The Gallstone Elimination Report
The gallbladder is a small sac attached to the liver. It collects a bitter, green juice called bile, which helps digest fatty foods. Gallbladder disease occurs most commonly in women over 40 who are overweight and still having menstrual periods. In truth, most bad-tempered persons have nothing wrong with their gallbladders or bile. However, persons who do suffer from gallbladder disease often live in fear of a return of this severe pain and perhaps for this reason are sometimes short-tempered or continually worried about their health. (In fact, the term 'hypochondria', which means to worry continually about one's own health, comes from 'hypo', meaning under, and 'chondrium', meaning rib referring to the position of the gallbladder )
Occasionally, the exudate or pus accumulation in acute cholecystitis or in perforated peptic ulcers may downward shift to the right lower quadrant of the abdomen, which results in a false reading McBurney point tenderness appears to mimic acute appendicitis. Therefore, the sequence of examination procedure begins from the epigastric area. Step one is to check the antrum, for the first portion of duodenum or for the presence of pneumoperitoneum. The second screening organ is the gallbladder. At this step, check the gallbladder for any inflammatory changes including wall thickness, triple layer, gallstone or fluid accumulation in the pericholecystic area. After screening the epigastric area and liver, right kidney and ascending colon. Along the descending colon downward toward the cecum, attention should be focused on the cecum, ileocecal area, ileum, appendix and adjacent bowel loops. Finally, the probe is shifted downward to the pelvic cavity to check the Douglas pouch, urinary...
Estrogens are used either systemically or topically. Side effects may include an increased risk for gynecological malignancies, fluid retention, depression, nausea, vomiting, elevated blood pressure, gallstones, and cardiovascular effects such as stroke and myocardial infarction. However, in addition to the aforementioned benefits of improved voiding function, hormone replacement therapy confers an overall benefit in mortality as compared to nontreated patients (24). Topical vaginal application through direct placement or vaginal implants are preferable because of the decreased systemic absorption and preferential local uptake (25). When mild atrophic changes of the vaginal epithelium are noted on pelvic examination despite systemic estrogen replacement, additional topical vaginal therapy may be useful in order to improve voiding function without incurring side effects from increasing the systemic administration. Yearly PAP smears and breast examinations should be performed when...
The prevalence of overweight and obesity is reaching epidemic proportions nationally and worldwide.75,76 In the U.S., 55 of adults aged 20 years and older are either overweight or obese. Overweight is defined as having a body mass index (BMI) of 25.0 to 29.9 kg m2 and obesity as BMI equal to or greater than 30 kg m2. Similar trends are observed in children and adolescents with a doubling of the number of obese children from 20 years ago.75 Obesity is a major risk factor for coronary heart disease, hypertension, type 2 diabetes, stroke, gallbladder disease, osteoar-thritis, respiratory problems, and some cancers. In addition to the enormous health consequences that result in increased health care costs, there are significant social and psychological burdens for obese individuals and their families.77
In the area of ultrasound-related suits, a 1984 survey by Dr. Sanders14 found the missed ectopic pregnancy as the most frequent reason for litigation in the missed diagnosis category. It also found several other nonobstetrical reasons for legal action, including missed appendiceal abscesses and missed gallstones. Finding lesions when, in fact, none existed, that is, carcinomas of the pancreas, gallstones, and IUDs, were another common cause for litigation.
This middle-aged white female had significant risk factors in the form of obesity, hypertension, and diabetes, even though no family members were known to have had a myocardial infarction. Although the description of her pain, its radiation, and the way she related the pain to a fatty meal could suggest gallbladder disease, it is also entirely compatible with AMI. Nausea, vomiting, diaphoresis, and a mild sensation of shortness of breath could be common to both.
While there is less litigation related to the newer imaging modalities as compared to the older techniques in time, it is likely that the newer techniques will become just as common a basis of malpractice suits. Many of the ultrasound-related legal actions relate to the physician failing to perform a sonogram. The majority of the cases involving ultrasonography involve obstetrical sonography. But, radiologists who don't perform obstetrical sonography may still become involved in a suit involving the missed ectopic pregnancy, the most common cause for litigation in Dr. Sander's missed diagnosis category.16 Other common nonobstetrical reasons for legal action include missed appendiceal abscesses and missed gallstones. A radiologist may also end up in court for finding lesions that don't exist, such as a carcinoma of the pancreas, gallstones, and intrauterine devices (IUDs). Therapeutic sonograms for muscular problems have also figured in the reported cases....
