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1.
Rev. chil. cir ; 69(1): 69-72, feb. 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-844328

RESUMO

Objetivo. Presentar el segundo caso descrito en la bibliografía de bilioescroto secundario a bilioma retroperitoneal espontáneo y mostrar a su vez de manera escalonada el tratamiento que se le suministró hasta la resolución completa del cuadro. Caso clínico: Varón de 69 años que debutó con dolor escrotal derecho en relación con bilioescroto secundario a bilioma retroperitoneal espontáneo. Discusión: El bilioma retroperitoneal es un hecho poco habitual; generalmente se debe a complicaciones quirúrgicas o de procedimientos invasivos (intervencionismo radiológico, CPRE y esfinterotomía endoscópica), aunque puede ser consecuencia de roturas espontáneas de la vesícula o la vía biliar principal. La bilis en el retroperitoneo puede discurrir hasta el escroto, originando la rara entidad conocida como bilioescroto. Generalmente se presenta simulando una hernia inguinal incarcerada. No existe un manejo estandarizado de esta patología ya que está escasamente descrita.


Objective: To present the second case described in the literature of biliscrotum secondary to spontaneous retroperitoneal biloma and show a sequential treatment that we provided until complete resolution. Clinical case: We report the case of a man 69 years old, who debuted with right scrotal pain related to biliscrotum secondary to spontaneous retroperitoneal biloma. Discussion: The retroperitoneal biloma is a rare event, usually due to surgical or invasive procedures complications (radiological interventionism, ERCP and endoscopic sphincterotomy), although it may be the result of spontaneous rupture of the gallbladder or bile duct. Bile in the retroperitoneum may extend into the scrotum, causing the rare condition known as biliscrotum. Usually it occurs simulating an incarcerated inguinal hernia. Does not exist a standardized management of this condition because is poorly described.


Assuntos
Humanos , Masculino , Idoso , Bile , Doenças dos Ductos Biliares/diagnóstico por imagem , Espaço Retroperitoneal/diagnóstico por imagem , Escroto , Doenças dos Ductos Biliares/terapia , Drenagem , Imagem por Ressonância Magnética , Ruptura Espontânea , Tomografia Computadorizada por Raios X
2.
Rev. colomb. cir ; 31(1): 27-33, ene.-mar. 2016. tab
Artigo em Espanhol | LILACS, COLNAL | ID: lil-780635

RESUMO

Introducción. El dolor abdominal constituye una causa frecuente de consulta y, en el Cauca, es el quinto motivo de consulta y hospitalización. Las infecciones de la vía biliar son una causa significativa de la bacteriemia y mortalidad secundaria; de allí, la importancia de instaurar una terapia antibiótica temprana y apropiada. Se buscó describir los gérmenes más frecuentemente aislados en los cultivos de bilis y hemocultivos de pacientes con colecistitis aguda grave, colangitis o ambas, del Hospital Universitario San José entre diciembre de 2013 y diciembre de 2014, y conocer su perfil de sensibilidad o resistencia a los antibióticos. Materiales y métodos. Este fue un estudio descriptivo, de corte transversal, de pacientes con diagnóstico de colangitis aguda y colecistitis grave, del Hospital Universitario San José, que fueron hospitalizados en el periodo de diciembre de 2013 a diciembre de 2014. Se tomaron cultivos de bilis y hemocultivos, y se hizo el antibiograma de los antibióticos más utilizados en el hospital. Resultados. Se estudiaron 106 pacientes, de los cuales hubo 49,1 % con cultivos positivos de bilis y 19 % con hemocultivos positivos. Los gérmenes más frecuentemente aislados fueron Escherichia coli (51,42 %), Klebsiella pneumoniae (17 %) y otros bacilos Gram positivos. Discusión. Los resultados de este y otros estudios reflejan que, a pesar de compartir el agente causal de infección en la vía biliar, la identificación de dichos microorganismos por pruebas de laboratorio y su sensibilidad antibiótica varía considerablemente, lo que puede asociarse con el lugar de residencia, el tipo de tratamiento antibiótico usado regularmente en cada centro hospitalario y su duración.


Introduction: Abdominal pain is a common presentation at out patient and emergency service in Cauca, Colombia, it is the fifth leading cause of consultation and hospitalization. Infections of the bile duct are a significant cause of bacteremia and high mortality, hence the importance of establishing an early and appropriate antibiotic therapy. We sought to describe the most frequently isolated bacteria in cultures of bile and blood cultures of patients with acute cholecystitis and / or cholangitis University Hospital San José from, Popayán, Colombia. December 2013 to December 2014 and know their profile sensitivity or resistance to antibiotics. Materials and methods: This was a descriptive, cross-sectional study in patients with acute cholangitis and acute cholecystitis at University Hospital San José, in the period December 2013 to December 2014. Bile cultures and blood cultures were taken and antibiotic sensitivity tests were performed. Results: Of a total of 106 patients, positive bile cultures were positive in 49.1% and blood cultures were studied in 19% of patients. Most isolates were: Escherichia coli (51.42%), Klebsiella pneumoniae (17%) and other Gram-positive organisms. Discussion: The results of this and other studies show that despite sharing the causative agent of infection in the bile duct, the identification of such organisms by laboratory testing and antibiotic susceptibility varies considerably, which may be associated with place of residence, the type of antibiotic therapy used regularly at each hospital and the duration of such treatment.


