Patients With Large Common Bile Duct Stones

When gallstones are suspected to be the cause of symptoms, the doctor is likely to do an ultrasound exam or CT Scan, the most sensitive and specific test for gallstones. Other exams that may be performed are a Cholescintigraphy a.k.a. HIDA (hepatobiliary iminodiactec acid) Scan, ERCP (endoscopic retrograde cholangiopancreatography), and blood tests.

I knew the severe symptoms that I had were not characteristic of gallbladder disease. Particularly not in the beginning, when there was only a very small amount of gallbladder sludge. The very elevated liver enzymes I had were also a mystery because they also do not occur when there is gallbladder sludge alone. They can occur when there is sludge blocking a duct, but there never appeared to be any obstructed ducts in either of the ultrasounds I had during that

The liver produces bile which contains conjugated bilirubin. It is then sent to the gallbladder, and it has to be excreted properly from there. However, the gallstones are blocking the way, which makes it hard for the bilirubin to get out, and results in a build-up. This leads to jaundice, which occurs when one has and excessive amount of bilirubin.

Review Ethics boards should be considerate of the patient’s they are using to conduct their research by first having them fill out an agreement to participate in the research. This idea is reinforced by a field researcher who had to get the patients to sign permission slips before interviewing them and the research wouldn’t reveal their identity. The field researcher found this was an effective way to make the patients whom the experiment is being conducted on comfortable and willing to participate. It allows the patients to have a say on whether they are willing to have specific research done on them whether related to psychological reasons such as asking questions or to have biological research

My assessment of practice evidence for Term B is based on a case study of a particular patient during her perioperative journey from the ward before the surgery until she was ready to be sent back on the ward post operative on the 25th February, 2017. I followed a female patient who was having a surgical procedure called Laparoscopic Cholecystectomy. Cholecystectomy is the removal of the gall bladder and usually performed as a day case procedure. The operaion is carried out under a general anaesthetics. A telescope the width of a small finger is placed into the abdomen through a small cut at the navel. In order to create spare around the organs within the abdomen and provide the surgeon with a clear view it is necessary to use carbon

Mr. Johnson’s reason for driving himself to the emergency room and the symptoms he is experiencing in conjunction with test, and lab results led me to this conclusion. Johnson noticed pain from his epigastric region, radiating to the right shoulder and scapular region. During his emergency room physical exam the physician noted, palpation of the epigastric region demonstrated tenderness with guarding, an above normal body temperature, increased blood pressure, as well as an increased heart rate. The increase in body temperature can be linked to a gallbladder infection. The pain Mr. Johnson is feeling radiating to the

The ultrasound will look for the presence of gallstones, inflammation of the liver, blockage of the bile duct, thickened gallbladder walls or an oversized bile duct tract. An ultrasound can detect gallstones that are two millimeters or larger in size.

The removed gallbladder was placed in a 10% formalin solution, to uphold the integrity of the specimen. It was labeled with patient’s name, date of birth, medical record number, surgeon, healthcare facility, type of specimen and date and time of specimen collection. This data was verified by the same scrub and scout nurses, for consistency and in

Patient CB is a 36 year old African American Female. She has a past medical history of hypertension, acid reflux, heartburn, and a hernia repair one year ago. She is a nonsmoker and reports never taking recreational drugs. Diagnostic tests related to her diagnosis include an abdominal ultrasound showing gallstones, an x-ray to verify stone presence, and tenderness with touch on the abdomin. CB was having a cholecystectomy because she was having pain in her abdomen related to gallstones. Her hernia was a result of a weakening of the abdominal wall.

(percutaneous endoscopic gastrotomy) tube installed. An esophageal foreign body can result in severe complications such

The initial plan started with ordering a CBC, CMP, amylase and lipase STAT. These are all standard labs that help to rule out gallbladder pathology as well as our other differential diagnoses. Her vital signs were stable and the physical exam revealed only moderate TTP of the RUQ and epigastric region. The lab results revealed no leukocytosis, no elevation of liver enzymes, bilirubin, amylase, lipase, alk phos or any other signs of cholecystitis, cholangitis, pancreatitis or other potential signs of infection. The plan of care began with keeping the patient NPO. This is recommended as this keeps the patient from further pain secondary to food stimulating gallbladder contraction.5 It also allows the patient to be prepared for surgery if urgent cholecystectomy is required. The next step was beginning IV normal saline to keep her well hydrated. After this we began to give her medication through the IV including Zofran for her nausea. Zofran is an effective anti-emetic and there were no contraindications for use in this patient. We also gave her Morphine 2 mg IV for pain control. Opioids are an effective option for a patient with significant biliary colic.6 Although NSAIDS are another option for pain control, PUD was part of the differential diagnosis so NSAIDS were not an appropriate therapy. We ordered an abdominal ultrasound as this is the diagnostic test of choice for cholelithiasis. The ultrasound revealed multiple gallstones in the gallbladder, some mild gallbladder thickening, and some dilatation of the common bile duct. At this point we consulted GI who scheduled the patient for MRCP in the morning in order rule out choledocholithiaisis. We also consulted the surgery team who admitted the patient. The stated they would likely plan for laparoscopic

Primary sclerosing cholangitis (PSC) is a slow progressive liver disease that ultimately leads to liver cirrhosis and liver failure. Primary sclerosing cholangitis is characterized by inflammation, fibrosis, and the structuring of the intrahepatic and extrahepatic bile ducts. PSC is closely associated with inflammatory bowel disease (IBD) and ulcerative colitis (UC). ) Approximately 75% of these patients were congruently diagnosed with IBD and of the patients, 80-90% were diagnosed with ulcerative colitis.

I. Introduction: It is estimated that approxiamately 10 to 20 percent of the population in the United States and Western Europe are currently being affected by Gallbladder attacks.

The aim of this study was to compare remifentanil to alfentanil in patient controlled sedation (PCS) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) (Mazanikov et al., 2012). Eighty-one patients between the ages of eighteen and seventy consented to undergo a voluntary ERCP after the Institutional Ethics Committee of Helsinki University Central Hospital and The Finnish National Agency of Medicines approved the study protocol (Mazanikov et al., 2012). Patients joined one of three groups in a randomized double-blind fashion with closed numbered and nontransparent envelopes (Mazanikov et al., 2012). All groups received 8 milligrams per milliliter (mg/mL) of propofol in the sedative mixture with group A1 getting 0.04 mg/mL of alfentanil, group A2 receiving 0.08mg/mL of alfentanil, and group R receiving 0.01 mg/mL of remifentanil (Mazanikov et al., 2012).

The gallbladder stores and concentrates bile. If the gallbladder was damaged or dysfunctional there would be softer and more frequent stools. (Audesirk, T., & Audesirk, G. (1999). Retrieved November 21, 2015 from Chapter 29: Nutrition and Digestion. In Biology: Life on Earth (5th ed., p. 585, 586). Upper Saddle River, N.J.: Prentice Hall.) (General Surgery- Gallstones (Cholelithiasis). (n.d.). Retrieved November 21, 2015, from