Ventriculoperitoneal shunt malfunction due to chronic cholecystitis: A case report.

RATIONALE: Ventriculoperitoneal shunt (VPS) is the most common treatment for idiopathic normal pressure hydrocephalus, a subtype of hydrocephalus characterized by gait disturbance, dementia, and urinary incontinence. However, while the malfunction of VPS is reported at a high rate, the involvement of chronic cholecystitis in shunt malfunction is rare. PATIENT CONCERNS: A 73-year-old woman with idiopathic normal pressure hydrocephalus who received a VPS but subsequently developed chronic cholecystitis. The patient suffered from drowsiness and was unable to walk. Her family found that she presented with poor appetite and was bloated. DIAGNOSES: Chronic cholecystitis was confirmed through abdominal computed tomography, which showed a swollen, and enlarged gallbladder, and flatulence. A head computed tomography scan indicated hydrocephalus with enlarged ventricular system and paraventricular edema. INTERVENTIONS: Laparoscopic cholecystectomy was performed successfully, requiring no further shunt manipulation. OUTCOMES: The patient's memory and cognitive ability were slightly impaired without a positive sign in the abdomen. No catheter or abdominal infection signs were observed during the following 3 months of follow-up. CONCLUSION: To the best of our knowledge, this report is the first to reveal that shunt malfunction may result from chronic cholecystitis, which induced the presently observed intra-abdominal hypertension.

[Clinical use of flavonoid enriched biologically active food supplements in patients with chronic atrophic gastritis in combination with chronic cholecystitis or bile ducts dyskinesia]. / Opyt klinicheskogo primeneniia flavonoidsoderzhashchikh biologicheski aktivnykh dobavok k pishche u bol'nykh khronicheskim atroficheskim gastritom na fone khronicheskogo kholetsistita libo diskinezii zhelchevyvodiashchikh putei.

60 patients with chronic atrophic gastritis and secretory insufficiency allied with chelicobacterial infection in combination with chronic unlithic cholecystitis or diskinesia of choledoch ways were explored with a view to study the efficiency of dietary cure including biologically active food supplements--flavonoids source. Fortification of the patients food intake with flavonoids-containing biologically active food supplements benefits mucous membrane of gastroduodenal zone that is evidenced in decrease of activity of pyloric chelicobacteriosis and resolvent and reparative effect, it also contributes to normalization of hepatobiliaric system condition and antioxidant status.

[Evaluation of the kallikrein-kinin system in patients with chronic impairments of the hepatobiliary system as affected by fasting-diet therapy]. / Vyvchennia kalikrein-kininovoï systemy u khvorykh na khronichni urazhennia hepatobiliarnoï systemy za umov rozvantazhuval'no-diietychnoi terapiï.

Evaluation of kallikrein-kinin circulatory system was performed via kallikrein, prekallikrein, a1-inhibitor proteinase, a2-macroglobulin, kininase-II and proteolytic activity in 60 patients with chronic persisting hepatitis and incalculous cholecystitis. Two types of kallikrein-kinin system reaction were revealed: hyperkininogenesis in 85% and hypokininogenesis in 15% of all the patients. The problem of fasting diabetics influence on kininogenesis was investigated as well.

[Use of whey in the diet of children with chronic diseases of the biliary tract]. / Primenenie molochnoi syvorotki v pitanii detei s khronicheskimi zabolevaniiami zhelchevyvodiashchikh putei.

The influence of whey on the function of the stomach, biliary system and pancreas was studied in 112 children with chronic cholecystocholangitis. It has been established that whey possesses a choleretic property and normalizes the exocrine function of the pancreas. Whey can be recommended as a therapeutic agent or an additive to products for diet therapy in the combined treatment of chronic diseases of the biliary system, especially, with concomitant affection of the stomach and pancreas.

[The effect of a diet enriched with food fibers and polyunsaturated fatty acids on the composition of the lipid components in the enterohepatic circulation system in rabbits with cholestasis]. / Vliianie ratsiona, obogashchennogo pishchevymi voloknami i polinenasyshchennymi zhirnymi kislotami, na sostav lipidnykh komponentov v sisteme pechenochno-kishechnoi tsirkuliatsii u krolikov pri kholestaze.

In experiments on rabbits that had undergone partial constriction of the choledochus, the development of calculous hepatocholecystitis was observed in a half of the operated on animals. No biliary calculi were detected in the animals that received the ration enriched with food vegetable fibres, beta-sitosterol and linoleic polyunsaturated fatty acids after similar operations.

[Changes in liver function in patients with alimentary obesity combined with cholecystitis as affected by diet therapy]. / Izmenenie funktsional'nogo sostoianiia pecheni u bol'nykh alimentarnym ozhireniem v sochetanii s kholetsistitom pod vliianiem dietoterapii.

A study was made of the effect of the reduced diet including a dry protein mixture (DPM) and Ocean paste on radionuclide and clinicobiochemical indicators of the bile in 66 patients with alimentary obesity associated with cholecystitis. The control group received the reduced diet. It was noted that improvement of the patients' general status and reduction of the main clinical disease manifestations were accompanied by liver function improvement that manifested in the normalization of absorption-excretory function of hepatocytes and a more marked and significant increase in the level of the main bile, components in patients given the DPM and Ocean paste. It is concluded that the DPM and Ocean paste should be introduced into the reduced diet, since this favours an increase in the diet biological value and efficacy of the management of alimentary obesity associated with cholecystitis.

[Diet therapy with correction of the fat component in the treatment of children with chronic cholecystocholangitis]. / Lechebnoe pitanie s korrektsiei zhirovogo komponenta v terapii detei s khronicheskimi kholetsistokholangitami.

The children suffering from chronic affections of the biliary system showed disturbances of the exocrine and esterifying function of the liver. They also had impaired concentration and disordered motor function of the gall bladder. This reverberates on the lipid spectrum of blood, bile and ion permeability of erythrocyte membranes. Comprehensive therapy in the presence of oil-enriched diet (up to 40% of the total fat amount) exerted a favourable action on the clinical course of the disease, promoted normalization of the lipid spectrum of blood and bile, and stabilization of the structural composition of the membranes. This allows recommending such a therapeutic diet as one of the components of comprehensive pathogenetically validated therapy of children with chronic cholecystocholangitis.

[Significance of nutrition and diet in diseases of the extrahepatic biliary tract]. / Die Bedeutung von Ernährung und Diätetik bei Erkrankungen der extrahepatischen Gallenwege.

On the basis of newer literature and of own experiences the author describes the present state of dietetics in diseases of the extrahepatic biliary ducts. The details of the basic diet in these diseases are discussed (nutrition of patients with limited fat and raw fibre supply). In acute cases the parenteral nutrition is to be recommended. In subacute cases, as well as before and after surgical interventions more frequently ballast-free, fully balanced peroral nutrition (cosmonautes' diet) is used. Finally the importance of the plant raw fibre for the prophylaxis of cholelithiasis is demonstrated.