No abstract available.
Adult ; Bile Ducts, Intrahepatic/pathology ; Caroli Disease/complications/*diagnosis/pathology ; Gallstones/complications/*diagnosis/radiography ; Humans ; Male ; Tomography, X-Ray Computed

Hemorrhagic acalculous cholecystitis is an extremely rare but potentially fatal disease if detection is delayed. Its risk factors include critical illness, diabetes, malignant disease, uremia, and bleeding diathesis. This is the first case report in which hemorrhagic acalculous cholecystitis not accompanied by any risk factor. We herein present a case of hemorrhagic acalculous cholecystitis in a previously healthy patient who suffered from acute abdomen.
Acalculous Cholecystitis/complications/*diagnosis/pathology ; Adult ; Endoscopy, Gastrointestinal ; Gallbladder/pathology ; Gallstones/diagnosis ; Hemobilia/*complications ; Humans ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed

BACKGROUND/AIMS: We sought to examine whether the presence of gallstone disease (GD) in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD) is associated with liver fibrosis and histological nonalcoholic steatohepatitis (NASH) score. METHODS: We included 441 Turkish patients with biopsy-proven NAFLD. GD was diagnosed in the presence of sonographic evidence of gallstones, echogenic material within the gallbladder with constant shadowing and little or no visualization of the gallbladder or absence of gallbladder at ultrasonography, coupled with a history of cholecystectomy. RESULTS: Fifty-four patients (12.2%) had GD (GD+ subjects). Compared with the GD- subjects, GD+ patients were older, had a higher body mass index and were more likely to be female and have metabolic syndrome. However, GD+ patients did not have a higher risk of advanced fibrosis or definite NASH on histology. After adjustment for potential confounding variables, the prevalence of GD in NAFLD patients was not associated with significant fibrosis (> or =2) (odds ratio [OR], 1.06; 95% confidence interval [CI], 0.53 to 2.21; p=0.68) or definite NASH (OR, 1.03; 95% CI, 0.495 to 2.12; p=0.84). CONCLUSIONS: The presence of GD is not independently associated with advanced fibrosis and definite NASH in adult Turkish patients with biopsy-proven NAFLD.
Biopsy ; Fatty Liver/pathology ; Female ; Gallbladder/pathology ; Gallstones/complications/*pathology ; Humans ; Liver/*pathology ; Liver Cirrhosis/pathology ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/complications/*pathology ; Prospective Studies ; Retrospective Studies ; Sensitivity and Specificity

Acute pancreatitis is common but remains a condition with significant morbidity and mortality. Despite a better understanding of the pathophysiology of acute pancreatitis achieved during the past few decades, there is no specific pharmacologic entity available. Therefore, supportive care is still the mainstay of treatment. Recently, novel interventions for increasing survival and minimizing morbidity have been investigated, which are highlighted in this review.
Acute Disease ; Antioxidants/therapeutic use ; Bacteremia/complications ; Cholangiopancreatography, Endoscopic Retrograde ; Fluid Therapy ; Gallstones/complications ; Humans ; Necrosis ; Pancreatitis/mortality/*pathology/therapy ; Protease Inhibitors/therapeutic use ; Renal Dialysis

Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Fibrosis ; drug therapy ; pathology ; surgery ; therapy ; Gallstones ; complications ; Humans ; Middle Aged ; Somatostatin ; therapeutic use ; Varicose Veins ; drug therapy ; pathology ; surgery ; therapy

The present case is one of gallstone obstructive ileus due to gallstones 3 yr after laparoscopic cholecystectomy. It is interesting because of the sex of the patient, the fact that ileus occurred 3 yr after cholecystectomy and that the localization of the obstruction was an old side-to-side ileoileal anastomosis due to a diverticulectomy following intussusception of Meckels' diverticulum at the age of 3.
Adult ; Anastomosis, Surgical/*adverse effects ; Child, Preschool ; Cholecystectomy, Laparoscopic/*adverse effects ; Gallstones/*complications ; Humans ; Ileum/pathology/*surgery ; Ileus/*etiology ; Intestinal Obstruction/*etiology ; Male ; Meckel Diverticulum/surgery

Bezoars ; complications ; Fruit ; adverse effects ; Gallstones ; diagnosis ; pathology ; Humans ; Ileus ; diagnosis ; etiology ; Male ; Middle Aged ; Seeds ; adverse effects ; Tomography, X-Ray Computed

BACKGROUND/AIMS: In order to determine the malignant potential of gallbladder adenoma for progression to carcinoma, we evaluated the histopathologic features of adenoma and adenoma-related lesions on cholecystectomized specimens. METHODS: Among 1,847 cholecystectomized specimens, 63 specimens from 26 benign adenomas, 9 carcinomas in situ (CIS), and 28 invasive carcinomas were selected. A pathologist reviewed all specimens and selected benign adenomas, CIS in the adenoma, and adenoma residue in invasive carcinomas. Adenomas and adenoma-related lesions were classified according to morphology (tubular, tubulopapillary, and papillary) and the consisting epithelium (biliary, pyloric metaplasia, and intestinal metaplasia). The age and the size of the benign adenomas and carcinomas in the adenoma were also compared. RESULTS: Adenoma and adenoma-related lesions were found in 34 out (1.8%) of all resected gallbladder. Among 9 CIS and 28 invasive carcinomas, adenoma-related lesions were detected in 7 and 1 case, respectively. All eight carcinomas arising in the adenoma were well-differentiated solitary tumors. The diameters of the carcinomas in the adenoma were, on average, larger than that of the benign adenomas (1.8 cm vs. 0.9 cm, p=0.01). The patients with carcinomas in the adenoma were, on average, older than those with benign adenomas, although the difference was insignificant (57 years vs. 47 years, p=0.09). The morphology and consisting epithelium did not differ between the benign adenomas and carcinomas in the adenoma. The malignant transformation occurred in 23.5% of adenomas. CONCLUSIONS: Gallbladder adenoma is a rare disease, although malignant transformation occurs frequently. Adenoma is a precancerous lesion and the adenoma-carcinoma sequence is one of the gallbladder cancer carcinogenesis.
Adenoma/epidemiology/*pathology/surgery ; Adult ; Age Factors ; Aged ; Carcinoma/epidemiology/pathology/surgery ; Cell Transformation, Neoplastic ; Cholecystectomy ; Cystadenoma/epidemiology/pathology/surgery ; Female ; Gallbladder Neoplasms/epidemiology/*pathology/surgery ; Gallstones/complications ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness