![]() Collins’ Sign: Validation of a Clinical Sign in Cholelithiasis. Gallbladder Stones: Imaging and Intervention. Bortoff G, Chen M, Ott D, Wolfman N, Routh W. Hanbidge A, Buckler P, O’Malley M, Wilson S. Best Practice & Research Clinical Gastroenterology. Epidemiology of Gallbladder Stone Disease. Predisposing factor: similar to cholesterol stonesĪ gallbladder full of stones may paradoxically be hard to visualize ( wall-echo-shadow sign) The terms cholelithiasis or gallstones have been largely used in clinical practice on their own to refer to stones in the gallbladderĬholedocholithiasis: gallstones within the bile ductsīiliary microlithiasis refers to gallstones 50% cholesterol contents form with supersaturation of bile, nucleation and stone growthĭiet, sedentary lifestyle, the rapid loss of weight, obesity, oral contraceptive pill, total parenteral nutrition (TPN)Įthnicity, genetic predisposition, older age, female sex Specific names can be given to gallstones depending on their location:Ĭholecystolithiasis: gallstones within the gallbladder Written informed patient consent for publication has been obtained.Gallstones (cholelithiasis) describe stone formation at any point along the biliary tree. This case demonstrates a rare complication of renal tract calculi along with other chronic inflammatory processes within the kidney and highlights the role of CT for the right diagnosis and early treatment. (therapeutic options, prognosis, impact of imaging on therapy planning)ĭepending on the renal function, there are three main treatments: open nephrectomy with duodenal oversewn or IV antibiotics with urinary diversion through either ureteric stent insertion or nephrostomy or endoscopic treatment by application of clips via OGD to close the fistula tract and subsequent ligation of the fistula tract using an endoloop. Obviously, it is necessary to find other causes that are responsible of the pathology, like chronic perinephric inflammation, renal calculi and/or obstruction, tumours, surgical instrumentation of the genitourinary tract, penetrating trauma, diseases in the gastrointestinal tract and others. On CT, inflammatory changes and/or adhesion between the kidney and the gastrointestinal tract may suggest the diagnosis of reno-alimentary fistula, particularly if we find, like in this case, calculi in the via fistulous. Typically, CT scanning identify renal-fistula, but there are other imaging modalities, like retrograde pyelography, o esophago- g astro- d uodenoscopy (OGD) and 99mTc scintigraphy that can be helpful in the diagnosis. (diagnostic pearls, key findings, which diagnostic procedures are useful, how is the final diagnosis made) Pionephrosis appears to be the most common cause of renoduodenal fistula (25.5%), followed by complicated nephrolithiasis (18.2%), iatrogenic causes (10.9%), malignancy and GI causes (9.1%), infectious disease and trauma (7.3%), and xanthogranulomatous pyelonephritis (5.5%). demonstrated that 58.9% of the renoalimentary fistula are renocolic, 34.8% renoduodenal and the remaing 6.3% renojejunal or renoileal. The main side involved is the right one this is due to the proximity of right kidney to the descending duodenum with its relative immobility, lack of posterior peritoneal covering, and close contact with the anterior kidney. Reno-duodenal fistulae are rare comprising 1% of renoalimentary fistulae. Renal-tract fistula is a recognised phenomenon originating either from trauma or spontaneously through chronic inflammatory states in the kidney, commonly as a result of calculi, infection and malignancy. (definitions, disease description, pathophysiology)
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |