2.A Case of Acute Cholecystitis Secondary to Hemobilia after Percutaneous Liver Biopsy.
Won MOON ; Joo Hyun SOHN ; Myung Hee JANG ; Chang Hee BAEK ; Yong Woo CHUNG ; Jong Pyo KIM ; Dong Soo HAN ; Yong Chul JEON ; Joon Soo HAHM ; Dong Hoo LEE ; Choon Suhk KEE
The Korean Journal of Gastroenterology 2006;47(1):72-76
Percutaneous liver biopsy is well established for the diagnosis and follow-up of many liver diseases. Although it is rather safe, major complications, such as bleeding into the peritoneal or thoracic cavity, hemobilia, enteric perforation and intrahepatic hematoma, have been reported related to the procedure. Recently, incidence of such major complications has been decreased since the introduction of ultrasonography-guided liver biopsy. We report a case of 59-year-old female patient with acute cholecystitis secondary to hemobilia 2 days after ultrasonography-guided percutaneous liver biopsy.
Biopsy, Needle/*adverse effects
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Cholecystitis, Acute/*etiology
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Female
;
Hemobilia/*etiology
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Humans
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Liver/*pathology
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Middle Aged
;
Ultrasonography, Interventional
3.A Case of Hemorrhagic Gallbladder Paraganglioma Causing Acute Cholecystitis.
Young Up CHO ; Jang Yong KIM ; Sun Keun CHOI ; Yoon Seok HUR ; Keon Young LEE ; Sei Joong KIM ; Seung Ik AHN ; Kee Chun HONG ; Ze Hong WOO ; Jee Young HAN ; Seok Hwan SHIN
Yonsei Medical Journal 2001;42(3):352-356
Gallbladder paraganglioma is a very rare tumor and so far only a few cases have been reported. Most of these were asymptomatic and were found incidentally during operation. Recently, we experienced a gallbladder paraganglioma that gave rise to hemorrhage, which in turn caused acute cholecystitis. Our case involved a 45 year-old female patient complaining of an intermittent right upper abdominal pain. After a preoperative evaluation, cholecystectomy and lymphadenectomy were performed under the impression of gallbladder cancer with acute cholecystitis. Postoperative pathologic examination revealed a hemorrhagic gallbladder paraganglioma accompanied by acute cholecystitis. Immunohistochemical staining of the chief cells for neuron specific enolase, chromogranin and synaptophysin were positive. Sustentacular cells also stained positively for S100 protein.
Acute Disease
;
Case Report
;
Cholecystitis/*etiology
;
Female
;
Gallbladder Neoplasms/*complications/pathology
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Hemorrhage/*complications
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Human
;
Immunohistochemistry
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Middle Age
;
Paraganglioma/*complications/pathology
4.Tension Pneumothorax after Endoscopic Retrograde Pancreatocholangiogram.
Sang Yun SONG ; Kyo Seon LEE ; Kook Joo NA ; Byoung Hee AHN
Journal of Korean Medical Science 2009;24(1):173-175
We report a case of tension pneumothorax after an endoscopic sphincterotomy. A 78-yr-old woman presented with progressing dyspnea. She had undergone an endoscopic retrograde cholangiopancreatogram three days before due to acute cholecystitis. She underwent endoscopic sphincterotomy for stone extraction, but the procedure failed. On arrival to our hospital, she complained about severe dyspnea and she had subcutaneous emphysema. A computed tomogram scan revealed severe subcutaneous emphysema, right-side tension pneumothorax, and pneumoretroperitoneum. Contrast media injected through a transnasal biliary drainage catheter spilled from the second portion of the duodenum. A second abdominal computed tomogram showed multiple air densities in the retroperitoneum and peritoneal cavity, which were consistent with panperitonitis. We recommended an emergent laparotomic exploration, but the patient's guardians refused. She died eventually due to septic shock. Endoscopic retrograde cholangiopancreatogram is a popular procedure for biliary and pancreatic diseases, but it can cause severe complications such as intestinal perforation. Besides perforations, air can spread through the abdominal cavity, retroperitoneum, mediastinum, and the neck soft tissue, eventually causing pneumothorax. Early recognition and appropriate management is crucial to an optimal output of gastrointestinal perforation and pneumothorax.
