Subject(s)
Cholelithiasis/complications , Cystic Duct/abnormalities , Pancreatitis/etiology , Adolescent , Female , HumansABSTRACT
Between 1980 and 1988, 23 female adolescents were hospitalized at the Bronx-Lebanon Hospital Center for symptomatic cholelithiasis. The known risk factors for gallstone formation in adolescents were considered. In ten of the patients (43%), none of the risk factors was present. All ten patients, however, had in common a recent history of pregnancy. This finding is consistent with the current literature on the possible mechanism of gallstone formation during pregnancy.
Subject(s)
Cholelithiasis/etiology , Pregnancy in Adolescence , Adolescent , Adult , Cholelithiasis/ethnology , Female , Humans , Pregnancy , Pregnancy Complications , Retrospective Studies , Risk FactorsABSTRACT
During a 5-year period (1980 to 1985) in the Adolescent Unit at Bronx-Lebanon Hospital Center, 18 patients were admitted with the diagnosis of gallstone disease, four of whom, at the time of their admission, had associated acute pancreatitis. Although gallstone pancreatitis is infrequent in adolescents, it is an important differential diagnosis of upper abdominal pain in youngsters with gallstone disease. The most frequently encountered mechanisms of gallstone pancreatitis in adolescents appear to be impacted stones, congenital pathology in the ampullary area, and passage of small stones through the common bile duct, with temporary obstruction and inflammation followed by disruption of pancreatic ductules and/or acinar cell membrane. Proper management includes cholecystectomy and the mandatory performance of an intraoperative cholangiogram. Sphincterotomy or sphincteroplasty, which are frequently performed in adults with gallstone pancreatitis, should be avoided in adolescents. Even if impacted stones have to be removed at this age, papillotomy suffices. After an acute episode, a properly timed surgical treatment is curative.
Subject(s)
Cholelithiasis/diagnosis , Pancreatitis/diagnosis , Acute Disease , Adolescent , Amylases/blood , Amylases/urine , Cholecystography , Cholelithiasis/complications , Cholelithiasis/therapy , Female , Humans , Pancreatitis/etiology , UltrasonographyABSTRACT
We have recently seen two cases of propranolol poisoning. In both instances, plasma propranolol levels were elevated. Both patients experienced generalized seizures and had a transient intraventricular conduction defect on electrocardiogram. The literature on intoxication of propranolol and other beta-adrenoceptor blocking drugs suggests that the effects of massive propranolol intoxication observed in our patients can be explained on the basis of the pharmacologic properties of propranolol. Therapy consisted of gastric lavage and agents to antagonize the beta-adrenoceptor blockade effect. Both patients recovered.