A varied diet based on plant proteins is adequate, yielding growth and body maintenance results equivalent to a diet based on meat protein.39 The lower incidence of obesity, constipation, lung cancer, hypertension, coronary artery disease, type 2 diabetes, gallstones, reduced risk of breast cancer, diverticular disease, colon cancer, calcium kidney stones, and osteoporosis appear to be obvious advantages particularly of the well balanced vegan diet for the elderly.3,39,40 Key et al.,40 (Table 11.1) show the protective effect of daily fresh fruit intake in ischemic heart disease, cerebrovascular disease, and lung cancer, and daily raw salad protection for ischemic heart disease. They also presented a higher incidence of breast cancer in the vegetarian women, but the confidence interval was broad. The smokers in their study population demonstrated a higher rate of ischemic heart disease, cerebrovascular disease, and, of course, lung cancer, to emphasize the disease problems associated...
Indications for the test include suspected gallstones, gallbladder inflammation, and cystic duct obstruction. Contraindications are allergies to iodine contrast media and diseases of the digestive tract that may interfere with the absorption of orally ingested contrast media. Variations from Normal. Various gallbladder disorders can be diagnosed via cholecystography. These include gallstones, polyps, and chronic Variations from Normal. Abnormal results include a variety of bile duct disorders such as tumors, strictures, or presence of gallstones. Sclerosis of the biliary tree and cysts of the common bile duct may also be identified.
Biofilm attach themselves to the polysaccharide matrix or to the bacterial cells beneath them. Adherence via a biofilm is a very effective mechanism used by bacteria to avoid several of the host defenses aimed at preventing enteric infection. For example, the majority of bacteria in a biofilm are protected under several layers of extracellular polysaccharide matrix and, therefore, are not easily flushed away or easily accessed by secretory antibodies, bacteriocidal enzymes, phagocytic immune system cells or antibiotics (Donlan and Costerton, 2002). Adherence via biofilms can contribute to persistence of an infection. Prouty et al. (2002) for example, demonstrated that Salmonella enterica can form biofilms on gall stones and thus cause chronic infection and be continually shed. Finally, the changes in gene expression that occur as a result of living in a biofilm often enhance stress resistance and may facilitate virulence. For example, biofilm-producing strains of Enterococcus faecalis...
Cholesterol stones 3. Clinical features of gallstones a. Definition acute inflammation of the gallbladder, usually caused by cystic duct obstruction by gallstones iii. Fistula formation and gallstone ileits (small bowel obstruction by a large gallstone) a. Definition ongoing chronic inflammation of the gallbladder usually caused by gallstones
Finally, C-RADS discusses the reporting of extra-colonic findings. To achieve cost effectiveness, the judicious reporting of extra-colonic findings to minimize unnecessary additional imaging tests will be critical. Significant extra-colonic findings, such as abdominal aortic aneurysms, solid renal or liver masses, adenopathy and lung nodules (greater than 1 cm) are emphasized. Less significant findings, such as small liver and renal cystic lesions (common findings which are often difficult to characterize without contrast), and gallstones hopefully will be under-reported. Further definition of how to categorize and follow these findings will be important.
A 9-year-old has a greenish-brown complexion, maxillary hyperplasia, splenomegaly, and gallstones. Her Hb level is 5.0 g dl, and she has an MCV of 65 ml. Physical Examination. The patients may have pallor or a greenish-brown complexion (jaundice). Facial deformities are present from expansion of the marrow. Splenomegaly is present. Heart failure may be present secondary to high urine output. Gallstones may be present.
The first clinical description of gallstone disease is attributed to Galen, who in the second century AD differentiated the pain of biliary colic from that of pleurisy. By the seventeenth century, gallstones were noted to be the cause of a spectrum of illness (Schlerk, 1609). The first reported therapeutic approach to cholecystitis used by Joenisius in 1676, was cholecystolithotomy, which he performed through a fistula after gallbladder perforation. In 1743, Petit showed that the presence of adhesions allowed percutenaeous drainage of bile from an immobilized gallbladder. Carre, in 1833, described a technique of anterior abdominal wall cholecystopexy with subsequent cholecystostomy and stone removal. However, percutaneous cholecystostomy was not widely embraced, because of the risk of bile leakage and peritonitis, until the 1980s, when refinements in catheterization techniques and real-time ultrasonography made this a safe and effective procedure for certain indications.
ERCP has both diagnostic and treatment applications. Bile and pancreatic ducts can be assessed for patency, obstruction, and other biliary and pancreatic disorders. Treatment applications include removal of small gallstones from the common bile duct, placement of biliary drains, and dilatation of strictures. Normal Findings. Patent biliary and pancreatic ducts, and the absence of gallstones, obstructions, and abnormal tissue. Variations from Normal. The ERCP can be used to diagnose gallstones, pancreatic stones, cholangitis, and pancreatitis. Tumors, cysts, and strictures of biliary and pancreatic ducts, as well as cirrhosis of the liver, can also be identified.