Assuntos
Humanos , Colecistite , Bactérias , Bile , Colangite , Meios de Cultura , Testes de Sensibilidade Microbiana
3.
Braz. j. microbiol ; 45(3): 1047-1054, July-Sept. 2014. graf, tab
Artigo em Inglês | LILACS | ID: lil-727037

RESUMO

Lactic acid bacteria capable of producing bacteriocins and presenting probiotic potential open innovative technological applications in the dairy industry. In this study, a bacteriocinogenic strain (Lactococcus lactis subsp. lactis DF4Mi) was isolated from goat milk, and studied for its probiotic potential. Lc. lactis DF4Mi was resistant to acidic pH and oxbile, presented co-aggregation with Listeria monocytogenes, and was not affected by several drugs from different generic groups, being sensitive to most tested antibiotics. These properties indicate that this Lc. lactis strain can be used for enhancement of dairy foods safety and quality, in combination with potential probiotic properties.


Assuntos
Animais , Bacteriocinas/metabolismo , Cabras , Lactococcus lactis/isolamento & purificação , Lactococcus lactis/metabolismo , Leite/microbiologia , Probióticos , Aderência Bacteriana , Bile/metabolismo , Inocuidade dos Alimentos/métodos , Concentração de Íons de Hidrogênio , Lactococcus lactis/efeitos dos fármacos , Listeria monocytogenes/fisiologia , Viabilidade Microbiana/efeitos dos fármacos
5.
GEN ; 67(1): 49-57, mar. 2013. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-681072

RESUMO

Las sales biliares, colesterol y fosfatidilcolina son los lípidos más importantes de la bilis; su transporte está regulado por una red compleja de proteínas de las familias Casete de Unión a ATP y transportadora de solutos. Los transportadores de lípidos biliares son proteínas que intervienen en la fisiopatología de numerosas enfermedades del sistema gastrointestinal, por lo tanto, son importantes moléculas de estudio y en un futuro pueden ser nuevas dianas terapéuticas que eviten la prevalencia de enfermedades como hipercolesterolemia, cálculos biliares, colestasis, trastornos de la bilirrubina, entre otras. La presente revisión hace una evaluación actualizada sobre la función específica de los transportadores de lípidos biliares, su regulación genética e implicación fisiopatológica


Bile salts, cholesterol and phosphatidylcholine are the major lipids of bile; its secretion is regulated by an elaborate network of family proteins such as ATP Binding Cassette and the Solute Carrier. Biliary lipids transporters are proteins involved in physiopathology of many diseases of gastrointestinal system, therefore it are important molecules of study and the future it may be new therapeutic targets to prevent the prevalence of diseases, such as hypercholesterolemia, gallstones, cholestasis, bilirubin disorders among other. This review makes a current evaluation on the specific role of biliary lipids transporters, its genetic regulation and physiopathological implications


Assuntos
Humanos , Doenças dos Ductos Biliares , Trato Gastrointestinal , Lipídeos , Terapêutica , Bile , Gastroenterologia
6.
Mem. Inst. Oswaldo Cruz ; 107(7): 935-939, Nov. 2012.
Artigo em Inglês | LILACS | ID: lil-656053

RESUMO

The objective of this study was to detect and identify hepatitis E virus (HEV) strains in liver and bile samples from slaughtered pigs in the state of Paraná, Brazil. Liver and bile samples were collected from 118 asymptomatic adult pigs at a slaughterhouse in a major Brazilian pork production area. The samples were assayed using a nested reverse transcription-polymerase chain reaction protocol with primer sets targeting open reading frames (ORF)1 and 2 of the HEV genome. HEV RNA was detected in two (1.7%) liver samples and one (0.84%) bile sample using both primers sets. The HEV strains were classified as genotype 3b on the basis of their nucleotide sequences. These data suggest that healthy pigs may be a source of HEV infection for consumers of pig liver and slaughterhouse workers in Brazil.


