[A case of ascariasis in the gallbladder successfully treated with an anthelmintic injection into the gallbladder via a percutaneous transhepatic catheter].

A man in his 40s who had made frequent visits abroad was admitted to our hospital complaining of epigastric pain. Ultrasonography (US) revealed an "inner tube sign" in the gallbladder, which suggested a diagnosis of ascariasis in the gallbladder. Pyrantel pamoate was directly injected into the gallbladder via a percutaneous transhepatic catheter.

Fatal hyperkalemia due to rapid red cell transfusion in a critically ill patient.

A 60-year-old woman in severe hemorrhagic shock underwent urgent laparotomy to control massive hematemesis. Severe metabolic acidosis due to hemorrhagic shock and hyperkalemia as well as hypocalcemia associated with rapid blood transfusion were aggressively corrected with administration of sodium bicarbonate, insulin, and calcium chloride. Following rapid transfusion of the last 8 units of red cell concentrate (RCC), however, cardiac arrest occurred because of hyperkalemia and did not respond to cardiopulmonary resuscitation.

Endoscopic transpapillary gallbladder drainage in patients with acute cholecystitis in whom percutaneous transhepatic approach is contraindicated or anatomically impossible (with video).

Background: In patients with acute cholecystitis and at high risk for surgery, decompression of the gallbladder by percutaneous transhepatic gallbladder drainage (PTGBD) or aspiration (PTGBA) is needed as salvage therapy. However, we sometimes encounter patients in whom puncture cannot be performed for several reasons. Recently, endoscopic transpapillary gallbladder drainage (ETGD) has been reported to be safe and effective for acute cholecystitis.