ipl-logo

Cholecystitis Case Study

803 Words4 Pages

Cholecystitis, cholangitis and Mirizzi's syndrome – A case report

Case Presentation
A 22-year-old male medical student with BMI 22 Kg/m2 presented to the outpatient clinic complaining of severe abdominal pain. The patient gave a history of multiple intermittent episodes of epigastric pain which started during his exams. He reported excessive drinking of caffeine during the last 3 months and these episodes were exacerbated mainly after eating fried food. The primary doctor prescribed omeprazole for a week, but there was no improvement.

Pelvi-abdominal ultrasonography was performed and revealed calcular cholecystitis (Fig. 1). The thickness of the Gall Bladder (GB) wall was normal with multiple echogenic stones seen inside, the largest stone …show more content…

He reported that the intervals between the episodes of biliary colic decreased from one time every 10 days until it became daily. Also, the attack of biliary colic was relieved by intramuscular injection of antispasmodics and analgesics at first, but they weren’t effective anymore.

The option of cholecystectomy was discussed and the patient agreed. Pre-operative laboratory investigations revealed normal kidney function, normal blood picture and elevated liver enzymes and elevated bilirubin
(AST=174 u/L), (ALT=399 u/L), (GGT=206 u/L), (Alkaline phosphatase=147 u/L), (Direct bilirubin=2.0 mg/dl) and (Indirect bilirubin= 0.6 mg/dl).
The patient was admitted to gastrointestinal endoscopy unit for Endoscopic retrograde cholangiopancreatography (ERCP). Pre-procedural investigation revealed normal serum amylase. Ultrasonography showed large GB stones measured about 17 mm with caliber 5 mm of the …show more content…

Then he was kept for observation for 3 days. The patient developed fever again (39oC) and parenteral paracetamol was able to decrease his temperature temporary for only 2 hours and kept rising again to 39oC. Parenteral antibiotics were started again for a week. However, the fever didn’t decline at all. Abdominal CT scan was performed but revealed nothing except cholelithiasis. A descion of removing the previously inserted plastic stent in CBD was made. The patient underwent ERCP under general anesthesia to remove the stent. The fever started to decline 24 hours after ERCP and was completely gone after 48 hours. The patient was kept on antibiotics for 4 more days and was discharged with instructions of eating only boiled food and weekly

Show More
Related
1746 Words | 7 Pages

Intestinal lymphangiectasia may be suspected by hypogammaglobulinemia, hypoalbuminemia, lymphopenia and increased alpha-1 antitrypsin excretion in the faeces[5] and can be supported by duodenal biopsy. Endoscopy shows dilated lacteals as white opaque spots, nodular lesions and xanthomatous plaques are also seen. The lesions are often patchy and localized.[5] However, several biopsies are often needed before lymphangiectasia is demonstrated. Lymphatic impairment due to malformed, hypoplastic lymphatics can be demonstrated by radionuclide lymphoscintigraphy.[5] CASE REPORT

Read More
340 Words | 2 Pages

CURES report was reviewed. Last urine drug screen on 12/04/14 was appropriate. On examination, there is tenderness upon palpation over right medial knee joint line. Mild atrophy of right medial quadriceps muscle is noted.

Read More
131 Words | 1 Pages

Reason for Visit: Puncture Wound to the Right FA S: TM works in GA Chassis when he injured his right FA. According to TM he was putting in nuts on the exhaust muffler and a piece of metal was sticking out of the muffler and stuck him in his right FA. TM denies previous injury to right arm. TM rates his pain at 2/10. O:

Read More
1209 Words | 5 Pages

Mr. A is admitted to the critical care unit post bowel resection, splenectomy, acute respiratory distress syndrome (ARDS) and patient-ventilator dyssynchrony (PVD). He is an eighteen-year-old African American man who is placed on an IV infusion of Norcuron and Ativan. The major outcomes expected for Mr. A would be for him to be able to wean of the ventilator, be hemodynamically stable, heal adequately, tolerate his diet, have adequate bowel elimination, and be able to adjust to his life with optimal functioning. The problems that are to be manage include, being on the ventilator, being sedated, having an elevated temperature, having a low hemoglobin, post surgical bowel resection, splenectomy, hypoxia and diet intolerance.