Assuntos
Animais , Bile/virologia , Vírus da Hepatite E/isolamento & purificação , Fígado/virologia , Sus scrofa/virologia , Matadouros , Brasil , Vírus da Hepatite E/genética , Filogenia , Reação em Cadeia da Polimerase
7.
GEN ; 66(1): 57-62, mar. 2012. ilus
Artigo em Espanhol | LILACS | ID: lil-664197

RESUMO

La investigación científica sobre la formación de cálculos biliares de colesterol, ha comprobado la participación de numerosos genes, entre los cuales se encuentran receptores nucleares y transportadores biliares. El desequilibrio fisicoquímico entre los lípidos biliares más importantes produce hipersecreción de colesterol en la bilis, una etapa necesaria para sobresaturar la vesícula biliar. Las sales biliares son insuficientes para solubilizar al colesterol en micelas mixtas, por lo que esta molécula se solubiliza, en su mayoría, dentro de liposomas (fosfolípidos y escasas sales biliares), y en ellos existe en alta concentración, que tiende a precipitar y a formar cristales, evento considerado como limitante para la formación de cálculos biliares. El desarrollo del cálculo puede acelerarse si existe hipersecreción de proteínas mucinas y escasa motilidad vesicular. La presente revisión tiene el objetivo de informar los nuevos aportes científicos sobre la formación de cálculos biliares de colesterol, analizando y discutiendo sus resultados enfocados a la búsqueda de tratamientos farmacológicos, porque la litiasis no tiene terapia eficaz y la colecistectomía es el método quirúrgico invasivo, cuando la enfermedad produce síntomas


Scientific research about cholesterol gallstone formation has shown the involvement of many genes, such as nuclear receptors and biliary transporters. Physicochemical imbalance of three major biliary lipids produces hypersecretion of cholesterol in bile, a key process for supersaturation of gallbladder. Bile salts are insufficient for solubilization of cholesterol in mixed micelles; therefore this molecule is solubilized mostly into liposome (phospholipids and few bile salts); there is a high concentration of cholesterol into liposomes, which leads to its precipitation and crystallization, the key factor for cholesterol gallstone formation. Development of gallstones might accelerated when there is hypersecretion of mucins and gallbladder hypomotility. The aim of this review is to inform about new scientific contributions of cholesterol gallstone formation, analyzing them to the investigation of possible pharmacological treatments, since it is a disease that has no effective treatment and the only cholecystectomy is an invasive surgical treatment for symptomatic gallstone


Assuntos
Feminino , Bile , Cálculos Biliares/diagnóstico , Cálculos Biliares , Colesterol/efeitos adversos , Lipossomos/uso terapêutico , Mucinas Gástricas/uso terapêutico , Gastroenterologia
8.
Radiol. bras ; 45(1): 59-60, jan.-fev. 2012.
Artigo em Português | LILACS | ID: lil-618397

RESUMO

Bilioma é qualquer coleção de bile fora das vias biliares. Geralmente, resulta de complicações cirúrgicas e trauma abdominal. A ocorrência espontânea é rara, ocasionalmente associada a coledocolitíase. Relata-se um caso de bilioma espontâneo, cujo diagnóstico foi confirmado radiologicamente. À laparotomia, observou-se bilioma retroperitoneal. A colangiografia transoperatória não evidenciou fístula. Após drenagem, o paciente teve boa evolução e alta hospitalar.


Biloma is defined as any collection of bile outside the biliary tree, usually resulting from surgery complications and abdominal trauma. Spontaneous occurrence of bilomas is rare, occasionally associated with choledocolithiasis. The present report describes a case of spontaneous biloma, whose diagnosis was radiologically confirmed. At laparotomy, the presence of a retroperitoneal biloma was observed. Intraoperative cholangiography has not demonstrated the presence of fistula. After drainage, the patient progressed well and was discharged.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Bile , Doenças Biliares , Coledocolitíase , Coledocolitíase/complicações , Tomografia Computadorizada por Raios X , Ultrassonografia
11.
Gastroenterol. latinoam ; 22(4): 296-301, oct.-dic. 2011. ilus, tab, graf
Artigo em Espanhol | LILACS | ID: lil-661633

RESUMO

Non-alcoholic fatty liver (NAFLD) is a clinical entity whose importance has been increasing, because of its potential progression to chronic liver disease. The alteration of bile secretory function may be a relevant factor of hepatic injury in NAFLD. Objectives: To assess basal bile secretory function and protein mass of three major hepatobiliary transporters in an experimental NAFLD model. Materials and Methods: The bile secretory function was determined by conventional techniques in Sprague-Dawley control rats fed with a choline-deficient diet (CDD) for 8 weeks. Protein mass of Ntcp, Bsep and Mrp2 was measured by western blot. Results: An impaired bile secretory function was observed in rats fed with DDC (reduction of bile flow and secretion of bile acids and organic anions). In addition, DDC fed rats showed higher levels of serum aminotransferases. Ntcp protein mass decreased in rats with DDC, while Bsep and Mrp2 did not show quantitative variations in this experimental model. Conclusions: In this experimental model of NAFLD an impaired bile secretory function was observed, determining a cholestatic pattern. The decrease in Ntcp protein mass with unaltered Bsep and Mrp2 protein mass, associated with a significant decrease in bile secretion suggests a functional impairment of these transporters in rats fed with DDC diet.


