It is widely agreed upon in medicine that time is of the essence when it comes to diagnosis and treatment of disease. The pediatric disease, biliary atresia (BA) is no different in this regard, as it has been well accepted for several decades that the timely recognition and repair of BA is essential1. BA is a progressive, idiopathic disease characterized by extensive fibrosis of the extrahepatic biliary tree resulting in blockage of bile flow. BA is the most common cause of surgically correctable jaundice. It may also clinically manifest as scleral icterus, acholic stools, and urobilinogen; eventually leading to cirrhosis and hepatic failure if the disease is left untreated. BA is often fatal before the age of one year old if left untreated and as a result has become the most common indication for liver transplant in children1,2. The hypothesized pathogenesis of BA includes viral, immunologic, and genetic etiologies but currently no definitive cause for BA is known. The gold standard in diagnosing BA is intraoperative cholangiogram, which allows for direct progression to surgical correction of the anomaly if characteristic findings of BA are seen. The most common surgery performed in patients with BA is the Kasai Portoenterostomy (KP); which is intended to restore bile flow to the liver and proximal small bowel3,4. An early indication of a successful KP is resolution of jaundice demonstrating return of bile flow; the earlier in infancy this occurs the better the
One of these symptoms is jaundice, which is characterized by yellowish skin and eyes because of an inability of the liver to remove bilirubin from the blood. Patient with cirrhosis also suffering from itching, due to deposited bile's products in the skin. This patient also suffers from accumulation of fluid in legs that is called edema. As a result of the blockage of blood flow via the liver, fluid accumulation in abdomen which is worsen by the decrease in protein production. Other symptoms include fatigue, weakness, loss of appetite, weight loss and nausea. As the disease progress, complications may develop ,such as varices that happens with cirrhosis patient when the blood flow through the liver slows, so the blood from intestine go back to the vessels of the stomach and esophagus, these vessels are not meant to carry this much of blood so they dilate (varices), with increasing
The prevalence of gallstones varies with the geographical region. In the western world, the rates range from approximately 8% in men to 16% in women.3 The typical course of cholelithiasis often begins as asymptomatic gallstones found incidentally on imaging studies. However, 2% of asymptomatic patients become symptomatic per year.8 Biliary colic is the most common symptom to manifest and approximately 20-40% of patients have recurring pain.8 Asymptomatic patients who have calcified gallbladders or large stones >2cm have a greater risk for gallbladder carcinoma and as a result these patients are recommended to have prophylactic cholecystectomy.8 Medical treatment is only advised for certain types of patients and is not the ideal treatment
Gallstones hold a very close annoying factor in my heart. As a registered nurse in a very busy Emergency Room, I find myself dealing with at least 2-4 gallstone/pain ER admits on every shift. I believe that one of the main reasons for the recurrent visits is due to the lack of education regarding their diet. My goal with this Outreach Project was to provide education regarding a healthy diet along with quick references to both the inappropriate and appropriate foods needed in order to manage the diagnosis of gallstones.
Patients with other abdominal anomalies may have an increased risk for intestinal atresia. For example, children with gastroschisis may also have intestinal atresia, and they should be examined for it (Bauman & Nanagas, 2015). The authors described a case of a neonatal child who was immediately diagnosed and treated for gastroschisis. However, the patient never had a bowel movement after surgical correction. By the fourth week without a bowel movement, an exploratory laparotomy was performed, and the child was diagnosed with intestinal atresia. Unfortunately, about 8 centimeters of small bowel was resected due to ill-appearance, but bowel to bowel anastomosis was performed. Interestingly, the patient still did not have a bowel movement, and
Wilson disease has a range of clinical manifestations, from an asymptomatic state to fulminant hepatic failure, chronic liver disease with or without cirrhosis, neurologic, and psychiatric manifestations. Often, the diagnosis is not made until adulthood, despite manifestations of the disease beginning to develop in childhood. Hepatic Wilson disease should be considered in the differential diagnosis of any unexplained chronic liver disease, especially in individuals younger than 40 years. The condition may also manifest as acute hepatitis. Hepatic dysfunction is the presenting feature in more than half of patients. The 3 major patterns of hepatic involvement are as follows: (1) chronic active hepatitis, (2) cirrhosis, and (3) fulminant hepatic failure. The most common initial presentation is
Open gallbladder removal, or open cholecystectomy, is a surgery to remove the gallbladder via it is a large open incision in the abdomen. Doctors perform the procedure to provide permanent relief to a patient that suffers from gallstones and there could be other problems associated with the gallbladder.
