Incidence of Choledocholithiasis in Gallstone Disease in Eastern Zone of India: A Single Centre Study

Common bile duct stones are found in 10-15% of patients having gall stone disease and the incidence increases with the age, both in India and in western countries and the majority of common bile duct stones are secondary to gall bladder stones, their incidence is more in Northern India

A Case of Hemobilia Caused by Calculous Cholecystitis / 대한소화기내시경학회지

Hemobilia is a status of bleeding into the biliary tract, which is caused by abnormal communication between the intrahepatic blood vessels and biliary tract, and is a rare cause of upper gastrointestinal hemorrhage. Most cases of the hemobilia originating in the gallbladder are related to gallstones. However, hemobilia is a rare complication of calculous cholecystitis. We report a case of hemobilia as a complication of calculous cholecystitis in a patient given continuous aspirin medication.

A Clinical Study for Gall Bladder Stones in Children / 대한소아소화기영양학회지

PURPOSE: Gall bladder (GB) stones in children are rarely observed, and so reports of them have been quite limited in Korea. Therefore, we tried to assess the epidemiology and clinical features of children with GB stone diagnosed at Severance Hospital. METHODS: A clinical study was performed on 18 patients below 15 years of age diagnosed with GB stone by abdominal ultrasonography or CT scan at Severance hospital from January 1999 to May 2005. RESULTS: Concerning patients' profile, their sex ratio of male to female in total 18 cases was 2:1 with the mean age of 6+/-4.3 years. 15 patients (83.3%) were asymptomatic. Inducing factors were found in 14 children (77.8%) including ceftriaxone therapy in 6 cases (33.3%), infection in 4 cases (22.2%), spherocytosis in 3 cases (16.7%), Down syndrome and abdominal operation in 1 case (5.6%) respectively. Single stone was found in 13 cases (76.5%) and multiple in 4 cases (23.5%). 15 cases (88.2%) had the stones less than 5 mm in size, and 2 cases (11.8%) between 5 and 10 mm. 17 patients received conservative treatment, and one patient had cholecystectomy due to Meckel diverticulum. CONCLUSION: In this report, Pediatric GB stones are predominant in male children, without typical symptoms, having inducing factors, single and small. Recently the diagnosis of them has been increased because of the development of imaging study. But the reports for them were still rare in Korea. Therefore the study for them is more necessary to find it's clinical characteristics.

Acute Acalculous Cholecystitis in a Spinal Cord Injured Patient: A case report

Patients with spinal cord injury (SCI) have an increased prevalence of cholecystitis. Neurologically intact patients with cholecystitis usually complain biliary colic of the right upper quadrant (RUQ). Because of the inability to localize visceral pain in patients with SCI, the pattern of symptoms are quite different. We reported a case of 48-year-old man with C5 incomplete tetraplegia (ASIA C) who presented an increased spasticity and vague pain of RUQ and later diagnosed as an acute acalculous cholecystitis. Antibiotics treatment and Percutaneous Transhepatic Gall Bladder Drainage (PTGBD) were performed. An open cholecystectomy was performed after the laparoscopic cholecystectomy which failed due to severe adhesion. Postoperatively, patient recovered well without complications. We suggested that even a vague abdominal pain shouldn't be underestimated in SCI patients.

Gallbladder Dysmotility and Gallstone Development after Gastrectomy in Gastric Cancer Patients

PURPOSE: Gallstone disease has been presumed to be a sequellae of gastrectomy. To know correlation between gallbladder disease and gastrectomy, we check anatomical and functional status of gallbladder with ultrasonogram in our study. METHODS: Gallbladder motility after gastrectomy was studied by means of measuring fasting and postprandial gallbladder volume using real time ultrasonography in 50 gastrectomized patients and in 28 controls (healthy but not operated gastric cancer patients) were selected as study subjects. RESULTS: Mean fasting and postprandial gallbladder volume was significantly increased in gastrectomized patient group (FV: 37.63+/-20.70 ml, PV: 11.50+/-10.26 ml) than control group (FV: 22.17+/-10.35 ml, PV: 5.44+/-3.67 ml, p<0.01). The ejection fraction of gallbladder in gastrectomized patient group (69.05+/-14.57%)was significantly smaller than control group (75.57+/-10.26%, p<0.05). CONCLUSION: The risk of gallbladder disease was independent of age, sex, and post-operative duration in our study. Gastrectomy may have the possibility of increasing the risk of gallbladder disease by causing gallbladder dysmotility and bile stasis. So, gallbladder motility evaluation would be helpful for prevention and understanding gallstone formation. Further study will be needed about the clinical benefits of prophylactic cholecystectomy during gastrectomy.