El hígado graso no alcohólico (HGNA) es una entidad clínica de importancia creciente por su potencial progresión a daño hepático crónico. La alteración de la función secretora biliar puede ser un factor relevante en el daño o lesión hepática asociada al HGNA. Objetivos: Evaluar la función secretora biliar basal y los niveles de expresión proteica de tres de los principales transportadores hepatobiliares en un modelo de HGNA experimental. Materiales y Métodos: La función secretora biliar fue determinada por técnicas convencionales en ratas Sprague-Dawley control y alimentadas con una dieta deficiente en colina (DDC) durante 8 semanas. Los niveles de expresión proteica de Ntcp, Bsep y Mrp2 fueron cuantificados por western blot. Resultados: Se observó un deterioro de la función secretora biliar en las ratas alimentadas con DDC (reducción del flujo biliar y de secreción de ácidos biliares y aniones orgánicos). Además, las ratas con DDC presentaron niveles más altos de transaminasas séricas. Los niveles de expresión proteica de Ntcp disminuyeron en las ratas con DDC, mientras que Bsep y Mrp2 no presentaron variaciones cuantitativas en este modelo experimental. Conclusiones: En este modelo de HGNA experimental se observó una función secretora biliar alterada, determinando un patrón colestásico. La disminución de los niveles de expresión proteica de Ntcp junto con la mantención de Bsep y Mrp2, asociados a una disminución significativa de la secreción biliar, sugiere un deterioro funcional de estos transportadores en ratas alimentadas con dieta DDC.


Assuntos
Animais , Ratos , Bile , Fígado Gorduroso/fisiopatologia , Fígado Gorduroso/metabolismo , Ácidos e Sais Biliares/metabolismo , Western Blotting , Deficiência de Colina , Colestase/metabolismo , Fígado/patologia , Tamanho do Órgão , Proteínas Associadas à Resistência a Múltiplos Medicamentos/metabolismo , Ratos Sprague-Dawley , Transportadores de Ânions Orgânicos Dependentes de Sódio/metabolismo
12.
Rev. chil. cir ; 63(1): 28-35, feb. 2011. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-582942

RESUMO

Background. Pancreaticobiliary reflux is a pathologic phenomenon occurring in patients with gallstones. However, the occurrence of pancreaticobiliary reflux has not been studied in patients without gallstones. The objective of this study was to measure the bile levels of amylase and lipase in patients without gallstones submitted to cholecystectomy as part of another surgical procedure, and to compare these values with patients submitted to cholecystectomy for gallstone disease. Patients and Methods. A prospective observational comparative study was designed. A sample of 136 consecutive patients was included. Amylase and lipase levels were measured in bile. Normal serum amylase levels at our institution are 28-100 U/L and for lipase are 13-60 U/L. There are no established normal levels for pancreatic enzymes in bile. However, we considered elevated the bile amylase and lipase levels whenever they were higher than normal plasma levels. Results. One-hundred three patients (76 percent) had gallstones and 33 (24 percent) liad healthy gallbladders without gallstones. According to normal plasma levels for amylase and lipase, these enzymes in bile were elevated in 83.5 percent patients with gallstones, compared to elevated levels of amylase in 6 percent patients and lipase in 3 percent patients without gallstones. Conclusions. Pancreaticobiliary reflux is a common phenomenon in patients with gallstones and occurs sporadically in patients without gallstones.


Introducción. El reflujo pancreáticobiliar es un fenómeno patológico que ocurre en pacientes con colelitiasis. La ocurrencia de este fenómeno no ha sido estudiada en pacientes sin colelitiasis. El presente estudio tiene por objetivo medir los niveles de amilasa y lipasa en la bilis de pacientes sin colelitiasis, colecistectomizados como parte de otro procedimiento quirúrgico y comparar estos valores con pacientes colecistectomizados por colelitiasis. Pacientes y Métodos. Se diseñó un estudio observacional y comparativo. Una muestra de 136 pacientes consecutivos fue incluida. Se midieron los niveles de amilasa y lipasa en la bilis. En nuestra institución los valores normales para amilasa son 28-100 U/L y para lipasa 13-60 U/L. No se han establecido valores normales de enzimas pancreáticas en la bilis. Para efectos del presente estudio, se consideró como elevados los niveles biliares de amilasa y lipasa cuando fueron mayores a los valores plasmáticos normales. Resultados. 103 pacientes (76 por ciento) tenían colelitiasis y 33 (24 por ciento) tenían vesículas normales sin cálculos. De acuerdo a los valores plasmáticos normales de amilasa y lipasa, estas enzimas se encontraron elevadas en 83,5 por ciento de los pacientes con colelitiasis comparados con valores elevados de amilasa en 6 por ciento en pacientes sin colelitiasis y de lipasa en 3 por ciento de estos pacientes. Conclusiones. El reflujo pancreaticobiliar es un fenómeno común en pacientes con colelitiasis y ocurre esporádicamente en pacientes sin colelitiasis.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Amilases/análise , Refluxo Biliar , Colecistectomia , Colelitíase/enzimologia , Lipase/análise , Amilases/sangue , Bile/enzimologia , Bile/química , Colelitíase/cirurgia , Disfunção do Esfíncter da Ampola Hepatopancreática/complicações , Cálculos Biliares , Lipase/sangue , Estudos Observacionais como Assunto , Estudos Prospectivos , Valores de Referência , Vesícula Biliar/enzimologia , Vesícula Biliar/patologia
13.
Clinics ; 66(3): 421-424, 2011. tab
Artigo em Inglês | LILACS | ID: lil-585951

