Cholecystitis, Concealment of Hepatobiliary-Pancreatic Pathology: The Role of Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound.

Cholecystitis is an inflammation of the gallbladder with classic symptoms of right upper quadrant abdominal pain and fever. The most common precipitating factor is cholelithiasis; however, it sometimes appears in conjunction with other hepatobiliary-pancreatic pathology. Management is generally done with antibiotics and supportive care with or without cholecystectomy. The surgical management in practice is often limited by surgery time and patient suitability considering their likely overall outcome. We have outlined two cases with different etiologies presenting as cholecystitis. The aim was to further understand the benefits of multidisciplinary team meetings to optimize patient care and emphasize the roles of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in hepatobiliary pathology.

A Retrospective Observational Study: Is Absolute Lymphocyte Count a Prognostic Marker in COVID-19?

Aim Our study aimed to find a correlation between low absolute lymphocyte count and COVID-19-related mortality. Methods This study followed a retrospective observational cohort design to analyze the data of patients who presented with symptoms and signs of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), at the Conquest Hospital and Eastbourne District General Hospital in East Sussex, United Kingdom, between February 10, 2020 and May 1, 2020, retrospectively. Survival and mortality for the first 30 days and comorbidities were analyzed for all patients who were tested for COVID-19 irrespective of swab results and had blood lymphocyte levels taken at the time of their visit to the ED and their data were analyzed for statistical significance. Results A total of 1226 patients had SARS-CoV-2 RNA identification swabs taken between February 10, 2020 and May 1, 2020. A cohort of 742 patients of these patients tested for COVID-19 also had blood lymphocyte levels measured. Overall, the lymphocyte count did not differ significantly between patients suspected to have COVID-19 infection with either positive or negative COVID-19 swab results. The lymphocyte count, however, was significantly lower in those who died from COVID-19 (p < 0.001) but when comorbidities were analyzed, we found an association between an increased number of comorbidities and a significantly decreased lymphocyte count. Conclusion Once adjusted for comorbidities, the lymphocyte count had no association with COVID-19 infection and mortality.