Background: Stone impaction is an obstacle to successful laparoscopic common bile duct exploration (LCBDE). This study aims to identify the incidence, operative difficulties and techniques used to disimpact and remove impacted stones during LCBDE.
Methods: Prospectively collected data from a large series of LCBDE.
CRSLS
January 2025
Department of Surgery, King Saud University Medical City, Riyadh, Saudi Arabia. (Drs. Aljunaydil, Mattar, Almufawaz, AlOthman, and Alalem).
Introduction: Acute appendicitis and acute cholecystitis are two of the most commonly encountered surgical entities. Multiple hypotheses are behind their coexistence, which include pathogen predilection, and mucosal ischemia inducing portal vein bacteremia as the management of uncomplicated acute cholecystitis and acute appendicitis is surgical, for which a single operation for synchronous presentation is effective. Here, we report a case with coexistent acute cholecystitis and acute appendicitis managed at our institution.
View Article and Find Full Text PDFCureus
December 2024
Nephrology, Hospital Clinic Barcelona, Barcelona, ESP.
Histoplasmosis, caused by the fungus , is a significant public health concern in endemic regions like Mexico. Immunocompromised individuals, especially those with HIV infection and those exposed to nitrogen-rich environments, such as bird excrement or bat guano, are particularly vulnerable. This case report describes a middle-aged patient with jaundice in the skin and mucous membranes.
View Article and Find Full Text PDFSarcoidosis is a multisystem disease process with a bimodal distribution typically affecting African American women and those of Scandinavian descent characterized by noncaseating granulomatous disease. We present a case of a 29-year-old African American male patient who was seen in the clinic for recurrent symptomatic cholelithiasis. He had no past medical history or symptoms besides intermittent postprandial right upper quadrant (RUQ) pain with imaging confirming cholelithiasis.
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December 2024
Interventional Radiology, Houston Vascular Care, Houston, USA.
Cystic artery pseudoaneurysms are a rare but life-threatening entity that commonly occurs as a sequela to acute cholecystitis. We present a case of a 52-year-old male with a past medical history of decompensated alcoholic liver cirrhosis who underwent a transjugular liver biopsy (TJLB) after correction of his baseline coagulopathy. On post-operative day one, the patient had significant blood loss with an inappropriate response to blood transfusions and without an identifiable source of bleeding.
View Article and Find Full Text PDFWorld J Emerg Surg
January 2025
Department of General Surgery, The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, 116023, China.
Background: Gangrenous cholecystitis (GC) is a serious clinical condition associated with high morbidity and mortality rates. Machine learning (ML) has significant potential in addressing the diverse characteristics of real data. We aim to develop an explainable and cost-effective predictive model for GC utilizing ML and Shapley Additive explanation (SHAP) algorithm.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Surgery, Yale New Haven Health System, New Haven, Connecticut, USA.
Haemorrhagic cholecystitis is an uncommon cause of abdominal pain that can lead to significant morbidity and mortality if not promptly identified and treated. Known risk factors include trauma, anticoagulation use and cholelithiasis. In a patient with right upper quadrant pain after blunt trauma on anticoagulation without cholelithiasis, haemorrhagic acalculous cholecystitis should be considered in the differential diagnosis, as appeared to be the case in the patient we present here.
View Article and Find Full Text PDFJ Ultrasound Med
January 2025
Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Objectives: To combine sonographic Murphy sign (SMS) with clinical parameters to effectively stratify patients into risk groups for acute cholecystitis.
Methods: Consecutive emergency department patients from April 1, 2019 to August 31, 2022 with possible acute cholecystitis were grouped using patient age, sex, and white blood cell count to determine the rate of acute cholecystitis found in subgroups. Three distinct clinical risk groups were established and then regrouped by prospective assessment of SMS into three non-imaging risk groups.
Am J Surg
December 2024
Upper GastroIntestinal Unit, Department of Surgery, St George Public Hospital, NSW Health, Australia; UNSW Department of Surgery, St George & Sutherland Clinical School, The University of New South Wales, Sydney, New South Wales, Australia.
Background: Laparoscopic cholecystectomy (LC) is a common operation performed worldwide. Indications include acute cholecystitis (AC), with a trend of increasing complexity post-COVID-19. We aim to evaluate the health expenditure on LC at an Australian tertiary centre.
View Article and Find Full Text PDFSurgery
December 2024
Department of Diagnostics and Intervention, Surgery, Umeå Universitet, Sweden.
Background: The optimal timing of surgery for acute cholecystitis has been a subject of debate, but the predominant view supports early cholecystectomy. This study investigated the safety of early cholecystectomy during weekends compared with delayed surgery until a weekday.
Methods: This was a population-based cohort study based on data from the Swedish National Register for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks).
Surg Endosc
December 2024
General and Digestive Surgery Department, Hepato-Biliary and Pancreatic Surgery Unit, Valme University Hospital, Ctra. de Cádiz Km548.9. 41014, Seville, Spain.
Introduction: Choledocholithiasis is a common clinical condition that may present with severe complications such as acute cholecystitis or cholangitis, requiring treatment on an emergency setting. This situation is frequently managed following an endoscopic approach by ERCP. However, access to emergent endoscopic biliary decompression is lacking in most centers.
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November 2024
Accident and Emergency, Pilgrim Hospital, United Lincolnshire Hospitals Trust, Boston, GBR.