RESUMO

BACKGROUND AND AIM: Biliary fistulas are the most common morbidity (8.2-26 percent) following hydatid liver surgery. The aim of our study was to reduce the incidence of postoperative biliary fistulas after the suturing of cystobiliary communications by applying a bile leakage test. PATIENTS AND METHODS: A total of 133 hydatid liver cysts from 93 patients were divided into two groups, according to whether the test was performed. Tests were performed on 56 cysts from 34 patients, and the remaining 77 cysts from 59 patients were treated without the test. In both groups, all visible biliary orifices in the cysts were suture ligated, and drains were placed in all cysts. The visibility of the biliary orifices and postoperative biliary drainage through the drains were recorded. Patients in both groups were also compared with respect to the number of days living with the drains, the length of the hospital stay, and secondary interventions related to biliary complications. RESULTS: Biliary orifices were more visible in the tested cysts (13 percent vs. 48 percent; P <0.001). Fewer biliary complications occurred in the tested patients (8.8 percent vs. 27.7 percent, P = 0.033). The mean drain removal time (4.1±3.3 days vs. 6.8±8.9 days, P<0.05) and the length of the hospital stay (6.7±2.7 days vs. 9.7±6.3 days, P,0.01) were shorter for the tested patients. None of the patients in the test group required postoperative Endoscopic retrograde cholangiopancreaticography (ERCP) or nasobiliary drainage (0.0 percent vs. 8.4 percent, P = 0.09). There were no long-term biliary complications for either group after three years of follow-up. CONCLUSIONS: Identification of biliary orifices with a bile leakage test and the suturing of cystobiliary communications significantly reduced postoperative biliary complications following hydatid liver surgery.


Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Bile , Fístula Biliar/prevenção & controle , Equinococose Hepática/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Fatores Etários , Ductos Biliares/cirurgia , Distribuição de Qui-Quadrado , Colangiopancreatografia Retrógrada Endoscópica , Fatores Sexuais , Fatores de Tempo , Resultado do Tratamento
14.
Cir. & cir ; 78(3): 239-243, mayo-jun. 2010. tab
Artigo em Espanhol | LILACS | ID: lil-565598

RESUMO

Introducción: La bactibilia es la presencia de bacterias en bilis vesicular y está relacionada con la aparición de complicaciones sépticas y con el desarrollo de infección en herida quirúrgica de la colecistectomía. En este estudio investigamos si la bactibilia se correlaciona con infección de herida posterior a colecistectomía abierta. Material y métodos: Estudio observacional, descriptivo, de pacientes sometidos, entre enero y diciembre de 2006, a colecistectomía abierta en forma electiva por colecistitis crónica litiásica, a quienes se les realizó cultivo de bilis en el transoperatorio. Se identificaron dos grupos: con cultivo biliar negativo (grupo 1) y con cultivo biliar positivo (grupo 2). Las variables estudiadas fueron edad, sexo, resultados del cultivo, absceso, celulitis, seroma y hematoma. El análisis estadístico incluyó c2 de Pearson o prueba exacta de Fisher y t de Student. Resultados: Se estudiaron 80 pacientes (n = 40 por grupo), 24 hombres (30%) y 56 mujeres (70%), en quienes se practicó colecistectomía abierta y que contaban con cultivo biliar para el análisis. La morbilidad general fue de 42.5%. La tasa de infección del sitio quirúrgico fue de 11.25%. En el grupo 1, dos pacientes presentaron abscesos y dos celulitis; en el grupo 2, cuatro abscesos y uno celulitis. No hubo diferencia significativa al comparar la infección del sitio quirúrgico entre ambos grupos. Conclusiones: La presencia de bacterias en los cultivos de bilis vesicular no se correlacionó con el desarrollo de infección en herida quirúrgica posterior a colecistectomía.


