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At least 1,153 records · Page 64Linked to original sources
PubMed1959

Radiographic signs of acute suppurative cholecystitis.

In a recent series of 26 pathologically proven cases of acute cholecystitis, preoperative radiographic examination of the abdomen confirmed the presence of an inflammatory process in 17. The radiographic signs associated with acute suppurative cholecystitis are:1. Enlargement of the gallbladder, as indicated by separation or alteration in position of opaque calculi or indentation of adjacent bowel.2. Localized peritoneal irritation, manifested by (a) ileus of hepatic flexure of colon; (b) ileus of duodenal loop; (c) effacement of haustra of the hepatic flexure or valvulae conniventes of the duodenum; (d) obscuration of fat line marking inferior border of liver.3. Cholecystitis emphysematosa.4. Perforation of gallbladder, which if localized (retroperitoneal) is manifested by bubbles of gas in the gallbladder bed. If generalized (intraperitoneal) the signs are adynamic ileus of small and large bowel, increased intraperitoneal fluid, subdiaphragmatic abscess and plate atelectasis of right lung base. Visualization of the gallbladder and biliary tree after intravenous cholecystography rarely occurred in the presence of acute cholecystitis. Plain film examination of the abdomen aids in establishing the diagnosis of an acute cholecstitis and leads to the early recognition of complications such as perforation and peritonitis.

Abdomen↗
PubMedDate not supplied

[X-ray and ultrasonic diagnosis of noninflammatory benign diseases of the gallbladder].

The author analyzes the results of x-ray (cholecystography) and ultrasonic examinations carried out in patients with noninflammatory benign diseases of the gallbladder (71 with cholesterosis and 28 with adenomyomatosis). X-ray and ultrasonic symptoms of these conditions are presented and the diagnostic potentialities of both methods in the detection of such diseases assessed. The author considers ultrasonic scanning the method of choice for the diagnosis of any forms of gallbladder cholesterosis, whereas an x-ray examination appears to be informative only in a polypous form of the disease. X-ray contrast examination is preferable for the recognition of gallbladder adenomyomatosis, for it presents a clear-cut pattern characteristic of each form of this condition, whereas ultrasonic symptoms of such involvement are nonspecific.

Adult↗
PubMed1979

Determinants of the rate of intestinal absorption of oral cholecystographic contrast agents in the dog jejunum.

Successful opacification of the gallbladder during oral cholecystography depends on adequate absorption of the contrast agent from the intestine. The present studies were undertaken to define the specific characteristics of the intestinal mucosa and the properties of the various contrast agents which determine their rates of intestinal absorption. The polarity of the compounds was established by determining the ratios of their distribution between bulk solvents (benzene and water). In addition, the maximum aqueous solubility of each compound was determined. Using in vivo cannulated segments of dog jejunum, apparent passive permeability coefficients were measured. From these data, the apparent maximal rate of intestinal absorption was calculated. The six cholecystopaques studied differed markedly in polarity as judged by their varying ratios of distribution between benzene and water. The permeability coefficients varied inversely with the polarity of the compounds. However, the incremental changes in the coefficients were considerably less than the corresponding changes observed in the partition ratios. The rates of absorption of the more polar contrast agents (tyropanoate, iopronic acid, and iocetamic acid) were greater than the less polar compounds (iopanoic acid, sodium ipodate, and calcium ipodate) under the conditions in which the resistance of the unstirred water layer is not rate limiting and where bile acid micelles are not present.

Animals↗
PubMed1992

Ultrasonography versus roentgenography in suspected cases of cholecystolithiasis.

The present study was carried out to evaluate the relative merits of ultrasonography and roentgenography in 50 cases of suspected cholecystolithiasis. The accuracy rate with roentgenography (plain X-ray abd, OCG and IVC) in the diagnosis of cholecystolithiasis was 92.5% where as it was 95% with ultrasonography. Oral cholecystography should be done in patients with normal ultrasound examination if the symptoms are strongly suggestive of cholecystolithiasis.

