Ask DR ELLIE CANNON: Could a diet give me gallstones?
Gallstones are incredibly common and for most people cause no symptoms. But when the stones travel in the gall bladder ducts or get stuck, pain occurs, writes DR ELLIE CANNON.
CONCLUSIONS Gut microbiome of PCS patients was dominated by Proteobacteria in feces and contained little Firmicutes and Bacteroidetes. The enhanced abundance of Proteobacteria might be the highly pathogenic risk factor for chronic abdominal pain and diarrhea in PCS patients. PMID: 31563920 [PubMed - in process]
Conclusions: This study identified acute HEV3 infection in 4% of the patients with elevated liver enzymes admitted to a surgical ward. HEV infection was not the solitary disease leading to hospitalization, instead it was found to be associated with other surgical conditions such as gallstone-related disease including biliary pancreatitis. Additionally, HEV RNA might be the preferential diagnostic tool for detecting ongoing HEV infection. PMID: 31553628 [PubMed - as supplied by publisher]
ConclusionTo our knowledge, Mirizzi syndrome with concurrent cholecystocolonic fistula is exceedingly rare with a paucity of reports within the literature. Our report discusses principles of management of Mirizzi syndrome as well as best practices of surgical management for Mirizzi syndrome with concurrent cholecystocolonic fistula.
Patients with inflammatory bowel disease (IBD) will often require abdominal surgical intervention for indications not directly related to their IBD. Because these patients often have a history of multiple previous abdominal operations and/or ostomies, they are at increased risk for incisional and parastomal hernias. They may also have develop symptomatic cholelithiasis, chronic pain, or desmoid disease. All of these potentially surgical issues may require special consideration in the IBD population.
The back pain and odd growth seemed to indicate cancer. But one doctor had a different idea entirely.
CONCLUSION: The closure of MDs eliminated the risk of IH in half of the operated patients of LRYGB in this series. PMID: 31521564 [PubMed - as supplied by publisher]
In this study, approximately 10% of Transient STEMI had no culprit found:Early or late intervention in patients with transient ST ‐segment elevation acute coronary syndrome: Subgroup analysis of the ELISA‐3 trialOne must use all available data, including the ECG, to determine what happened.Final Diagnosis?If the troponin remained under the 99% reference, then it would be unstable angina. If it rose above that level before falling, it would be acute myocardial injury due to ischemia, which is, by definition, acute MI. If that is a result of plaque rupture, then it is a type I MI. The clinical presentat...
CONCLUSIONThe presence of a foreign body in the bile ducts is well reported in literature, and it is directly dependent on previous history. We should always avoid using cholangioresonance in dubious cases. To keep the ERCP as initial treatment is recommended due to the advances on the procedure quality, but in more severe cases or lack of resources, the surgical exploration is still indicated.
Publication date: Available online 24 June 2019Source: Journal of Visceral SurgeryAuthor(s): A. Sokal, A. Sauvanet, B. Fantin, V. de LastoursSummaryAcute cholangitis is an infection of the bile and biliary tract which in most cases is the consequence of biliary tract obstruction. The two main causes are choledocholithiasis and neoplasia. Clinical diagnosis relies on Charcot's triad (pain, fever, jaundice) but the insufficient sensitivity of the latter led to the introduction in 2007 of a new score validated by the Tokyo Guidelines, which includes biological and radiological data. In case of clinical suspicion, abdominal ul...
Publication date: August 2019Source: Clinica Chimica Acta, Volume 495Author(s): Boudour Khabou, Ayman Trigui, Tahya Sellami Boudawara, Leila Keskes, Hassen Kamoun, Véronique Barbu, Faiza FakhfakhAbstractLow phospholipid-associated cholelithiasis (LPAC) is characterized by the association of ABCB4 mutations and low biliary phospholipid concentration with symptomatic and recurring cholelithiasis. In the present study, we reported a case of a 63-year-old woman, who presented a biliary pain beginning at the age of 30, recurrent after cholecystectomy, along with “comet-tail shadows” revealed by ultrasonograph...