BACKGROUND: Bactibilia is the presence of bacteria in gall bladder bile and may play a role in the appearance of septic complications. It has been related to increased rates of surgical site infection after cholecystectomy. In this study we investigated whether bactibilia correlates with the presence of surgical site infection after cholecystectomy. METHODS: In this observational and descriptive study we investigated those patients operated by open cholecystectomy because of chronic cholecystitis. Patients had bile culture during surgery (January-December 2006). There were two study groups: patients with negative biliary culture (group 1) and patients with positive biliary culture (group 2). Variables were age, gender, biliary culture reports, abscess, cellulitis, seroma, and hematoma. Statistical analysis included Pearson chi(2) or Fisher's exact test. For independent variables, Student t-test was used. RESULTS: Eighty patients were included (n = 40 per group). There were 24 males (30%) and 56 females (70%) who had open cholecystectomy and had biliary culture. General morbidity was 42.50% and surgical site infection rate in general was 11.25%. There were two patients with abscesses and two patients with cellulitis in group 1. There were four patients with abscesses and one patient with cellulitis in group 2. There was no statistically significant difference when comparing surgical site infection in both groups. CONCLUSIONS: The presence of bacteria in gall bladder cultures does not correlate with the development of surgical site infection after open cholecystectomy.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Bactérias/isolamento & purificação , Bile/microbiologia , Colecistectomia/efeitos adversos , Colecistectomia/métodos , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia
15.
Rev. venez. cir ; 63(2): 88-93, jun. 2010. tab
Artigo em Espanhol | LILACS | ID: lil-594497

RESUMO

Se presenta la experiencia de los autores con 77 casos de estenosis biliares benignas tratadas en Unidad de Cirugía Hepática, Biliar y trasplante de hígado del Hospital Universitario de Maracaibo. Desde agosto de 1989 hasta diciembre de 2009, fueron registrados 77 casos de estenosis biliares benignas. Se tipificaron según la clasificación de Bismuth. 83,12% (64) de los pacientes habían sido colecistectomizados (estenosis post-iatrogenia durante este procedimiento): 41 (53,25%) abiertas y 23 (29,87%) laparoscópicas. 89,61 (69) de los pacientes consultaron por ictericia, 62,34% fiebre y 58,44% dolor abdominal. 9% (7) presentó estenosis Bismuth I, 22% (17) tipo II, 44,16% (34) tipo III y 24,68% (19) tipo IV. A todos se les realizó exploración biliar quirúrgica y anastomosis mucosa-mucosa con Y-Roux, tipo Hepp-Couinaud en 70 (87,5%) de los pacientes. La mortalidad fue 2,6% (2) paciente en el transoperatorio. Se presentaron en el peri-operatorio 19 (24,39%) complicaciones en 17 (22%) pacientes: 12 (15,6%) mayores y 7 (8,79%) menores. En un seguimiento promedio de 49 meses, 7-79% (6) pacientes presentaron re-estenosis de la derivación bilioentérica. El mayor porcentaje de estenosis biliares benignas son posteriores a procedimientos quirúrgicos, principalmente colecistectomia. La anastomosis bilioentérica tipo Hepp-Couinaud se realizó en el mayor número de pacientes con excelentes resultados.


Present experience of the authors with 77 cases of bening biliary strictures. From August of 1989 to December of 2009, 77 patients were recorded. Classification of Bismuth was used to classificate the strictures 64 (83,12%) patients were cholecistectomizated (stricture by iatrogenia during this procedure): 41 (53,25%) open and 23 (29,87%) laparoscopic. 89,61% (69) consulted by jaundice, 62,34 by fever and 58,44% by abdominal pain. 9%(7) had stricture Bismuth 1,22% (17) type II, 44,16% (34) type III and 24,68% (19) type IV. All patients were summated to surgical biliary exploration and mucous-mucous biliary anastomosis with Y-Roux. Hepp-Couinaud type in 70 (87,7%) of the patients. Perioperative mortality was 2,6% (2). Perioperative complications were 19 (24,39%) in 17 (22%) patients: 12 (15,6%) mayor and 7(8,79%) minors. In medial following of 49 months, 7,79% (6) presented re-stricture of bilio-enteric anastonosis. The majority of the strictures were due to surgical procedures. Hepp-Couinaud anastomosis was performed in almost all the patients with excellent outcome.


Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Pessoa de Meia-Idade , Colecistectomia/métodos , Colestase/complicações , Colestase/patologia , Ducto Colédoco/lesões , Infecções/etiologia , Laparoscopia/métodos , Bile/fisiologia , Constrição Patológica/patologia , Dor Abdominal/etiologia
16.
Rev. GASTROHNUP ; 12(1): S27-S30, ene.15 2010.
Artigo em Espanhol | LILACS | ID: lil-645079

RESUMO

La colestasis, tiene incidencia de 1:60-375 ictéricos a las 2 semanas de edad, es potencialmente grave, presentan riesgos inmediatos como coagulopatías por hemorragia severa ante el déficit de la absorción de la vitamina K, y con su diagnóstico precoz, se identifican patologías que tienen tratamiento, incluso, trasplante hepático. Como consecuencia de la colestasis, hay retención de sales biliares, daño celular hepático, y descenso de la bilis a nivel intestinal, que ocasionan mala digestión de grasas y proteínas, con defectos en las vitaminas liposolubles. Existen hepatopatías primariassecundarias a una serie de entidades genéticas y metabólicas, y colestasis secundarias a otros problemas, que en el adulto generan enfermedad hepática. Es necesario establecer protocolos deidentificación del niño con ictericia.