Bile Duct Diseases↗
PubMed1991

[Diagnosis and treatment of benign tumors of the gallbladder].

The article generalizes experience in the treatment of 226 patients with benign tumors and preneoplastic diseases of the gallbladder, who underwent cholecystectomy. The increased number of patients with the disease is noted, they accounted for 12.77% of all patients who were operated on for gallbladder diseases. Females 40 to 60 years of age have the disease most frequently. In most cases (n = 190) it is seen with calculi. In the absence of concomitant pathological conditions it is generally asymptomatic. The diagnosis is based on instrumental examination. Ultrasonic examination in combination with cholecystography is preferable. Operation is the recommended method of treatment.

Adenoma↗
PubMed1991

[Adenomyomatosis vesicae felleae].

Adenomyomatosis of the gall bladder is a condition of benign hyperplasia of unknown etiology. Characteristic of the condition is local or diffuse thickening of the muscular layer with invagination of the epithelium forming the so-called Rokitansky-Aschoff's sinus. The prevalence is unknown. In a prospective autopsy material, localized adenomyomatosis, adenomyoma, was found in 7%. This is considered to be the lowest value for the prevalence in the older age groups. Cholecystography and cholecystectomy materials show varying frequencies of adenomyomatosis, 2-33%. There is no definite proof that adenomyomatosis is a symptom-producing condition but several studies suggest that it may be and that in selected cases it may be treated by cholecystectomy. Selection depends upon the duration and severity of the symptoms. Routine diagnosis may be made with the aid of ultrasonic scanning. In more obscure cases with symptoms from the biliary tract, oral cholecystegraphy may be recommended possibly including exposures after a meal rich in fats or after administration of cholecystokinine.

Adult↗
PubMed1990

Adenomyomatosis of the gall bladder: the NUH experience.

Adenomyomatosis (AD) is a degenerative disorder of the gall bladder wall which can be complicated by chronic inflammation and calculi. The true incidence of this disorder in South East Asians is not known. Nine Chinese patients with AD were discovered amongst 200 consecutive right upper quadrant ultrasound examinations. Four of them had cholecystectomy and were diagnosed as cholecystitis by the pathologist. Adenomyomatosis can be suspected on ultrasonography, but should be confirmed by oral cholecystography (OCG). There is great disparity in the ultrasound, OCG, surgical and histopathological diagnosis of this condition. This may be due to the fact that only complicated cases of AD come to surgery, where the presence of chronic cholecystitis or calculi detracts from recognising or overshadows the presence of AD. It is not known whether uncomplicated AD has any clinical significance and whether it, if given sufficient time, will lead to inflammation of the gall bladder.

Adult↗
PubMedDate not supplied

[A clinical survey on 17 cases of cholelithiasis in childhood (author's transl)].

A series of 17 cases of gallstones in children observed over a period of 10 years in the area of Marseilles is described and the literature reviewed. The majority of children were girls over 10 years old. Symptoms were constantly present and the disease revealed nine times by acute "mechanical" cholecystitis, compared to 16 infectious cholecystitis followed during the same period, three times by an accident of migration (cholangitis in a 14 years old girl, bile ascitis in two infants). A cholecystography should be performed in acute recurrent abdominal pain of unknown origin in children, gallstones appearing to be radiotransparent in six patients. Among causes of gallstone formation, the authors dig out only 6 hemolytic anemias, related to hemoglobinopathies in three patients, and they emphasize the frequency of idiopathic cholelithiasis which should lead to a more complete investigation of the enterohepatic cycle and chemical constitution of bile in such patients.

Adolescent↗
PubMed1990

[Abdominal x-ray diagnosis using digital luminescent radiography--a comparison with conventional film-screen systems].

