China
Africa
Explore chapters and articles related to this topic
Acute Cholecystitis
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Takanori Morikawa, Michiaki Unno
In cases with acute acalculous cholecystitis, the patient is usually critically ill and may have no ability to present their symptom due to sedated, intubated, and/or unconscious status. Therefore, it is very difficult to diagnose acute acalculous cholecystitis in the early stages, and high clinical suspicion for this disease is warranted in all critically ill patients [4].
Hepatobiliary and pancreatic emergencies
Published in Alexander Trevatt, Richard Boulton, Daren Francis, Nishanthan Mahesan, Take Charge! General Surgery and Urology, 2020
Acalculous cholecystitis is inflammation of the gallbladder in the absence of gallstones, representing approximately 5%–10% of cases of cholecystitis. As with calculous cholecystitis the condition occurs due to bile stasis, however it is due to decreased gallbladder motility rather than obstruction. It typically affects patients with sepsis, in intensive care units or on long-term total parenteral nutrition (TPN) and is more common in patients with diabetes.
Diseases of the Hepatobiliary Tree and Pancreas Associated with Fever
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Acalculous cholecystitis — This accounts for less than 5% of cases of inflammation of the gallbladder. Infection primarily by Gram-negative organisms appears to be a major factor. The condition may develop following surgery and trauma. Unexplained postoperative fever is often the principal manifestation,199 and diagnosis often rests upon the clinical finding of tenderness in the right upper quadrant. Imaging procedures will occasionally demonstrate an enlarged, tense gallbladder, and blood cultures and febrile agglutinin titers may be useful. However, the absence of abnormal findings should not deter the clinician from making the diagnosis, since this condition carries a higher morbidity and mortality than the calculous variety. Recently acalculous cholecystitis has been described with increasing frequency as a complication of AIDS. 133,134 In these patients it is usually associated with infection with CMV, Cryptosporidium, or Campylobacter fetus.
Advances in preventing adverse events during monoclonal antibody management of multiple sclerosis
Published in Expert Review of Neurotherapeutics, 2019
Laura De Giglio, Alessandro E. Grimaldi, Federica Fubelli, Fabiana Marinelli, Carlo Pozzilli
The possible presence of ALZ-specific antibodies has been described in 0.6% of people before the second-infusion. During the clinical studies, antibodies had no clinical significance at population level. However, at the individual level the presence of neutralizing antibodies led to poor lymphocyte depletion suggesting a possible efficacy reduction. The frequency of detection of these antibodies increases at the end of the second cycle (31% of people had neutralizing antibodies and 75% had binding antibodies) suggesting that in people requiring additional ALZ cycles the problem could be clinically relevant [43]. Monitoring depletion following infusion and assessment of the neutralizing response before re-infusion may help inform the decision to retreat or to switch therapy to limit treatment failure. The ALZ cell depletion may increase the risk of acute acalculous cholecystitis. In controlled clinical studies, 0.2% of time to onset of symptoms ranged from less than 24 h to 2 months after ALZ infusion [26].
Acute acalculous cholecystitis in an infant after gastroschisis closure
Published in Baylor University Medical Center Proceedings, 2023
Irfan Shehzad, Nicholas Nelson, Niraj Vora, Hale Wills, Krista Birkemeier, Vinayak Govande
Acute acalculous cholecystitis (AAC) is defined as an acute inflammatory disease of the gallbladder in the absence of cholelithiasis. Tsakayannis et al8 estimated only 1.3 pediatric cases for every 1000 adult cases. AAC is believed to arise by two main mechanisms: ischemic injury from hypoperfusion and chemical injury from bile stasis. Moreover, concomitance and/or superimposition of infection with enteric pathogens including E. coli, Enterococcus faecalis, Klebsiella pneumonia, Pseudomonas, Proteus species, and Bacteroides9 contribute to the pathogenesis of AAC. Without immediate treatment, there may be rapid progression to perforation, gangrenous cholecystitis, or bile peritonitis.
Safety and effectiveness concerns of lopinavir/ritonavir in COVID-19 affected patients: a retrospective series
Published in Clinical Toxicology, 2021
Marc-Antoine Lepage, Nicholas Rozza, Richard Kremer, Ami Grunbaum
All 12 patients exceeded reported cholestasis toxicity thresholds (6.43 mcg/mL) [2]. Patient 12 had an acute acalculous cholecystitis confirmed by ultrasound performed for persistent fevers despite broad-coverage antibiotics for ventilator-associated pneumonia and central line associated bloodstream infection. 11/12 patients exceeded dyslipidemia toxicity thresholds (9.71 mcg/mL) [3]. Patients 10 and 12 were receiving propofol sedation. Patient 12’s hypertriglyceridemia necessitated cessation of propofol.