Cholestasis has 1:60-375 incidence of jaundice at 2 weeks of age, are potentially serious, immediateand present risk of severe bleeding coagulopathy to the shortfall in the absorption of vitamin K, andearly diagnosis, identify diseases that are treatable, even liver transplantation.As a result of cholestasis, there is retention of bile salts, liver cell damage and decrease of bile in the intestine, causing poor digestion of fats and protein, with defects in soluble vitamins. There are primaryliver disease secondary to a variety of metabolic and genetic entities, and cholestasis secondary toother problems, generated in the adult liver disease. It is necessary to establish protocols for the identification of children with jaundice.


Assuntos
Criança , Colestase/classificação , Colestase/complicações , Colestase/diagnóstico , Colestase/epidemiologia , Colestase/fisiopatologia , Colestase/patologia , Colestase/sangue , Ductos Biliares/lesões , Ductos Biliares/metabolismo , Ductos Biliares/patologia , Bile , Síndrome de Alagille/classificação , Síndrome de Alagille/genética , Síndrome de Alagille/patologia , Vitamina K
17.
Rev. Soc. Boliv. Pediatr ; 49(3): 150-154, 2010.
Artigo em Espanhol | LILACS | ID: lil-652544

RESUMO

Se presenta el caso clínico de un niño de 33 días de vida con síndrome de bilis espesa que simuló ser un quistedel colédoco. Se hace énfasis en el diagnóstico diferencial de la colestasis neonatal y de la observación meticulosadel cuadro clínico.


Assuntos
Bile , Colestanóis
18.
Braz. j. microbiol ; 40(4): 757-766, Oct.-Dec. 2009. ilus, graf, tab
Artigo em Inglês | LILACS | ID: lil-528157

RESUMO

Miang is a kind of traditional fermented tea leaves, widely consumed in northern Thailand as a snack. It contains several kinds of Lactobacilli spp. The aim of this study was to isolate strains of Lactobacillus fermentum from miang and to investigate their antibacterial and antioxidant activities. The agar spot and well assays were used for determination of antibacterial power. The antibacterial mechanism was investigated by cell morphologic change under scanning electron microscope (SEM). Antioxidant activity was studied by means of free radical scavenging and ferric reducing power assays. The acid and bile screening tests indicated that L. fermentum FTL2311 and L. fermentum FTL10BR presented antibacterial activity against several pathogenic bacteria: Listeria monocytogenes DMST 17303, Salmonella Typhi DMST 5784, Shigella sonnei DMST 561 (ATCC 11060)and Staphylococcus aureus subsp. aureus DMST 6512 (ATCC 6538Ptm). The results from SEM suggested that the antibacterial action was due to the destruction of cell membrane which consequently caused the pathogenic cell shrinking or cracking. The antioxidant study suggested that both L. fermentum FTL2311 and L. fermentum FTL10BR strains could liberate certain substances that possessed antioxidant activity expressed as trolox equivalent antioxidant capacity (TEAC) and equivalent concentration (EC) values for free radical scavenging and reducing mechanisms, respectively. The supernatant of L. fermentum FTL2311 broth revealed TEAC and EC values of 22.54±0.12 and 20.63±0.17 µM.mg-1 respectively, whereas that of L. fermentum FTL10BR yielded TEAC and EC values of 24.09±0.12 and 21.26±0.17 µM.mg-1 respectively. These two strains isolated from miang present high potential as promising health-promoting probiotics.


Assuntos
Ágar , Antibacterianos/isolamento & purificação , Antioxidantes/isolamento & purificação , Bile , Técnicas In Vitro , Lactobacillus fermentum/isolamento & purificação , Métodos , Microscopia Eletrônica de Varredura , Folhas de Planta , Técnicas
19.
Rev. chil. cir ; 61(2): 142-147, abr. 2009. tab
Artigo em Espanhol | LILACS | ID: lil-538025

RESUMO

Background: Bacterial colonization of bile is common in patients with bile duct obstruction, even in the absence of clinical signs of sepsis. Aim: To determine the association between bile bacterial count and postoperative complications in patients with bile duct obstruction. Material and Methods: A bile bacterial count was performed to patients with acute cholangitis caused by biliary stones, operated between 2004 and 2006. Post operative complications and length of hospital stay were recorded in these patients. Results: Fifty four patients aged between 25 and 95 years (34 females) were studied. The most common bacteria found, were Escherichia coli in 32 cultures (50 percent), followed by Klebsiella pneumoniae in 6 cultures (9 percent). In 45 cases the bacterial load was over 10(5) colony forming units (CFU)/ml. Among patients with and without complications, 68 and 69 percent had a bacterial load over 10(5) CFU/ml, respectively (p = NS). A multivariate analysis showed an association between platelet count and prothrombin time with the incidence of complications. Conclusions: In this series of patients with acute cholangitis, no association between bile bacterial count and postoperative complications was observed.


