Biomedical subjects

J J Fontana

Publications and source records attributed to J J Fontana.

13 recordsLinked to original sources

PubMed1989

Risk factors for acute pancreatitis in patients with migrating gallstones.

Stool screening for gallstones and ultrasound monitoring of diameter changes of the biliary and pancreatic duct were performed in 129 patients with choledocholithiasis. Gallstone migration was found in 44 patients, all of whom were operated on electively. At surgery, acute pancreatic lesions were found in 16 patients; in the remaining 28 there was no evidence of pancreatic inflammation. There were no significant differences among patients in both groups regarding sex, age, stone size, shape or number found in stools, interval between admission and migration, or the presence of a dilated pancreatic duct before migration. Pancreatic duct reflux, however, was significantly more frequent in cholangiograms of patients with acute pancreatitis, implying that a common channel may be a major factor relating to acute pancreatitis in patients with migrating gallstones.

Acute Disease↗

PubMed1988

Biliary and pancreatic obstruction during gallstone migration.

A prospective study on biliary and pancreatic obstruction during gallstone migration was performed in patients without acute pancreatitis. From January to October 1986, 125 patients with upper abdominal pain due to cholelithiasis were admitted to the hospital. Ultrasonography performed in all patients at admission demonstrated a distal bile duct measuring 7 mm or more in 39 patients, who were monitored for diameter changes of the biliary and pancreatic duct every 24 h and their stools screened for gallstones. Patients underwent surgery at least 8 days after admission. Gallstone migration was found preoperatively in 10 patients, of whom 6 had total serum bilirubin values lower than 2 mg/100 ml. Migration time was accurately determined by the sudden decrease in bile duct caliber. Simultaneous dilatation of biliary and pancreatic duct was found in 4 out of 10 patients with migrating gallstones and in 7 out of 23 patients without gallstone migration, though differences proved non-significant. Acute pancreatitis developed in 2 patients with lithiasis of the distal bile duct who ingested a fatty meal against medical advice. Gallstone migration, even of small stones, was preceded by a period of biliary obstruction. Pain and jaundice before migration were not as frequent as expected.

Acute Disease↗

PubMed1981

[Acute suppurative cholangitis].

1) Acute suppurative cholangitis is the most severe clinical form of bacterial biliary infection. 2) During a 14 year period, 29 patients were treated at the General Surgery Division A, of the Cosme Argerich General Hospital. 3) Patients were divided in two groups; a) acute suppurative cholangitis with (n:100 or b) without (n:19) evidence of biliary obstruction. In the former group, in addition to Charcot's triad, we found mental confusion and septic shock among clinical signs. 4) Gall stones were the most common cause of obstruction, followed by pancreatic and biliary carcinoma. 5) Diagnosis on admission was correct in 40% of patients. Charcot's triad was present in 19 of the 29 patients. 6) All 22 operated patients survived whereas 7 non operated patients died. 7) The high mortality observed was similar to that reported in other publications and could be partly due to delayed diagnosis, and the high frequency of multiple liver abscesses found at autopsy. 8) Newer diagnostic procedures have improved the differential diagnosis of obstructive jaundice. It is hoped that they will help in the earlier recognition of acute suppurative cholangitis and decrease the incidence of severe complications.

Adult↗

PubMed1967