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Gastrointestinal system
Published in David A Lisle, Imaging for Students, 2012
US is the most sensitive investigation for the presence of gallstones and is therefore the investigation of choice for suspected acute cholecystitis. The diagnosis of acute cholecystitis is usually made by confirming the presence of gallstones in a patient with RUQ pain and fever (Fig. 4.16). Other signs of acute cholecystitis that may be seen with US include thickening of the gallbladder wall, fluid surrounding the gallbladder, and localized tenderness to direct probe pressure (Fig. 4.17).
Human physiology, hazards and health risks
Published in Stephen Battersby, Clay's Handbook of Environmental Health, 2016
David J. Baker, Naima Bradley, Alec Dobney, Virginia Murray, Jill R. Meara, John O’Hagan, Neil P. McColl, Caryn L. Cox
Secretions from the liver also enter the duodenum via the bile duct. The bile is stored and concentrated in the gall bladder, which also contracts due to the action of the vagus nerve, and can also contract due to the action of some hormones. The bile constituents may concentrate in the gall bladder and give rise to gall stones. The associated inflammation of the gall bladder is termed as cholecystitis.
Human physiology, hazards and health risks
Published in Stephen Battersby, Clay's Handbook of Environmental Health, 2023
Revati Phalkey, Naima Bradley, Alec Dobney, Virginia Murray, John O’Hagan, Mutahir Ahmad, Darren Addison, Tracy Gooding, Timothy W Gant, Emma L Marczylo, Caryn L Cox
Secretions from the liver also enter the duodenum via the bile duct. The bile is stored and concentrated in the gall bladder, which also contracts due to the action of the vagus nerve and can also contract due to the action of some hormones. The bile constituents may concentrate in the gall bladder and give rise to gall stones. The associated inflammation of the gall bladder is termed as cholecystitis.
Towards an AI-based assessment model of surgical difficulty during early phase laparoscopic cholecystectomy
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2023
Julian. R. Abbing, Frank J. Voskens, Beerend G. A. Gerats, Ruby M. Egging, Fausto Milletari, Ivo A.M.J. Broeders
Laparoscopic cholecystectomy (LC) is currently one of the most commonly performed minimally invasive (abdominal) procedures in elective and emergency settings. (Sugrue et al. 2019) The procedure is considered the standard surgical treatment for patients with symptomatic cholelithiasis, cholecystitis, gallstone pancreatitis and gallbladder polyps. (Priego et al. 2009; Soper and Malladi 2022) The procedure has evolved into a relatively safe and tolerable daycare procedure. However, there is high variability in perioperative findings. (Griffiths et al. 2019; Ward et al. 2022) LC can be relatively easy in patients with a floppy, non-inflamed pink gallbladder. However, the procedure can be challenging in patients with dense adhesions and severe cholecystitis. These high complex procedures can result in prolonged OR time, more blood loss, and an increased risk of complications. (Atta et al. 2017; Madni et al. 2018; Sugrue et al. 2019)
Spatial access to Emergency General Surgery (EGS) services and EGS bypass behaviours in California
Published in Annals of GIS, 2023
Jiuying Han, Neng Wan, Simon C. Brewer, Marta McCrum
The California Inpatient Discharge Data contains all administrative claims data of all inpatient hospitalizations. We identified all adult patients with a non-elective admission for a primary diagnosis of one of nine common EGS conditions, with severity grading scales defined by the American Association for the Surgery of Trauma (AAST): appendicitis, cholecystitis, diverticulitis, abdominal hernia, acute pancreatitis, intestinal obstruction, gastroduodenal ulcer disease with perforation or haemorrhage, soft tissue infection and mesenteric ischaemia (Ogola, Haider, and Shafi 2017; Utter et al. 2015). In 2014, the American Association for the Surgery of Trauma (AAST) published an anatomic grading scale for common EGS diseases based on clinical assessment, imaging, operative findings and pathologic criteria (Shafi et al. 2013; Tominaga et al. 2016). Utter et al. (Utter et al. 2015) subsequently demonstrated the feasibility of mapping these anatomic grading scales to ICD-9-CM and ICD-10-CM diagnosis codes using both primary and secondary codes, which are commonly used to identify EGS patient populations using administrative claims databases. Scott et al. (Scott et al. 2020) then dichotomized the resulting categories into ‘more complex’ vs ‘less complex’ disease, which were associated with in-hospital mortality, complications and length of stay (2021). The codes we used to identify complex vs non-complex disease are those published by Scott et al. We also conducted a sensitivity analysis using only patients with complex conditions. The results are similar to the original model and can be found in the supplemental document. To minimize the influence of multiple visits to a specific hospital by the same patient, we excluded records for which the patient ID and hospital ID were the same to a previous record. Race/ethnicity were categorized as non-Hispanic White, non-Hispanic Black, Hispanic, Asian, Native American/American Indian, and ‘other’ using standardized OSHPD coding. Other patient characteristics obtained from the inpatient discharge dataset included age, sex, primary expected payer (Medicare, Medi-Cal/Medicaid, private insurance, self-pay, and ‘other’) and home zip code. Patient zip code was linked with ACS data to obtain ZCTA level socio-demographic variables. Poverty rate was used to represent the socioeconomic status of ZCTAs. Rural/urban status of ZCTAs were defined following the instruction of the Federal Office of Rural Health Policy (2021).