Introducción: La colonización bacteriana de la bilis parece ser frecuente en pacientes con obstrucción de la vía biliar ya sea con o sin signos de sepsis. Objetivos: Determinar asociación entre el recuento bacteriano en la bilis de pacientes con colangitis aguda (CA) y el desarrollo de complicaciones postoperatorias; y, determinar asociación entre variables fisiológicas y desarrollo de complicaciones en el mismo grupo. Material y Método: Reporte preliminar de estudio de cohorte de pacientes con CA litiásica, intervenidos quirúrgicamente en los servicios de cirugía y urgencias del Hospital Regional de Temuco en el período diciembre de 2004 a noviembre de 2006. Se realizó cultivo cuantitativo y se registraron variables clínicas y de laboratorio al ingreso. Se efectuó medición de complicaciones postoperatorias, estancia hospitalaria y evolución de los pacientes. Se aplicó estadística descriptiva y posteriormente análisis univariado y multivariado. Resultados: Se estudió un total de 54 pacientes, 34 (63 por ciento) fueron de género femenino y 20 (37 por ciento) de género masculino, con una mediana de edad de 68 años (25 a 95 años). El germen más frecuentemente aislado fue Escherichia coli en 32 cultivos (50 por ciento), seguido por Klebsiella pneumoniae en 6 cultivos (9 por ciento). De los gérmenes aislados 45 (82 por ciento) tenían cargas bacterianas sobre 10(5) UFC/ml. De los pacientes que presentaron alguna complicación 68 por ciento tenían cargas bacterianas superiores a 10(5) UFC/ml y de los pacientes que no presentaron complicaciones 69 por ciento tenían cargas bacterianas inferiores a 10(5) UFC/ml (p = 0,513). En el análisis univariado se encontró asociación entre desarrollo de complicaciones y las variables frecuencia cardíaca, creatinina, recuento de plaquetas y tiempo de protrombina. Con el análisis multivariado se determinó asociación entre desarrollo de complicaciones y las variables recuento de plaquetas y tiempo de protrombina (OR: 4,35 y 4,58)...


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Bile/microbiologia , Colangite/microbiologia , Complicações Pós-Operatórias/epidemiologia , Doença Aguda , Análise de Variância , Estudos de Coortes , Contagem de Colônia Microbiana , Chile/epidemiologia , Colangite/cirurgia , Escherichia coli/isolamento & purificação , Infecções Bacterianas/epidemiologia , Klebsiella pneumoniae/isolamento & purificação , Tempo de Internação , Morbidade
20.
Braz. j. infect. dis ; 12(3): 222-225, June 2008. tab
Artigo em Inglês | LILACS | ID: lil-493652

RESUMO

The current study determined the spectrum of biliary microflora with special emphasis on enteric fever organisms in patients with acute cholangitis with and without cholelithiasis or other biliary diseases. The patients were divided into three groups: Group A consisted of patients with acute cholecystitis with cholelithiasis; Group B consisted of patients with acute cholecystitis with gastrointestinal ailments requiring biliary drainage and group C consisted of patients with gallbladder carcinoma. Gallbladder, bile and gallstones were subjected to complete microbiological and histopathological examination. Antimicrobial susceptibility of the isolates was performed as per CLSI guidelines. Bacteria were recovered from 17 samples (32 percent) in Group A, 17 (51.4 percent) in Group B and 1 (1.6 percent) in Group C. The most common organisms isolated were Escherichia coli (11, 29.7 percent), Klebsiella pneumoniae (10, 27 percent), Citrobacter freundii (3, 8.1 percent), Salmonella enterica serovar Typhi (3, 8.1 percent), etc. The majority of Enterobacteriaceae isolates were susceptible to piperacillin-tazobactam and meropenem. As regards Salmonella spp., S. Typhi was isolated from 2 (3.8 percent) patients in Group A and 1 (16 percent) in Group C. Antimicrobial susceptibility of potential causative organisms, the severity of the cholecystitis, and the local susceptibility pattern must be taken into consideration when prescribing drugs. A protocol regarding the management of such cases should be formulated based on observations of similar studies.


Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Bile/microbiologia , Colecistite Aguda/microbiologia , Colelitíase/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Antibacterianos/farmacologia , Bactérias Gram-Negativas/classificação , Bactérias Gram-Positivas/classificação , Testes de Sensibilidade Microbiana , Adulto Jovem
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