Abdominal x-ray examinations represent a variety of indications with different demands on exposure latitude, contrast resolution and spatial resolution of screen-film system combinations. The diagnostic value of digital luminescent radiography (DLR) was thus compared to conventional x-ray examinations carried out with screen-film systems, speed class 200, by analysing matched digital and conventional exposures in 46 abdominal and 25 pelvic x-ray examinations in supine and left lateral view, 156 contrast examinations of the gastrointestinal tract, 140 excretory urographies, 8 cholecystographies, 22 lymphographies and in 6 phlebographies. The digital exposure dose was 50% of the conventional one. In DLR two differently post-processed images were obtained from one x-ray exposure: a display with low spatial frequency enhancement was processed to look like a conventional radiograph and was complemented by a display with high spatial frequency enhancement. Analysing the results statistically, DLR proved to be diagnostically equivalent to conventional radiography despite the reduction in exposure dose and the lower digital spatial resolution. Since high spatial frequency enhancement did not provide further diagnostic information and eventually resulted in border line artifacts, high spatial frequency enhancement is superfluous in abdominal x-ray examinations.

Cholecystography↗
PubMed1986

Controlled study of the effects of tiropramide on biliary dyskinesia.

A controlled trial was carried out in patients with biliary dyskinesia to compare the effects of the new calmodulin-independent and antispastic drug tiropramide with those of imecromone. Forty patients were randomly divided into two groups, one treated with 300 mg tiropramide per day and the other with 1200 mg imecromone per day, both treatments lasting for 3 months. The results showed that tiropramide was significantly more effective in decreasing the number of attacks of pain and in improving pain and dyspepsia symptoms than imecromone. In subjects with delayed filling of the gall bladder during cholecystography, tiropramide but not imecromone was able to normalize the condition. These results confirm the antispastic synchronizing effect of tiropramide on the motor activity of the gall bladder and the sphincter of Oddi and indicate that it should be the drug of choice for treatment of motor disorders of the biliary tract.

Biliary Dyskinesia↗
PubMed1989

Gallbladder carcinoma. Diagnostic procedures with emphasis on ultrasound diagnosis.

Gallbladder carcinoma is a highly malignant disease occurring with increasing frequency in Sweden. Early diagnosis influences the prognosis favourably. A series of 20 patients suffering from gallbladder carcinoma, was analyzed in search of criteria for early diagnosis. Among the imaging modalities, not only ultrasonography (US) but also oral cholecystography were found to provide important information. A plan for investigation and treatment of suspected gallbladder malignancy is proposed.

Adult↗
PubMed1989

[Local tumefaction of the gallbladder wall due to pancreatic heterotopia].

A 38-year-old woman was examined because of vague abdominal symptoms. Cholecystography and US studies demonstrated a lobulated tumor, 14 mm in length, with a homogeneous structure, sharp limits, adjacent to the posterior wall of the gallbladder and producing no acoustic shadow. Pathological examination demonstrated subserosal pancreatic heteropia. More than 22 different kinds of focal lesions affecting the gallbladder wall have been described. Unfortunately, no clinical or US criteria allow a definite diagnosis. Only the size makes a difference: more than 94% of the adenomas measuring less than 10 mm are benign whereas 88% of the malignant lesions are over 10 mm. Considering the absence of specific criteria, surgical removal is therefore indicated for lesions over 10 mm.

Adult↗
PubMed1977

[Radiographic magnification technique with a high-speed rare-earth screen-film system (author's transl)].

The advantages of radiographic magnification technique - better detail recognition and improved contrast with an enlarged field of vision - should prove an important supplement to the properties of a high-speed rare-earth system - low-current intensity, low voltage, short exposure time and, consequently, lower irradiation dosage. Physical measurements of the Wiener spectral value, MTF and HD curve proved the superiority of the radiographic magnification technique in combination with a rare-earth screen-film system as compared with a conventional system (Dupont Par speed screen, RP films). Phantom radiographs confirmed these results. The clinical usefulness of this method was assessed with respect to the detection rate of gall-stones by means of oral cholecystography. Two out of 25 cases showed gallstones only following implementation of the radiographic magnification technique. This method seems to be particularly valuable in angiography. In 7 out of 18 abdominal angiograms and 4 out of 14 renal angiograms the number of visible vessel ramifications was greater with the magnification technique. In 5 cases valuable diagnostic information was revealed only by means of the magnification technique. Despite two-fold or 1.7-fold magnification, measurements of skin irradiation exposure showed a reduction of about half in comparison with conventional techniques. Reduced exposure to irradiation combined with improved detail resolution should ensure that this method receives an established place in routine radiodiagnosis.

