. 2008. ilus
Article in Spanish | LILACS | ID: lil-506167

ABSTRACT

La colecistitis enfisematosa es un raro proceso infeccioso que se caracteriza por la presencia de gas en la vesícula biliar, asociado frecuentemente con gérmenes anaerobios. Se presenta el caso de una paciente femenina de 58 años de edad que ingresó por guardia con un cuadro de dolor abdominal en epigastrio irradiado al dorso. El diagnóstico se basa en su presunción clínica; en los casos dudosos una ecografía o una tomografía computada pueden confirmarlo. La administración de antibióticos de amplio espectro y la colecistectomía de urgencia constituyen el tratamiento adecuado para la resolución de esta patología.


Subject(s)
Humans , Female , Middle Aged , Emphysematous Cholecystitis/diagnosis , Emphysematous Cholecystitis/therapy , Emphysematous Cholecystitis , Cholecystitis/diagnosis , Ultrasonography
17.
Rev. SOCERJ ; 21(5): 338-344, set.-out. 2008. ilus
Article in Portuguese | LILACS | ID: lil-503509

ABSTRACT

O objetivo desse relato de caso é descrever as abordagens diagnósticas e terapêuticas empregadas durante a avaliação de um paciente com queixa de dor torácica e história clínica sugestiva de miocardite aguda...


Subject(s)
Humans , Female , Adult , Cholecystitis/complications , Cholecystitis/diagnosis , Magnetic Resonance Spectroscopy , Myocarditis/complications , Myocarditis/diagnosis , Myocarditis/therapy , Inflammation/therapy
18.
Col. med. estado Táchira ; 17(3): 19-21, jul.-sept. 2008. graf
Article in Spanish | LILACS | ID: lil-531273

ABSTRACT

La laparoscopía es un método importante en la cirugía. Presentamos la experiencia en pacientes con Colecistitis asistidos en nuestro hospital, mediante técnica laparoscópica. Durante enero-2005 a junio-2007 retrospectivamente analizamos hallazgos y tiempo quirúrgico, estancia hospitalaria, complicaciones postoperatorias y tiempo de seguimiento. De 156 pacientes, 140 presentaron litiasis, no en casos restantes. Predominó el sexo femenino. La edad media fue de 39,5 años (rango 19-78). 107 casos debutaron como abdomen agudo, 26 con dolor crónico y 22 de forma casual. La laparoscopia es una técnica válida para manejar La colecistitis. Este abordaje trata la patología de manera reglada.


Subject(s)
Humans , Male , Adult , Female , Middle Aged , Abdomen, Acute/etiology , Cholecystectomy, Laparoscopic/methods , Cholecystitis/surgery , Cholecystitis/diagnosis , Cholecystitis/pathology , Abdominal Pain/diagnosis , Inflammation/diagnosis , Laparoscopy/methods , Biopsy/methods , Gallstones/pathology , Gastrointestinal Diseases/physiopathology , Medical Records , Lithiasis , Ultrasonography
19.
São Paulo med. j ; 124(4): 234-236, July -Aug. 2006. ilus
Article in English, Portuguese | LILACS | ID: lil-437234

ABSTRACT

CONTEXT: Spontaneous cholecystocutaneous abscess or fistula is an extremely uncommon complication secondary to cholecystitis. Over the past 50 years fewer than 20 cases of spontaneous cholecystocutaneous fistulas have been described in the medical literature. We here report a case of subcutaneous gallstone as a rare clinical presentation of the already uncommon cholecystocutaneous fistula. CASE REPORT: An 81-year-old man presented with a large subcutaneous abscess in the right subcostal area with surrounding cellulitis and crepitus. An abdominal computed tomography scan showed two subcutaneous gallstones and communication between the abscess and the gallbladder. Cholecystectomy was performed and the abdominal wall abscess was drained externally. This case report demonstrates that maintaining a high degree of suspicion of this rare entity is helpful in achieving correct preoperative diagnosis, and that computed tomography scan should be performed in all cases of unexplained abdominal wall suppuration or cellulitis.


CONTEXTO: A fístula e/ou o abscesso colecistocutâneo são complicações extremamente raras da colecistopatia crônica calculosa. Nos últimos 50 anos, menos de 20 casos de fistulas colecistocutâneas foram descritos na literatura médica. Nós descrevemos um caso de cálculos biliares no tecido subcutâneo como rara apresentação clínica de fístula biliar. RELATO DO CASO: Paciente de 81 anos deu entrada no serviço de emergência apresentando um grande abscesso na região de hipocôndrio direito. A tomografia computadorizada de abdome demonstrou a presença de dois cálculos no tecido celular subcutâneo e a comunicação da vesícula biliar com a parede abdominal. O paciente foi submetido a uma colecistectomia e drenagem externa do abscesso da parede abdominal. Este caso demonstra que um alto grau de suspeita desta rara complicação da colecistopatia crônica calculosa é fundamental para o correto diagnóstico pré-operatório, e a tomografia computadorizada deve ser realizada rotineiramente em todos os casos de abscessos de parede abdominal de origem indeterminada.


Subject(s)
Humans , Male , Aged, 80 and over , Biliary Fistula/etiology , Cholecystitis/complications , Cutaneous Fistula/etiology , Gallstones/diagnosis , Gallstones/etiology , Biliary Fistula/diagnosis , Biliary Fistula/surgery , Cholecystectomy , Cholecystitis/diagnosis , Cholecystitis/surgery , Chronic Disease , Cutaneous Fistula/diagnosis , Cutaneous Fistula/surgery , Fatal Outcome , Gallstones/surgery , Preoperative Care , Tomography Scanners, X-Ray Computed
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