ABSTRACT
Salmonella infections can cause a variety of diseases, but acute acalculous cholecystitis complicated by gallbladder perforation occurs very rarely in adults. Here, we report a case of acute acalculous cholecystitis with gallbladder perforation after non-typhoidal group D Salmonella infection. A 71-year-old man was admitted with fever, chills, and watery diarrhea. Blood cultures taken on admission were positive for non-typhoidal group D Salmonella. The patient subsequently developed acute acalculous cholecystitis, and abdominal ultrasound and computed tomography revealed gallbladder perforation. Because of other medical problems, cholecystectomy could not be performed. The patient's symptoms and signs were not resolved, even after parenteral antibiotic injection and percutaneous cholecystostomy. Despite meticulous supportive care, the patient died after progression to multiple organ dysfunction.
Subject(s)
Adult , Aged , Humans , Acalculous Cholecystitis , Chills , Cholecystectomy , Cholecystostomy , Diarrhea , Fever , Gallbladder , Salmonella , Salmonella InfectionsABSTRACT
Primary gastric lymphoma is relatively rare in the context of gastric malignancies. Synchronous primary gastric lymphoma and hepatocellular carcinoma (HCC) are even rarer. We report a case of synchronous primary gastric lymphoma and HCC in a 46-year-old man that appeared to be associated with hepatitis B virus infection. Pathologic examination and immunohistochemical analysis of gastric and liver specimens showed diffuse large B-cell lymphoma and HCC, respectively. The patient was initially treated for primary gastric lymphoma with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone) chemotherapy. During the chemotherapy interval, he was treated for HCC by transarterial chemoembolization (TACE) and laparoscopy-assisted left hemihepatectomy.
Subject(s)
Humans , Middle Aged , B-Lymphocytes , Carcinoma, Hepatocellular , Cyclophosphamide , Doxorubicin , Hepatitis B virus , Liver , Lymphoma , Lymphoma, B-Cell , Lymphoma, Non-Hodgkin , Stomach Neoplasms , VincristineABSTRACT
BACKGROUND/AIMS: Liver biopsy is a standard method for diagnosis of liver cirrhosis in patients with chronic hepatitis. Because liver biopsy is an invasive method, non-invasive methods have been used for diagnosis of compensated liver cirrhosis in patients with chronic hepatitis. The current study was designed to evaluate the usefulness of ultrasonography and routine blood tests for diagnosis of compensated liver cirrhosis in patients with chronic viral hepatitis. METHODS: Two hundred three patients with chronic viral hepatitis who underwent liver biopsy were included in this study and ultrasonography and routine blood tests were analyzed retrospectively. Ultrasonographic findings, including surface nodularity, parenchyma echogenecity, and spleen size, were evaluated. The diagnostic accuracy of ultrasonography and routine blood tests were examined. RESULTS: Discriminant analysis with forward stepwise selection of variables showed that liver surface nodularity, platelet count, and albumin level were independently associated with compensated liver cirrhosis (p95% specificity: platelet count 1.3; and surface nodularity. If at least one of the four variables exists in a patient with chronic viral hepatitis, we can predict liver cirrhosis with 90% specificity and 61% sensitivity. CONCLUSIONS: These results suggest that four variables (platelet count 1.3, and surface nodularity) can be used for identification of liver cirrhosis in patients with chronic viral hepatitis with high specificity.