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2.
Rev Mal Respir ; 40(7): 646-652, 2023 Sep.
Article in French | MEDLINE | ID: mdl-37543507

ABSTRACT

INTRODUCTION: Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disease. The majority of patients are asymptomatic. The disease is often diagnosed on routine radiological examination. CASE REPORTS: We report two familial cases of PAM. A 17-year-old girl with a chest X-ray showing an alveolar syndrome, especially on the right side, a bronchointerstitial syndrome, and diffuse calcifications. The thoracic CT scan showed calcified micro- and macronodules with pleural and pericardial calcifications. Respiratory function tests showed restrictive syndrome and normal blood gas values suggestive if PAM, which was confirmed by the presence of microliths in bronchoalveolar lavage (BAL). Family investigation led to chest radiograph of a 14-year-old sister who was asymptomatic but presented with an aspect of "sandstorm" calcifications. CONCLUSION: PAM is known to be radio-clinically dissociative. In typical cases, radiology can suggest the diagnosis, which is often confirmed by SLC34A2 mutation or microliths in BAL or sputum. The prognosis is compromised in the long-term. The only effective treatment nowadays is lung transplantation.


Subject(s)
Calcinosis , Lithiasis , Lung Diseases , Female , Humans , Adolescent , Morocco , Lung Diseases/diagnostic imaging , Lung Diseases/genetics , Calcinosis/diagnosis , Calcinosis/genetics , Lithiasis/diagnostic imaging , Lithiasis/genetics , Pulmonary Alveoli
3.
J Med Case Rep ; 17(1): 316, 2023 Jul 24.
Article in English | MEDLINE | ID: mdl-37482621

ABSTRACT

BACKGROUND: Residual lithiasis is the presence of stones in the common bile duct, ignored after one or more biliary interventions. We report an atypical case of chronic symptomatic lithiasis of the lower bile duct occurring 41 years after biliary surgery, managed successfully by ideal choledochotomy. CASE PRESENTATION: A 68-year-old Black African female with several past laparotomies including a cholecystectomy forty-one years ago presented with hepatic colic-type pain that had been intermittent for several years but worsened recently. Her clinical, biological, and imaging test assessments were suggestive of a residual obstructive lithiasis of the lower common bile duct. Through an open right subcostal laparotomy approach, a dilated bile duct of approximately 3 cm was found and managed by transverse choledochotomy in which the stone was extracted in retrograde manner. After confirmation of disobstruction, a primitive bile duct suture without biliary drainage was performed and a tubular drain was positioned under the liver. The postoperative course was uneventful at follow-up of 30 days. CONCLUSION: Residual choledocholithiasis can be avoided. We performed an ideal choledochotomy, of which the follow-up was simple.


Subject(s)
Biliary Tract Surgical Procedures , Choledocholithiasis , Lithiasis , Humans , Female , Aged , Lithiasis/diagnostic imaging , Lithiasis/surgery , Cholecystectomy , Common Bile Duct/diagnostic imaging , Common Bile Duct/surgery , Choledocholithiasis/diagnostic imaging , Choledocholithiasis/surgery
4.
Eur J Pediatr ; 182(7): 3195-3202, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37129614

ABSTRACT

The purpose of this study is to evaluate the clinical characteristics and prognosis of primary hepatolithiasis in hospitalized children. This retrospective cohort study included 106 hospitalized patients with primary hepatolithiasis at Beijing Children's Hospital. Clinical data were derived from electronic inpatient (2010-2021) and outpatient (2016-2021) medical records. The prognosis was evaluated by outpatient ultrasounds after discharge and telephone interviews performed in December 2022. Intrahepatic bile duct stones in patients enrolled in the study were all found incidentally by abdominal ultrasound during hospitalization, with an incidence of 1.7 per 10,000 hospitalized children. The mean age at diagnosis was 9.3 ± 3.6 years, with male predominance (69/106, 65.1%). The right lobe of the liver (80/106, 75.5%) was preferentially affected. All patients underwent conservative observation. Seventy-eight patients (78/106, 73.6%) were followed up with a mean follow-up age of 17.1 ± 5.0 years, and 4 (4/78, 5.1%) had intermittent abdominal pain. From 2016 to 2021, 32 patients were diagnosed with primary hepatolithiasis, and follow-up abdominal ultrasounds were performed in 20 of them (20/32, 60.0%) with a median time of 2.1 (0.1, 3.5) years. The stones were present in 17 patients (17/20, 85.0%). CONCLUSION: Primary hepatolithiasis in hospitalized children is rare, almost found accidentally; mostly affects the right lobe of the liver; and can be conservatively observed without surgical treatment in childhood. WHAT IS KNOWN: • Primary hepatolithiasis in adults often presents with severe clinical symptoms and requires hepatectomy.. • There are few studies on primary hepatolithiasis in children. WHAT IS NEW: • Primary hepatolithiasis in children is mostly found accidentally by abdominal ultrasound without associated symptoms during hospitalization. • Children with accidental primary hepatolithiasis can be conservatively observed without surgical treatment in childhood.