Read More
537 Words | 3 Pages

Crohn and his two co-workers, Oppenheimer and Ginzburg, presented a paper on “Terminal Ileitis”, and it was described in the features of Crohn’s disease to the JAMA. It was published later that year as a landmark article in the Journal of the American Medical Association aka “JAMA” and with the title “Regional Ileitis: A Pathologic and Chronic Entity.” The JAMA article was published at a time

Read More
682 Words | 3 Pages

Jaundice may also be caused by a tumor in the head of the pancreas. The best method of prevention, after an organic diet, is the liver cleanse. It will remove the gallstones. Only a 2-day experience, and you 'll want to remain close to the

Read More
290 Words | 2 Pages

.) Compare and contrast ulcerative colitis and Crohn's Disease. Include any genetic component or immune factors that may be involved. Diagnose which disease is present in this patient. Support your diagnosis with the s/s presented and the Patho-physiology you detailed.

Read More
2129 Words | 9 Pages

CASE STUDY INTERNAL MEDICINE: SYNCOPE MICHAEL RAMARA 27419399 22 SEPTEMBER 2014 Table of Contents 1. Patient’s Case Information. 2.

Read More
690 Words | 3 Pages

This is important to remember down the road because instead of waiting uncomfortably, you or your patient could remember the symptoms and suggest to your doctor that you think it might be inflammatory bowel disease. This would save time and discomfort. I was also informed during the discussion how hygiene can have an impact on Crohn’s disease because it will affect the immune system. A fact that I found interesting is that inflammatory bowel disease can be caused by hereditary through your genes, but also because of your smoking status. This is just another reason why people should not smoke.

Read More
432 Words | 2 Pages

In addition, gallstones and kidney stones may also develop as a result of Crohn 's disease. It is often inherited. About 20% of people with Crohn 's disease may have a close relative with Crohn 's disease. It can affect people of all ages, it is primarily an illness of the young. Most people are diagnosed before age 30, but the disease can occur in people in their 60 's, 70 's, or even later in life.

Read More
426 Words | 2 Pages

Complication of gallstones can be inflammation of the bladder, blockage of the common bile duct, blockage of the pancreatic duct, and gallbladder cancer. You may prevent the chance of getting gallstone by not skipping meals; lose weight slowly and by maintaining a healthy weight. How to determine gallstones is by your doctor may recommend an abdominal ultrasound to see if there is anything that seems like gallstones. Another way is by to test to check if your bile ducts for gallstone that may be causing a blockage. A third way they may test you is blood test that may reveal complications you may have.

Read More
1526 Words | 7 Pages

He stays in the hospital over a liver condition that fails to be jaundice, but his fever

Read More
1532 Words | 7 Pages

Depending on where the inflammation occurs within the large intestine UC is classified by how far the disease extends up the colon. Research has shown that genes, the environment, and an overactive immune response could play a role in causing UC unfortunately, the exact cause of the disease is not known. “Research sponsored by CCFA has led many scientists to believe that ulcerative colitis may be the result of an interaction of a virus or bacterial infection of the colon and your body’s natural immune system response”(Crohn’s & Colitis Foundation of America, 2015). Although research has not be able to pinpoint the exact cause of Ulcerative Colitis it can actually occur in people of any age. Nonetheless, research has shown that it hoes have a higher occurrence rate in people between the ages of 15 and 30, who have family members with Inflammatory Bowel Disease, and who are of Jewish

Read More
350 Words | 2 Pages

When I was first diagnosed with ulcerative colitis, a common colon disease, I had no idea what it was. It wasn’t until several tests and explanations from multiple doctors that my parents and I started to understand the extent of the problem. Although it didn’t seem like it would be a big deal, it quickly took over my entire life. Dealing with the condition meant chronic pain, medication, and many more doctors’ visits. Fortunately, my case wasn’t too severe.

Read More
974 Words | 4 Pages

In pathological cases with portal hypertension,

Read More

More about Cholecystitis Case Study

Related Topics

Open Document