ABSTRACT
Myotonic dystrophy is the most common systemic disease causing myotonia. We report the case of respiratory failure in a patient with myotonic dystrophy after laparoscopic cholecystectomy. We carried out neurologic testing, electromyography and DNA testing in this patient and electromyography in the family of the patient. Through electromyography and DNA testing, this patient was diagnosed with myotonic dystrophy type I. Myotonic dystrophy is characterized by gradual decline of muscle tone and myotonia. It is important that this disease be excluded through preoperative history taking, physical examination and family history taking.
Subject(s)
Humans , Cholecystectomy , Cholecystectomy, Laparoscopic , DNA , Electromyography , Muscles , Myotonia , Myotonic Dystrophy , Physical Examination , Respiratory InsufficiencyABSTRACT
A biloma is an encapsulated bile collection outside the biliary tree. Most cases of biloma are caused by iatrogenic injury or trauma. Intrahepatic rupture of the biliary tree due to nontraumatic cause is a rare event. A 68- year-old man was admitted because of abdominal pain and fever. He had no past history of abdominal surgery, instrumentation or trauma. Computed tomography (CT) scan and magnetic resonance cholangiopancreatography (MRCP) demonstrated a large subcapsular fluid collection in the right liver associated with choledocholithiasis and cholecystitis. Biloma was confirmed by sono-guided percutaneous needle aspiration and was drained through a pigtail catheter. After the successful treatment by percutaneous drainage and endoscopic sphincterotomy, the patient recovered. Here, we report an uncommon case of spontaneous biloma formation in association with choledocholithiasis with a review of literatures.