Subject(s)
Lithiasis , Liver Diseases , Adult , Child , Humans , Male , Child, Preschool , Adolescent , Young Adult , Female , Liver Diseases/diagnostic imaging , Liver Diseases/epidemiology , Lithiasis/diagnostic imaging , Lithiasis/therapy , Retrospective Studies , Treatment Outcome , Child, Hospitalized , Bile Ducts, Intrahepatic , Prognosis
6.
Asian J Surg ; 46(2): 767-773, 2023 Feb.
Article in English | MEDLINE | ID: mdl-35843823

ABSTRACT

OBJECTIVE: The present study aimed to investigate the safety, feasibility, and efficacy of three-dimensional visualization technique (3DVT)-guided hepatectomy in the treatment of complicated hepatolithiasis. METHODS: The clinical and follow-up data of 279 patients with complicated hepatolithiasis were retrospectively analyzed. The patients were divided into a 3DVT group (group A, 66 cases) and a non-3DVT group (group B, 213 cases). After baseline data were balanced using propensity score matching (PSM), the clinical characteristics and follow-up data of the two groups were observed. RESULTS: After 1:1 PSM, 58 patients in each group were successfully matched with each other. When the groups were compared, the surgical duration (p = 0.033) and intraoperative blood loss (p = 0.002) of group A were lower than those of group B. The immediate stone clearance rate (91.4% vs. 75.9%, p = 0.024) and quality of life outcome (p = 0.034) of group A were significantly higher than those of group B. Logistic regression analysis showed that history of two or more biliary tract operations (odds ratio [OR] = 6.544, 95% confidence interval [CI] = 1.193-35.890, p = 0.031), bilateral stone distribution (OR = 4.198, 95% CI = 1.186-14.854, p = 0.026), and Geng grade III or IV (OR = 12.262, 95% CI = 2.224-67.617, p = 0.004) were independent risk factors for poor outcomes in patients with complicated hepatolithiasis. CONCLUSION: Compared to conventional imaging examinations, 3DVT can be used to guide and achieve accurate preoperative diagnosis of complicated hepatolithiasis and has good safety, feasibility, and efficacy.


Subject(s)
Lithiasis , Liver Diseases , Humans , Liver Diseases/complications , Liver Diseases/diagnostic imaging , Liver Diseases/surgery , Hepatectomy/methods , Lithiasis/diagnostic imaging , Lithiasis/surgery , Retrospective Studies , Propensity Score , Imaging, Three-Dimensional , Quality of Life , Treatment Outcome
7.
Radiography (Lond) ; 29(1): 1-7, 2023 01.
Article in English | MEDLINE | ID: mdl-36179409

ABSTRACT

OBJECTIVES: This narrative review aims to collate the data in the existing literature on appendicoliths, by reviewing the available information on appendicoliths that have been previously reported in 24 publications, and providing the information in one article. KEY FINDINGS: Appendicoliths are frequent culprits in causing luminal obstruction of the appendix, leading to appendicitis. They are calcified masses formed as a result of the aggregation of faecal particulates and inorganic salts within the lumen of the appendix. The presence of appendicoliths in an inflamed appendix influences the patient's treatment, as surgery is usually done to avoid appendix perforation and abscess formation, and also to prevent a future recurrence of the disease. Appendicoliths are mostly imaged using CT, Ultrasound, and plain X-rays; however, CT is the most frequently used modality, particularly in the imaging of complications caused by 'retained' appendicoliths. 'Retained' appendicoliths and their consequential abscesses have been reported in the sub-hepatic and intrahepatic regions, pelvic and tubo-ovarian regions, gluteal region, subcutaneous layer, subphrenic region, and through the diaphragm into the chest cavity. CONCLUSION: This review provides useful information on the imaging appearances and complications caused by the presence of appendicoliths in an inflamed appendix, and it also provides information on the clinical implications of 'dropped' appendicoliths during appendectomy. IMPLICATIONS FOR PRACTICE: Based on the findings of this review, it is recommended that the appropriate imaging modality (ultrasound and/or CT) should be considered when imaging appendicoliths and its complications. It is also suggested that retained appendicolith be considered a differential diagnosis when imaging patients with a history of appendectomy due to complicated appendicitis/perforation.