Epigastric pain and vomiting are common presentations associated with various causes of acute abdomen. Acute abdomen encompasses a range of different pathologies, with epigastric pain narrowing the differential diagnosis to conditions such as pancreatitis, bowel obstruction, acute cholecystitis, gastritis, acute coronary syndrome (ACS), and peptic ulcer disease, such as gastric ulcers and duodenal ulcers with/without perforation. This is a case of a male patient in his 80s who came to the emergency department with symptoms of generalized abdominal pain, vomiting, and constipation.
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November 2024
Internal Medicine, Corewell Health, Royal Oak, USA.
Leptospirosis, an infection caused by the spirochete Leptospira and commonly attributed to the underdeveloped world, is frequently under-diagnosed in the United States. This report discusses the case of a 79-year-old male with no significant medical history who presented to the ED with recurrent falls. Initial laboratory results demonstrated severe acute kidney injury, hyperbilirubinemia, and thrombocytopenia.
View Article and Find Full Text PDFTrauma Surg Acute Care Open
December 2024
Surgery, Westchester Medical Center, Valhalla, New York, USA.
Background: This study aims to compare outcomes of robotic cholecystectomy (RC) versus laparoscopic cholecystectomy (LC) in the setting of a level 1 trauma center.
Methods: We performed a retrospective study of our hospital data (2021-2024) on patients who underwent LC or RC. Using a previously validated intraoperative grading system, four grades of cholecystitis were defined as mild (A), moderate (B), severe (C), and extreme (D).
Int J Surg Case Rep
December 2024
Department of Surgery, Osaka City Juso Hospital, Osaka, Japan.
Introduction And Importance: Type 1 gallbladder perforation (GBP) in the free abdominal cavity causes pan-peritonitis, which is both rare and difficult to diagnose.
Case Presentation: An 80-year-old man presented to our hospital with acute left upper abdominal pain. Twenty days prior to presentation, he had been admitted for 12 days with coronavirus disease 2019 (COVID-19).
World J Gastrointest Endosc
December 2024
Department of Gastroenterology, Central Hospital Affiliated to Chongqing University of Technology, Chongqing 400054, China.
Background: Endoscopic resection of giant gastric leiomyomas, particularly in the fundus and cardia regions, is infrequently documented and presents a significant challenge for endoscopic surgery.
Case Summary: Herein, a case of a 59-year-old woman with a giant gastric leiomyoma was reported. The patient presented to the department of hepatological surgery with a complaint of right upper abdominal pain for one month and worsening for one week.
World J Gastrointest Surg
December 2024
Department of General Surgery II, The First Affiliated Hospital of Dali University, Dali 671000, Yunnan Province, China.
Background: Laparoscopic cholecystectomy is considered the gold standard for the treatment of patients with gallstones. However, bile duct injury is one of the most serious complications of this surgery, with an incidence rate of 0.3%-0.
View Article and Find Full Text PDFACG Case Rep J
January 2025
Department of Internal Medicine, Japanese Red Cross Kochi Hospital, Kochi, Japan.
BMC Infect Dis
December 2024
Infectious Disease Hospital of Heilongjiang Province, No. 1 Jian She Street, Hulan District, Harbin, Heilongjiang, 150500, China.
Background: Tuberculosis (TB) remains a significant global health issue. Drug-resistant TB and comorbidities exacerbate its burden, influencing treatment outcomes and healthcare utilization. Despite the growing prevalence of TB comorbidities, research often focuses on single comorbidities rather than comorbidity patterns.
View Article and Find Full Text PDFObjective: Limitations are sometimes encountered in the application of laparoscopic cholecystectomy to the treatment of acute cholecystitis. Endoscopic gallbladder stenting (EGBS) has emerged as an additional option. However, the long-term stent patency remains an issue.
View Article and Find Full Text PDFJ Family Med Prim Care
November 2024
Department of Basic Science College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
An 80-year-old woman with epigastric pain and weight loss presented to our hospital with cancer of the ascending colon and cholelithiasis. Initially hospitalized for a suspected gallstone attack, she later developed gangrenous cholecystitis. She underwent a laparoscopic cholecystectomy, which revealed abscess formation and necrosis extending into the gallbladder duct.
View Article and Find Full Text PDFActa Med Okayama
December 2024
Department of Surgery, Nagasaki University Graduate School of Biomedical Science.
Gangrenous cholecystitis (GC) is classified as moderate acute cholecystitis according to the Tokyo Guidelines from 2018 (TG18). We evaluated the risk factors for GC and the outcomes of early cholecystectomy. A total of 136 patients who underwent emergency cholecystectomy for acute cholecystitis were retrospectively analyzed; 58 of these patients (42.
View Article and Find Full Text PDFAm J Trop Med Hyg
December 2024
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Dengue infection poses a significant public health challenge in tropical countries. In Thailand, children ages 5-14 years are among the groups with the highest incidence of dengue. This study aimed to determine the prevalence of gastrointestinal (GI) manifestations in children with dengue infection and assess prognostic factors for severe dengue.
View Article and Find Full Text PDFJ Surg Case Rep
January 2025
Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Laparoscopic cholecystectomy is the preferred method for treating acute cholecystitis. Although the incidence of postoperative infections in laparoscopic cholecystectomy is low, serious postoperative surgical site infections are still reported. Hepatic abscesses, particularly fungal, can occur post-cholecystectomy leading to significant mortality and morbidity.
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