There was no sonographic evidence of cholelithiais or choledocholithiasis. HIDA scan revealed sluggish & delayed emptying by the distended gall bladder even after fatty meal with an ejection fraction of <14%. Contrast enhanced CT scan showed a benign appearing cyst of water density with imperceptible wall measuring 3 x 3 cm noted along the falciform ligament between the right and left lobe of the liver suggestive of falciform ligament cyst. No significant abnormality was seen in chest radiograph. Her complete blood count, renal and liver function parameters were found to be within normal limits.
Guarding/rigidity present, positive Murphy’s sign ,X-ray abdominal standing was normal. Urgent Ultrasound Abdomen shows fatty liver, mild hepatosplenomegaly , lammelated gall bladder . Contrast computed tomography abdomen showed- increased gall bladder(GB) wall thickness with peri GB fluid collection and there was no evidence of GB calculi so diagnosis of acute acalculous cholecystitis was made. Patient was advised to manage conservatively by surgeon. Ryle's tube was inserted and was made continuous .She was kept nil by mouth .
• Incidental gallbladder cancer: GB cancer may be an incidental finding at LC, with an incidence ranging from 0.3% to 5.0%. Uncertainty about the diagnosis, lack of clarity regarding of the degree of tumor spread, or postoperative identification of cancer on pathologic examination of a routine cholecystectomy specimen should warrant early reoperation (Rakić, et al. 2014). National Comprehensive Cancer Network (NCCN) guidelines advocate simple cholecystectomy as definitive treatment for patients with mucosal (T1a) disease and a negative CD margin; all other patients (ie, those with involvement of muscle or beyond, a positive CD margin, or a positive cystic lymph node) should undergo repeat operation for extended cholecystectomy (which includes hepatic resection, lymphadenectomy and, possibly, bile duct excision) (Eil, et al.
Summary Ischemic colitis is damage to the large intestine due to reduced blood flow (ischemia) to the colon. Some of the symptoms of this condition include abdominal pain or tenderness, bloody stools, and an urgent need to have a bowel movement. Diagnosis usually includes a procedure to examine the inside of the colon using a scope passed through the rectum
The patient was monitored for postoperative complications. Ureteric catheter was removed along with Foley catheter in first post-operative day. DJ stent was removed after 4weeks. The patients were re-evaluated with KUB to assess the stone free rate at day 1 and 1-month follow up. Clearance was defined as no residual stone on KUB and ultrasound.
Endocarditis or septic thrombophlebitis should be suspected if blood cultures remain positive for more than 48 hours after the device has been removed (Hovarth R et al., 2003). As per the Infectious Disease Society of America (IDSA) guidelines, Trans Esophageal Echocardigraphy (TEE) should be done for patients with CRBSI who have persistent bacteremia or fungemia and/or fever 13 days after initiation of appropriate antibiotic therapy and catheter removal; and any case of S. aureus CRBSI in which duration of therapy less than 4–6
Figure 1 shows the electrocardiogram (ECG) after the angiography. A carotid endarterectomy was performed 5 months before due to an atheroembolic stroke. During the postoperative period, she presented atrial fibrillation with rapid ventricular response and amiodarone was added to her habitual treatment. Her current treatment is ASA 325 mg/day, atenolol 50 mg bid, enalapril 20 mg bid and amiodarone 200 mg bid. One month before the event she attended the outpatient clinic and an echocardiogram was performed, which showed: normal left ventricular dimensions, wall thickness mildly increased, normal left atrium and aorta, mild left ventricular dysfunction with an estimated ejection fraction of 50%, hypokinetic basal inferior and mid inferior segments and mitral inflow filling pattern of delayed relaxation (according to her age).
This patient is 1 year post second bilateral lung transplant and completely immunocompromised from CF and the transplant. One week prior to developing symptoms of high fever, headache, and vague abdominal pain the patient had their stent removed that was placed for treatment of choledocholithiasis, gallstones. This case is presented as rare case due to the imaging of patient virtually identical to a inflamed swollen pancreas (acute interstitial edematous pancreatitis). With further testing and increase of symptoms candida albican infections, a type of yeast infection, was concluded. It was successfully treated by antifungal therapy.
After more than 6 months the patient showed to the office. The CBCT showed that the root fragment “socket shield” was still intact, clinically the site was healed, for no signs of infection was observed, there was no swelling, no exudates, no pain, and the most important finding was the retaining socket shield which wasn’t rejected from the bony socket. Placement of another implant was planned, a new implant “4.2X8 root form type, Roott Dental Implant System” was placed with an insertion torque of 35 Ncm, a cover screw was placed to the implant and a temporary Maryland bridge was bonded to replace the missing tooth for aesthetic reasons. after around 8 months, the patient showed for the final restoration, an impression was taken using the closed technique, a cement-retained PFM crown was fabricated with an opening on the occlusal surface to insert the screw and screwdriver