Subject(s)
Appendicitis , Appendix , Lithiasis , Humans , Appendicitis/diagnostic imaging , Appendicitis/surgery , Appendicitis/complications , Lithiasis/diagnostic imaging , Lithiasis/complications , Lithiasis/surgery , Tomography, X-Ray Computed/adverse effects , Appendix/diagnostic imaging , Appendectomy/adverse effects , Appendectomy/methods
8.
Rev Esp Enferm Dig ; 115(7): 405-406, 2023 07.
Article in English | MEDLINE | ID: mdl-36412492

ABSTRACT

Intrahepatic bile duct stones are rare in the West and relatively common in Asia. MRI and CT cannot confirm the diagnosis of atypical stones. We learned from the successful experience of spyglass and completed the operation with direct visualization system.


Subject(s)
Lithiasis , Liver Diseases , Humans , Liver Diseases/surgery , Lithiasis/diagnostic imaging , Lithiasis/surgery , Bile Ducts, Intrahepatic/diagnostic imaging , Endoscopes , Magnetic Resonance Imaging
9.
Br J Oral Maxillofac Surg ; 60(10): 1385-1390, 2022 12.
Article in English | MEDLINE | ID: mdl-36109276

ABSTRACT

The purpose of this paper was to describe the characteristics of salivary calculi and their relationship to epidemiological factors, through a cross-sectional study. We analysed 100 calculi obtained in 2017-2021. Patient data including age, time since onset of symptoms, gland involved, and site of location in the salivary system were studied. The calculi were studied to determine their morphological features using scanning electron microscopy and energy dispersive plain radiographic analysis. Most of the calculi had formed in the submandibular gland (SG) (82%). The mean age of patients at onset was 45.83 years; patients presenting parotid gland (PG) stones were somewhat older (p = 0.031). The mean time since the onset of symptoms was longer in PG calculi (p = 0.038). The most common lithiasis site was the main duct (74%), followed by the hilum (22%). Hilar stones were the largest (p < 0.05) and heaviest (p = 0.028). Octacalcium phosphate (OCP) was the most common crystalline phase (Cp) founded, followed by hydroxyapatite (HA) and whitlockite (WH). Specifically, OCP had a higher presence in PG calculi (p = 0.029) and WH was the most common phase in SG calculi (p = 0.017). The most prevalent site of lithiasis was the main duct, and the largest and heaviest calculi were found in the SG. PG stones were associated with a longer history of symptoms and older age. OCP was the most frequent Cp of the calculi studied, and the main Cp in PG stones. WH was the predominant Cp in SG stones. The Cp of the calculi was not influenced by location, patient age, or time of symptoms.


Subject(s)
Lithiasis , Salivary Duct Calculi , Salivary Gland Calculi , Humans , Middle Aged , Salivary Gland Calculi/diagnostic imaging , Salivary Gland Calculi/epidemiology , Lithiasis/diagnostic imaging , Lithiasis/epidemiology , Cross-Sectional Studies , Endoscopy , Retrospective Studies , Salivary Duct Calculi/diagnostic imaging , Salivary Duct Calculi/epidemiology
10.
Cir. Urug ; 6(1): e302, jul. 2022. ilus
Article in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1384411

ABSTRACT

Se comunica el primer reporte nacional del tratamiento de pancreatitis aguda recidivante mediante derivación Wirsung-yeyunal en pediatría. Se trata de un paciente con múltiples ingresos hospitalarios por episodios de pancreatitis, con complicaciones evolutivas de pseudoquistes pancreáticos, estenosis y litiasis del conducto de Wirsung. Se realiza derivación Wirsung-yeyunal por vía convencional con buena evolución posterior.


The first national report of the treatment of recurrent acute pancreatitis by means of Wirsung-jejunal diversion in pediatrics is communicated. This is a patient with multiple hospital admissions for episodes of pancreatitis, with evolutionary complications of pancreatic pseudocysts, stenosis, and Wirsung duct lithiasis. Wirsung-jejunal bypass was performed by conventional route with good subsequent evolution.


