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Liver and biliary system, pancreas and spleen
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Upper abdominal pain may have many causes and the site of the disease is often poorly localised, so that imaging is needed to define the underlying cause. If the symptom is associated with dyspeptic symptoms, upper GI disease may be suspected and investigated as described in Chapter 5. Pain localised to the right upper quadrant (RUQ) may be due to gallbladder disease – either acute biliary colic or chronic cholecystitis – in which case ultrasound is the preferred initial investigation due to its high sensitivity and specificity in detecting gallbladder calculi and signs of inflammation. If there is a calculus at the lower end of the CBD it may be difficult to show using ultrasound due to overlying gas (see comments on pancreatic visualisation by ultrasound above), but there will usually be dilatation of the CBD with or without dilatation of the intrahepatic ducts, which will prompt the next appropriate investigation such as MRCP.
Health effects and the post-1983 generation
Published in J. Mangano Joseph, Low-Level Radiation and Immune System Damage, 2018
Obesity is not a disease per se, but research has shown that heavy children have a greater risk later on in life for gallbladder disease, osteoarthritis, diabetes, heart disease, some cancers, and early death. Obesity is seen as a function of overeating, eating the wrong foods, and a sedentary lifestyle. Increasingly, however, clinicians are finding that there may be a genetic predisposition to being overweight, and we know that genetic damage can be caused by radiation. Furthermore, it is well established that radioactive iodine, which seeks out and disrupts the thyroid gland, has an effect on metabolism. When large numbers of thyroid cells are damaged, it is more likely to reduce a person’s vitality and make them sluggish and sedentary, and unable to utilize the body’s energy supply from food intake. Rosalie Bertell says that “a mild exposure experienced by a large population could cause a decrease in average thyroid hormone levels and an increase in average body weight.”10 A mild exposure is precisely what has happened to American children in the 1980s, as iodine emissions from nuclear power plants continue.
Homo Sapiens)
Published in J. P. Dubey, C. A. Speer, R. Fayer, Cryptosporidiosis of Man and Animals, 2018
Gallbladder disease, primarily acalculous cholecystitis, but sometimes sclerosing cholangitis, has been increasingly reported, especially in HIV-infected patients in whom chronic gallbladder carriage may be responsible for the inability to eradicate intestinal cryptosporidiosis.111,163,208,299,300,348,401,514,639,724 The first case was actually described in 1981, in which an AIDS patient with diarrhea and intestinal cryptosporidiosis underwent a cholecystectomy because of cholestasis, a dilated common bile duct, and no visible stones; organisms were found postoperatively in the gallbladder mucosa,300,639 Approximately a dozen other cases have been recorded since then. Usual symptoms include fever, right upper quadrant nonradiating pain, nausea, and vomiting. Although not discussed in all reported cases, some, but not all, patients had simultaneous diarrhea. Jaundice may also occur. Alkaline phosphatase and bilirubin have been elevated whenever measured. Noninvasive imaging (sonography or computed tomography) usually shows dilated extrahepatic biliary ducts associated with distal common bile duct (CBD) stenosis, although occasionally the CBD is normal and the gallbladder simply enlarged with a thick wall; ducts may have a beaded appearance.111,208,348 Diagnosis has generally been made by histological examination of the gallbladder (sometimes retrospective rereview of specimens), by ampullary biopsy, or by direct examination of bile for oocysts; not all patients have oocysts detectable in fecal specimens. Cytomegalovirus has been found concurrently in at least six patients;111,348,396,401Enterobacter cloacae was associated in another instance.396 Sphincterotomy proved beneficial in some instances,724 although prognosis is usually poor, and pancreatitis and cholangitis are possible sequellae.348,514,724 T-tube drainage and cholecystectomy have also been used to relieve cholestasis although biliary oocyst drainage continued after cholecystectomy in one patient.514
Patient-specific fluid–structure interaction model of bile flow: comparison between 1-way and 2-way algorithms
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Alex G. Kuchumov, Vasily Vedeneev, Vladimir Samartsev, Aleksandr Khairulin, Oleg Ivanov
The process of gallstone formation is referred to gallbladder disease (Diehl 1991; Stinton and Shaffer 2012). Gallstones develop when substances in the bile (such as cholesterol, bilirubin and bile salts) form hard particles that block the passageway to the gallbladder (Diehl 1991). It means that bile changes its structural and rheological properties, which in this case is called ‘lithogenic bile’ (i.e. a bile that tends to generate gallstones). Also, gallstones, which can be as large as a golf ball (Mohan et al. 2014), tend to form when the gallbladder does not empty completely.