1.Fish Bone as a Nidus for Stone Formation in the Common Bile Duct: Report of Two Cases.
Young Hwan KIM ; Yong Joo KIM ; Won Kyu PARK ; Sang Kwon LEE ; Jung Hyeok KWON ; Seong Ku WOO
Korean Journal of Radiology 2004;5(3):210-213
We report two cases of common bile duct stone formed around a fish bone which migrated from the intestinal tract, along with their characteristic imaging findings. Two patients who had no history of previous operation were admitted because of cholangitis. Percutaneous transhepatic biliary drainage (PTBD) was performed and the cholangiogram showed filling defects with an unusually elongated shape in the common bile duct. After improvement of the cholangitic symptoms, the stones were removed through the PTBD tract under fluoroscopic guidance. A nidus consisting of a 1.5 cm sized fish bone was found in each stone removed.
Aged
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Animals
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Bone and Bones/*radiography/*ultrasonography
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Cholangiography
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Cholangitis/etiology
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Choledocholithiasis/*etiology/surgery
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Female
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Fishes
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Foreign Bodies/*complications/surgery
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Humans
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Male
2.Type of Electric Currents Used for Standard Endoscopic Sphincterotomy Does Not Determine the Type of Complications.
Se Joon LEE ; Kee Sup SONG ; Jun Pyo CHUNG ; Dok Yong LEE ; Yon Soo JEONG ; Sang Won JI ; Yong Han PAIK ; Seung Woo PARK ; Si Young SONG ; Kwan Sik LEE ; Jae Bock CHUNG ; Sang In LEE ; Jin Kyung KANG ; Seung Ho CHOI
The Korean Journal of Gastroenterology 2004;43(3):204-210
BACKGROUND/AIMS: The blended current is usually used for endoscopic sphincterotomy (EST) to minimize bleeding. The pure cutting current may induce less edema of the ampulla and therefore result in less injury to the pancreas theoretically. The aim of this study was to evaluate effects of electric currents used on the development of serum pancreatic enzyme evaluation, clinical pancreatitis or bleeding after EST. METHODS: One hundred and eighteen consecutive patients who underwent EST with standard papillotome alone for the treatment of choledocholithiasis were reviewed. All EST had been performed by two endoscopists whose experience on EST was similar: one uses 'blended current' (BC group, n=74), while the other uses 'pure cutting current' (PC group, n=44). RESULTS: Baseline clinical, laboratory, and procedural parameters were similar in both groups. The incidences of hyperamylasemia and hyperlipasemia were similar between two groups. There was no significant difference in the incidence of clinical pancreatitis between two groups (BC 6.8% vs PC 0.0%, p=0.1557). All episodes of pancreatitis were mild. No episodes of significant bleeding occurred after EST. The incidences of sepsis, cholangitis and perforation were also not different between two groups. CONCLUSIONS: Development of complications after standard EST such as hyperamylasemia, clinical pancreatitis, and bleeding may not depend on the electric current used.
Aged
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Choledocholithiasis/surgery
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English Abstract
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Female
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Humans
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Male
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Middle Aged
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Pancreatitis/etiology
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Sphincterotomy, Endoscopic/*adverse effects/methods
3.A Case of Afferent Loop Syndrome with Acute Cholangitis Developed after Percutaneous Transhepatic Cholangioscopic Lithotripsy for Treatment of Choledocholithiasis in a Patient Who Underwent Billroth II Gastrectomy.
Seong Hyun KIM ; Kye Sook KWON ; Seok JEONG ; Don Haeng LEE ; Kyung Sun MIN ; Jin Woo LEE ; Yong Woon SHIN ; Yong Sun JEON
The Korean Journal of Gastroenterology 2012;59(2):180-184
Afferent loop syndrome is a rare complication which can occur in patients with Billroth II gastrectomy. Bile and pancreatic juice is congested at afferent loop in the syndrome. This syndrome can progress rapidly to necrosis, perforation, or severe sepsis, and therefore early diagnosis and swift surgical intervention is important. But, cases of endoscopic or percutaneous transhepatic drainage have been reported when surgical management was inappropriate to proceed. We report a case of afferent loop syndrome accompanying acute cholangitis developed after percutaneous transhepatic cholangioscopic lithotripsy for the retrieval of common bile duct stone in a patient who underwent Billroth II gastrectomy due to early gastric cancer. There was no other organic cause. We treated afferent loop syndrome successfully by performing balloon dilation of afferent loop outlet.
Acute Disease
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Afferent Loop Syndrome/*etiology
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Aged, 80 and over
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Balloon Dilation
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Cholangiography
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Cholangitis/*etiology
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Choledocholithiasis/*diagnosis/radiography/therapy
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Common Bile Duct
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Gallstones/*diagnosis/therapy
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Gastroenterostomy
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Humans
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Lithotripsy/*adverse effects
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Male
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Stomach Neoplasms/surgery
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Tomography, X-Ray Computed