• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.195-198
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• 2009

Acalculous hemorrhagic cholecystitis is a rare complication of acute cholecystitis and is associated with a high mortality rate. We present a case of acalculous hemorrhagic cholecystitis with hematoma in the gallbladder lumen, which was diagnosed using magnetic resonance imaging (MRI). The T1- & T2-weighted MRI revealed gallbladder distension with a hypointense intraluminal hematoma. The excellent tissue contrast provided by MRI is useful for detecting hematomas in the cases of hemorrhagic cholecystitis.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.91-95
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• 2003

The nephrotic syndrome is characterized by generalized edema, hypoproteinemia(<2 g/dL), proteinuria(>40 $mg/m^2/hr$), and hypercholesterolemia(>200 mg/dL). It is reported that hypoalbuminemia, which is one of the four diagnostic criteria of the nephrotic syndrome, is associated with gallbladder wall thickening. An explanation for the thickened wall in hypoalbuminemic states is the accumulation of fluid in the subserosal layer of the gallbladder wall which contains the most areolar tissue. This report describes a patient who was initially diagnosed with the nephrotic syndrome at the age of 4 and subsequently developed acute acalculous cholecystitis at the age of 5.8 with an albumin level of 1.3 g/dL. The patient responded to fluid therapy, nasogastric suction, and broad spectrum antibiotics.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.605-609
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• 2010

A 10-year-old spayed female Yorkshire terrier presented with vomiting, and anorexia. Obstructive choledocholith with concurrent pancreatitis and hepatorenal syndrome was diagnosed based on analyses of the blood profiles, abdominal radiographs, ultrasonography and CT. Choledoliths were removed from the common bile duct, yet the patient died suddenly 10 days after surgery. Recurrent choledolithiasis has not been reported in a cholecystectomized dog and this report focuses on the imaging features of ultrasonography and CT of recurrent choledoliths.

• Journal of radiological science and technology
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• v.31 no.4
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• pp.323-327
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• 2008

Porcelain gallbladder is a rare disorder by deposition of calcium in the wall of gallbladder. The chronic cholecystitis is reported to produce mural calcification and obstruction to the cystic duct by stone. Since porcelain gallbladder is commonly associatedwith gallbladder cancer, cholecystectomy is prerformed to prevent it. We report here a case of a patient with porcelain gallbladder. This case showedthe typical ultrasonogaphic, computer tomogaphic and radiaographic findings of the disease.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.225-229
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• 2009

Churg-Strauss syndrome (CSS) is a disorder that is characterized by asthma, hypereosinophilia and systemic vasculitis affecting a number of organs. The manifestations of acute cholecystitis and diffuse alveolar hemorrhage are rarely reported in CSS. A 22-year-old woman with bronchial asthma visited our hospital complaining of right upper quadrant pain with a sudden onset. The abdominal computed tomography (CT) scan revealed gall bladder edema consistent with acute cholecystitis. On the initial evaluation, marked hypereosinophilia was observed in the peripheral blood smear. The nerve conduction velocity measurements and a skin biopsy performed to confirm the organ involvement of disease indicated typical mononeuritis multiplex and necrotizing vasculitis, respectively, which was complicated with CSS. On the 12th hospital day, ground glass opacity and consolidations were newly developed on both lung fields. The bronchoalveolar lavage (BAL) fluid showed increasing bloody return in sequential aliquots that were characteristic of a diffuse alveolar hemorrhage. We report a case of CSS with acute cholecystitis and diffuse alveolar hemorrhage.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.203-208
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• 2012

Purpose: The purpose of this study is to investigate the incidence of acalculous cholecystitis after multiple trauma with fractures and to analyze the characteristics of cholecystitis. Methods: We performed a retrospective study of multiple trauma patients with fractures between April 2010 and April 2012. Sixty- nine patients were identified, and the average age was 46.8(range: 15-74) years. Data were collected regarding associated injury, injury severity score (ISS), the diagnosis time after trauma, diagnostic tool, and management Results: There were three cases(4.3%) of cholecystitis among the 69 cases, and cholecystitis was diagnosed an average of 20.7(range: 8-33) days after injury. Two patients complained of abdominal pain at diagnosis, but the other patient who had undergone surgery for small bowel perforation at the time of the injury had no abdominal pain. All three patients had abnormal liver function tests (LFTs) at diagnosis. The cholecystitis was confirmed with ultrasonography or computed tomography, and all cases were acalculous cholecystitis. At first, percutaneous transhepatic gallbladder drainage was performed; then, laparoscopic cholecystectomy (LC) was tried an average of 12(range: 11-13) days later. An laparoscopic cholecystectomy was successfully done in only one case, the other cases being converted to an open cholecystectomy due to severe inflammation. Conclusion: The incidence of acaculous cholecystitis was 4.3% after multiple trauma with fractures. We should consider cholecystitis in patients with abdominal pain, fever and elevated LFTs after multiple trauma.

• Journal of Yeungnam Medical Science
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• v.23 no.2
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• pp.171-181
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• 2006

Background: $Clonorchis$ $sinensis$ is an important human parasite that is usually found in the biliary tract. It is widely distributed in East Asia in Taiwan, Japan, China and Korea. About 2 million people are estimated to be infected with $C.$ $sinensis$ in Korea. This study was conducted to evaluate the state of infestation and clinical aspects of $C.$ $sinensis$. Material and Methods: We evaluate 1,063 patients with clonorchiasis retrospectively at Yeungnam University Hospital and Health Promotion Center from January 2001 to December 2003. All patients were diagnosed by a positive stool test for $C.$ $sinensis$ eggs. Clinical features, laboratory data and imaging studies were evaluated. Results: The ratio between affected males and females was 3.6 : 1. The highest infection rate was noted in the 40-60 age groups regardless of sex. The infection rate of $C.$ $sinensis$ among the residents of urban areas was higher than in rural areas. There were 813 (76.5%) patients who were asymptomatic. Common symptoms included right upper abdominal pain in 7.6% and epigastric pain in 7.2%. For the laboratory studies, serum ALP and GGT levels were within normal limits in 85.2% and 56.0% respectively. Peripheral eosinophilia was noted in 66.1% of cases. Of the 83 cases undergoing ERCP, 27 cases (32.5%) showed peripheral dilatation of the intrahepatic duct. Conclusion: This study suggests that $C.$ $sinensis$ infection is still endemic even in rural areas of Korea and that asymptomatic infections are common. Further work should be focused on the early diagnosis and treatment of patients with subclinical infection.