Acute Disease
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Aged
;
Cholangiopancreatography, Endoscopic Retrograde/*adverse effects
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Cholecystitis/diagnosis
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Female
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Humans
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Intestinal Perforation/etiology
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Pneumothorax/*diagnosis/etiology
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Retropneumoperitoneum/*diagnosis/etiology
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Sphincterotomy, Endoscopic
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Tomography, X-Ray Computed
5.A Case of Portal Vein Thrombosis Associated with Acute Pancreatitis and Cholangitis.
Dae Young CHEUNG ; Jae Kwang KIM ; Don Hyoun JO ; Hyun Jong OH ; Tae Ho KIM ; So Yeon LEE ; Soo Heon PARK ; Joon Yeol HAN ; Kyu Won CHUNG ; Hee Sik SUN
The Korean Journal of Gastroenterology 2005;46(1):60-65
Portal vein thrombosis is a rare complication accompanied with acute pancreatitis or cholangitis/cholecystitis. The main pathogenesis of portal vein thrombosis in pancreatitis or cholangitis/cholecystitis are suggested to be venous compression by pseudocyst and an imbalance between the blood coagulation and fibrinolysis. In this case report, we experienced a 63 year old male who developed portal vein thrombosis later in the course of the treatment of acute gallstone pancreatitis with cholangitis/cholecystitis without any symptom or sign. The diagnosis of portal vein thrombosis was given on follow up CT scan and serum protein S activity was decreased to 27% in laboratory study. Immediate anticoagulation therapy with heparin and thrombolytic therapy with urokinase and balloon dilatation were performed. Despite the aggressive treatment, complete reperfusion could not be obtained. With oral warfarin anticoagulation, the patient showed no disease progression and was discharged. We report a case of portal vein thrombosis as a complication of acute pancreatitis and cholangitis/cholecystitis with a review of literatures.
Acute Disease
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Cholangitis/*complications/diagnosis
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Cholecystitis/complications
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Humans
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Male
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Middle Aged
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Pancreatitis/*complications/diagnosis
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*Portal Vein
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Tomography, X-Ray Computed
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Venous Thrombosis/diagnosis/*etiology
6.Acute Acalculous Cholecystitis Associated with Cholecystoduodenal Fistula and Duodenal Bleeding: A Case Report.
Sang Bae LEE ; Kwang Hyun RYU ; Ji Kon RYU ; Hoi Jin KIM ; Jin Kwang LEE ; Hyun Seung JEONG ; Jin Soo BAE
The Korean Journal of Internal Medicine 2003;18(2):109-114
Although acute acalculous cholecystitis (AAC) accounts for less than 10% of acute cholecystitis in the adult population, gangrene and perforation are much more frequent compared to the usual cases of acute cholecystitis (calculus cholecystitis). However, spontaneous biliary-enteric fistula is well recognized in AAC, 90% of which are cholecystoduodenal fistula (CDF) though it is an uncommon disorder. The majority of the CDF are caused by cholelithiasis. As patients are usually associated with complicated clinical illness, the diagnosis is often difficult to make and required surgery is often delayed. We have studied a rare complication of acute acalculous cholecystitis which was presented as intermittent upper gastrointestinal bleeding. Ulceration of the superficial branch of the cystic artery has been observed due to acalculous cholecystitis associated with a cholecystoduodenal fistula. We have performed a transfixing ligation of the bleeding vessel, cholecystectomy and simple closure of the CDF. We have finally made a diagnosis of early gallbladder cancer through a frozen section. There was no serious complication after the operation and the patient has achieved an uneventful recovery.
Acute Disease
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Cholecystectomy
;
Cholecystitis/*diagnosis
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Duodenal Diseases/*complications
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Gallbladder Neoplasms/diagnosis
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Gastrointestinal Hemorrhage/*etiology
;
Human
;
Intestinal Fistula/*complications
;
Male
;
Middle Aged
7.A Case of Acute Cholecystitis after Colonoscopy.
Jung Ho YUN ; Woo Jin JEONG ; Woo Sung CHANG ; Min Hyeong JO ; Jong Kyu PARK ; Sang Jin LEE ; Young Don KIM ; Gab Jin CHEON
The Korean Journal of Gastroenterology 2013;61(1):42-45
A 43-year-old man, who received total gastrectomy five years ago for advanced gastric cancer, underwent a screening colonoscopy and abdominal CT scan. Abdominal CT scan revealed no abnormal findings. Colonoscopy revealed polyps at the rectum, which were removed by polypectomy. The patient did not complain of abdominal pain or discomfort throughout the procedure. But, he developed right upper quadrant abdominal pain on the next day after colonoscopy. Abdominal CT scan revealed the distended gallbladder with mild wall thickening and suspicious sandy stones or sludge in the gallbladder. The patient underwent an open cholecystectomy. Pathology was compatible with acute cholecystitis. We should be aware of and consider cholecystitis in the differential diagnosis for patients with abdominal pain after colonoscopy.