O primeiro relato nacional do tratamento de pancreatite aguda recorrente por derivação Wirsung-jejunal em pediatria é relatado. Trata-se de um paciente com múltiplas internações hospitalares por episódios de pancreatite, com complicações progressivas de pseudocistos pancreáticos, estenose e cálculos do ducto de Wirsung. A derivação Wirsung-jejunal foi realizada por via convencional com boa evolução posterior.


Subject(s)
Humans , Female , Child , Pancreatic Ducts/surgery , Pancreatitis/surgery , Constriction, Pathologic/surgery , Pancreatic Ducts/diagnostic imaging , Pancreatitis/complications , Recurrence , Digestive System Surgical Procedures/methods , Acute Disease , Treatment Outcome , Constriction, Pathologic/diagnostic imaging , Lithiasis/diagnostic imaging
14.
Article in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1358272

ABSTRACT

Se presenta el caso de una paciente de 40 años portadora de litiasis biliar sintomática que se operó de coordinación por abordaje laparoscópico


Subject(s)
Humans , Female , Adolescent , Lithiasis/diagnostic imaging , Gallbladder/abnormalities , Cholangiography , Cholecystectomy, Laparoscopic , Lithiasis/surgery
18.
Acta Medica (Hradec Kralove) ; 64(2): 125-128, 2021.
Article in English | MEDLINE | ID: mdl-34331433

ABSTRACT

Hepatolithiasis is a benign disease, where stones are localized proximal to the confluence of hepatic ducts. The clinical picture may differ depending on whether the stones cause complete, partial, or intermittent biliary obstruction. The course can vary from asymptomatic to fatal, thus, early diagnosis and treatment is critical for a good prognosis. The gold standard in imaging is magnetic resonance cholangiopancreatography (MRCP). However, correct diagnosis can be challenging due to atypical clinical picture and laboratory findings. We present a case where hepatolithiasis was misdiagnosed initially due to incomplete reporting and documentation of MRCP. Choledocholithiasis was diagnosed based on initial MRCP, and endoscopic stone extraction was indicated. However, an unusual post-interventional course and signs of obstructive cholangitis led to an endoscopic re-intervention, which confirmed absence of pathology in extrahepatic biliary ducts. The cholangitis recurrence required intensive antibiotic treatment, and CT examination revealed intrahepatic S3 bile duct dilatation. Thus, a re-evaluation of initial MRCP and repeated MRCP confirmed hepatolithiasis. Further, laparoscopic bisegmentectomy was chosen as the definitive treatment due to the location of the lesion. The patient recovered and remained symptom free upon a 12 month follow up.


Subject(s)
Lithiasis/diagnostic imaging , Liver Diseases/diagnostic imaging , Cholangiopancreatography, Magnetic Resonance , Diagnosis, Differential , Hepatectomy , Humans , Laparoscopy , Lithiasis/surgery , Liver Diseases/surgery , Tomography, X-Ray Computed
20.
ANZ J Surg ; 91(7-8): E439-E445, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33844407

ABSTRACT

BACKGROUND: Left lateral hepatic resection is the preferred surgical approach for treating left hepatolithiasis. However, it is not clear whether cholangioscopy via left hepatic duct (LHD) orifice can replace conventional common bile duct (CBD) approach during laparoscopic procedures. METHODS: We performed a comprehensive literature search by screening medical databases, then compared perioperative outcomes and occurrence of recurrent stones between LHD and CBD approaches. RESULTS: A total of five studies, comprising 345 patients, were included in this meta-analysis. The reported operative times, intra-operative blood loss and incidence of post-operative complications were comparable between the approaches. Pooled results revealed a positive correlation between LHD approach with shorter length of hospital stay (standard mean difference = -1.36; 95% confidence interval: -2.10, -0.61; P < 0.001). Additionally, bile duct exploration via LHD orifice was associated with similar rate of recurrent stones and cholangitis across both groups. CONCLUSIONS: Our results demonstrated that biliary tract exploration via LHD stump can be safely performed in left-sided hepatolithiasis. Additionally, the LHD approach was associated with comparable intra-operative outcomes and shorter post-operative hospitalization relative to CBD approach, and does not increase incidence of stone recurrence.


Subject(s)
Laparoscopy , Lithiasis , Liver Diseases , Common Bile Duct/diagnostic imaging , Common Bile Duct/surgery , Hepatic Duct, Common/surgery , Humans , Length of Stay , Lithiasis/diagnostic imaging , Lithiasis/surgery , Liver Diseases/surgery , Retrospective Studies , Treatment Outcome
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