Against primary and secondary osteoporosis (due to hypogonadism, glucocorticoid excess, immobilization, hyperthyroidism, diabetes mellitus, or primary hyperparathyroidism). Estrogen supplementation is the first choice for prevention and treatment of osteoporosis in women who are postmenopausal. The mechanism of action is thought to be decreasing bone resorption by inhibiting the synthesis of interleukins such as IL-6 as well as retarding the bone-resorbing effects of PTH. Estrogen is contraindicated in pregnancy, breast cancer, or active hepatitis. Side effects include breast tenderness, migraines, and vaginal bleeding spotting. Long-term adverse effects include gallstones, breast cancer, and thrombophlebitis. Estrogen alone also increases the risk of endometrial cancer, and progesterone is often added to decrease this risk.
Laboratory tests include a complete blood count, reticulocyte count, sickle prep, and Hb electrophoresis. Gallstones (secondary to increased bile production from chronic hemolysis) may be visualized oivuitrasound. A blood culture and chest roentgenogram should be performed on febrile patients.
Chronic gallbladder disease, diabetes mellitus, chronic pancreatitis, cigarette smoking, diets high in meat and fat, and occupational exposure to carcinogens are predisposing factors. Carries a poor prognosis (85 are already locally invasive or metastatic at the time of diagnosis) associated with a mutation in the Ki-ras oncogene. Tumor complications include splenic vein obstruction, splenomegaly, portal hypertension, and hypercoagulability. p.232
Dehydrocholic acid is used to increase the volume of bile produced and secreted in the digestive system. It is used to relieve excessive constipation as well as to remove fragments of gallstones from the body. The usual dose of this drug is 3 to 5 milliliters of a 20 percent solution administered intravenously.
Gallbladder ultrasonography is an ultrasound examination of the gallbladder and the bile ducts that is performed to assess the size, shape, and position of the gallbladder and biliary ducts. Identification of gallstones, abnormalities, and inflammation can be accomplished with this sonogram. If the liver
In addition to its diagnostic value, ultrasound technology can also function as a treatment modality. At a frequency higher than that required for diagnostic purposes, ultrasound is used to produce heat in body tissues that treat or relieve back pain. Ultrasound is also used to produce sound waves that are able to pulverize kidney and gallstones in a procedure called percutaneous ultrasonic lithotripsy (PUL).
Major surgery and or prolonged immobilization Unexplained or continuing liver or gallbladder disease Age over 35 years and smoker Uncontrolled hypertension Undiagnosed vaginal bleeding Pregnancy, postpartum, lactation Interacting drugs Gallstones Severe headaches Uncontrolled diabetes Sickle cell disease Lipid disorder
Acute and chronic pancreatitis, cirrhosis of the liver, gallstones, and pancreatic cancer can be diagnosed using laparoscopy. Staging cancers of the liver and lymph system, as well as evaluating metastatic cancers, can also be accomplished with laparoscopic examinations.
An in-hospital workup of a 78-year-old, hypertensive, mildly asthmatic man who is receiving chemotherapy for colon cancer reveals symptomatic gallstones. Preoperative laboratory results are notable for a hematocrit of 24 and a urinalysis with 18-25 WBCs and gram-negative bacteria. On call to the operating room he receives intravenous penicillin. His abdomen is shaved in the operating room. An open cholecystectomy is performed and, despite a lack of indications, the common bile duct is explored. The wound is closed primarily with a Penrose drain exiting a separate stab wound. On postoperative day 3 the patient develops a wound infection.
Disorder characterized by hemolytic anemia with spherical RBCs and splenomegaly. It is caused by a defect in RBC membrane spectrin with loss of the normal biconcavity and a higher rate of splenic sequestration and hemolysis. If left untreated, it may give rise to pigment gallstones and cholecystitis.
A congenital, autosomal-dominant disorder characterized by hemolytic anemia with spherical RBCs and splenomegaly caused by a defect in RBC membrane spectrin with loss of the normal biconcavity and a higher rate of splenic sequestration and hemolysis. If left untreated, it may give rise to pigment gallstones and cholecystitis.
389, The answer is d. (Hardman, pp 9. 4-935.) Chenodeoxycholic acid (chenodiol) and ursocliol have proved to be effective in some patients with cholesterol gallstones. Lovastatin lowers blood cholesterol levels but has no effect on gallstones. Methyl tertiary butyl ether and a new agent, monoctanoin, are infused directly into the common duct and will dissolve gallstones.
A life-style health advantage can be rated relative to improved mortality of those in other life-styles. Certainly, we must also relate to improved quality of life, or as reduced morbidity. Vegetarians, as health-conscious people, have reduced mortality from ischaemic heart disease, cerebrovas-cular disease, and all causes combined.40,41 More specifically, they experience reduced morbidity and mortality due to obesity, constipation, lung cancer, hypertension, Type II diabetes, and gallstones compared with omnivores.40 Diet and immune function are a very important part of the reduced mortality
Get Rid of Gallstones Naturally
One of the main home remedies that you need to follow to prevent gallstones is a healthy lifestyle. You need to maintain a healthy body weight to prevent gallstones. The following are the best home remedies that will help you to treat and prevent gallstones.