Angiography↗
PubMed1988

Radiologic and ultrasonographic diagnosis of gallstones.

Several new nonsurgical modes of therapy for gallstone disease are being introduced almost simultaneously in the United States. These include orally administered bile acids, contact dissolution with methyl t-butyl ether (MTBE), and extracorporeal shock wave lithotripsy. Paralleling these developments is a similar period of transition in the field of gallstone imaging. Technical considerations in performing ultrasonographic, roentgenographic, and cholecystographic studies become more important, since the criteria for use of the nonsurgical techniques place a greater emphasis on gallstone morphology. In ultrasonography, sizing artifacts from reflective surfaces, optimizing measurements, magnifying hard-copy images, positioning the patient, and optimizing transducer frequencies will need to be addressed. In roentgenography, coned views of the right upper quadrant, with the patient prone, will give the best results. Oral cholecystography (OCG) has largely been replaced by ultrasonography for the detection of gallstones, but it is still an essential part of the imaging workup because it permits adequate visualization of the gallbladder to assure patency of the cystic duct. Correlation of the findings from the several techniques has disclosed new insights and encouraged the use of tailored techniques. Based on the current criteria for the use of orally administered ursodeoxycholic acid, an estimated 60-70% of all patients who have gallstones may be suitable candidates for such treatment.

Cholecystography↗
PubMed1988

Cholelithiasis after Billroth II gastric resection.

We evaluate whether Billroth II (BII) gastric resection is a predisposing condition in the formation of gallstones. In our department radiologic and echographic imaging is a routine examination before abdominal surgery. From 1980 to 1985, 202 patients underwent cholecystography or ultrasonography before BII gastric resections for peptic ulcers. The prevalence of cholelithiasis in a random sample of the population of the town near our institution was used to calculate the expected frequency of gallstones. The comparison of the expected and the observed frequencies of cholelithiasis in these patients did not show any statistically significant difference between men and women. All these patients were recalled for a follow-up of the long-term effects of gastric surgery, and 66% (133/202) returned and were examined. They underwent ultrasonography of the biliary tract. Again the observed and the expected (obtained as before) frequencies of cholelithiasis were compared. A statistically significant difference was apparent in male patients. We conclude that BII gastric resection could be a predisposing factor in the formation of gallstones in men.

Adult↗
PubMed1987

Biliary calculi caused by hemobilia.

Formation of biliary calculi caused by hemobilia is rare. Including the two cases reported here, there are only a total of four in the literature. The characteristics of these calculi in vitro, on computerized tomographic scan, and cholecystography are described. The condition for the occurrence seems to be that blood clots remain in the gallbladder sufficiently long (about 6 months) to become encrusted with bile constituents. Patients with hemobilia with clots in the gallbladder should be observed for this complication.

Adolescent↗
PubMed1986

Agenesis of the gallbladder: case report and familial investigation.

In this article we report a case of gallbladder agenesis, confirmed at laparotomy, and the subsequent investigation of that patient's family for others with evidence of agenesis. Ultrasonography was chosen as the principal diagnostic tool, and of the eight family members available for study, one was found to have no demonstrable gallbladder by either ultrasonography or oral cholecystography. The overall incidence of gallbladder agenesis is said to approximate 0.01% to 0.04%. However, in each of the four existing familial studies a much higher incidence is noted. With regard to gallbladder agenesis, these data strongly suggest the existence of a familial hereditary trait.

Adult↗