Adult
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Cholangiopancreatography, Magnetic Resonance
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Cholecystectomy
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Cholecystitis, Acute/*diagnosis/etiology/pathology
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Colonoscopy/*adverse effects
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Diagnosis, Differential
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Gallbladder/pathology
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Gallstones/diagnosis
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Humans
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Male
;
Polyps/pathology
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Tomography, X-Ray Computed
8.Acute Cholecystitis in Patients with Scrub Typhus.
Hyun LEE ; Misuk JI ; Jeong Hwan HWANG ; Ja Yeon LEE ; Ju Hyung LEE ; Kyung Min CHUNG ; Chang Seop LEE
Journal of Korean Medical Science 2015;30(11):1698-1700
Acute cholecystitis is a rare complication of scrub typhus. Although a few such cases have been reported in patients with scrub typhus, the clinical course is not well described. Of 12 patients, acute cholecystitis developed in 66.7% (8/12) of patients older than 60 yr. The scrub typhus group with acute cholecystitis had marginal significant longer hospital stay and higher cost than the group without cholecystitis according to propensity score matching. Scrub typhus should be kept in mind as a rare etiology of acute cholecystitis in endemic areas because the typical signs of scrub typhus such as skin rash and eschar can present after the abdominal pain.
Aged
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Aged, 80 and over
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Cholecystitis, Acute/*diagnosis/*etiology/therapy
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Diagnosis, Differential
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Female
;
Humans
;
Male
;
Republic of Korea
;
Scrub Typhus/*complications/*diagnosis/therapy
;
Treatment Outcome
9.Effect of jinhong decoction in regulating the systemic inflammatory response syndrome caused by acute biliogenic infection.
Ying NIU ; Xue-lin ZHANG ; Bang-jiang FANG
Chinese Journal of Integrated Traditional and Western Medicine 2004;24(8):707-709
Adult
;
Aged
;
Cholangitis
;
complications
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Cholecystitis, Acute
;
complications
;
Drugs, Chinese Herbal
;
therapeutic use
;
Female
;
Humans
;
Interleukin-2
;
blood
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Interleukin-6
;
blood
;
Male
;
Middle Aged
;
Phytotherapy
;
Systemic Inflammatory Response Syndrome
;
drug therapy
;
etiology
;
Tumor Necrosis Factor-alpha
;
metabolism
10.Bedside Endoscopic Ultrasound-guided Transgastric Gallbladder Aspiration and Lavage in a High-risk Surgical Case Due to Acute Cholecystitis Accompanied by Multiorgan Failure.
So Hee YUN ; Moon Shik PARK ; Jae Un LEE ; Min A YANG ; Sang Hoon HAN ; Young Jae LEE ; Geum Mo JEONG ; Yong Keun CHO ; Ji Woong KIM ; Jin Woong CHO
The Korean Journal of Gastroenterology 2015;65(6):370-374
Cholangitis and cholecystitis are intra-abdominal infections that show poor prognosis upon progression to sepsis and multiorgan failure. Administration of antibiotics with high antimicrobial susceptibility and removal of infected bile at the initial treatment are important. After undergoing ERCP for diagnostic purposes, a 58-year-old man developed acute cholangitis and cholecystitis accompanied by rhabdomyolysis, multi-organ failure, and severe sepsis. Broad-spectrum antibiotics with bedside endoscopic nasobiliary drainage were administered, but clinical symptoms did not improve. Therefore, bedside EUS-guided transgastric gallbladder aspiration and lavage was performed, resulting in successful treatment of the patient. We report the above described case along with a discussion of relevant literature.
Cholangiopancreatography, Endoscopic Retrograde
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Cholecystitis, Acute/complications/*diagnosis/diagnostic imaging
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Drainage
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Duodenoscopy
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Endosonography
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Escherichia coli/isolation & purification
;
Humans
;
Male
;
Middle Aged
;
Multiple Organ Failure/pathology
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Rhabdomyolysis/complications/diagnosis
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Sepsis/diagnosis/etiology/microbiology
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Therapeutic Irrigation
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Tomography, X-Ray Computed