Experts claim that the consumption of the mixture within the morning, on an empty abdomen, prevents the expansion of gallstones. Moreover, the consumption of a glass of water, olive oil, and juice an hour before the breakfast will detoxify the liver, kidneys, and the
The gallbladder is located under the right lobe of the liver. It stores bile that produced by the liver until it releases into the duodenum to expedite absorption of fats, fat-soluble vitamins, minerals which is part of the digestive system. According to Jorden’s symptoms such as mild pain in midepigastric region, radiating to the right upper quadrant of the abdomen and right subscapular are, as his nurse, I could acknowledge the reasons cause all that symptoms are due to cholesterol problem. It’s a major constituent of gallstone which is one of the gallbladder disorders. Patient who experience it will be in a high risk of inflamed gallbladder due to a big heavy consumption of high-fat meal. And also because the gallbladder is located under
Endoscopic retrograde cholangiopancreatography (ERCP) is a medical technique that is used primarily to investigate and treat pathologies involving the biliary tree and pancreatic ducts. Indications for ERCP include gallstones, tumors, defective sphincters, sclerosis of ducts and pseudocysts, which are accumulations of fluid and tissue components. ERCP has been traditionally used for diagnostic purposes. However, with the advent of safer and less invasive advances in imaging technologies such as ultrasound and magnetic resonance cholangiopancreatography (MRCP), ERCP is now mainly used for therapeutic interventions.
Gallbladder is a small organ of the body which is located in the right side of the liver. It is responsible of storing the bile and releasing it to the intestine. The gallbladder can subject to the mechanical deformation/loading as a result of the cholecystitis, cholesterolosis of the gallbladder, etc. However, so far the mechanical properties of the human gallbladder have not been measured. This study was aimed at conducting an experimental study to measure the mechanical properties of the human gallbladder under the axial and transversal tensile loadings. To do that, the gallbladder tissue of 16 male individuals were excised during the autopsy and subjected to a series of axial and transversal loadings under the strain rate of 5 mm/min. The
The gallbladder is known for being a storage space for bile in the form of a pear that is partially accommodated in a shallow depression on the inferior area of the
Joan Middleton was presented to the emergency department with acute cholecystitis. It is important to understand the patient’s condition to figure out the underlying cause of the situation. Acute cholecystitis is an inflammation of the gallbladder that involves swelling and irritation in the area due to a gallstone blocking the cystic duct (Schaider, Barkin and Barkin, 2015). A gallbladder is an organ that is located below the liver. Its primary function is to store bile, which the body uses to digest fat in the small intestines. When the bile becomes too concentrated, it begins to form insoluble minerals and salt and these deposits are called gallstones. Small gallstones do not cause any problems if they can be flushed down the bile duct and
The incidence of postoperative bile leak cannot be assessed accurately as many cases may heal spontaneously. (14) Postoperative bile leak usually occurs from the liver bed or bile duct injury, (15) as a result of pressure gradient created by the sphincter of Oddi. (16) The commonest cause of postoperative bile leak was post-cholecystectomy and the commonest site was the cystic duct stump, and this was comparable with the previously published results. (17) Cholangiogram was the standard method of the diagnosis in most cases, however, the leak was minimal and not evident in 25 cases, such cases may heal spontaneously according to the literature.
Physical exam findings show no lymphadenopathy or hepatosplenomegaly and her stool guaiac test is positive.
The prognosis for an infant with jaundice is extremely good when they are treated at the right time with the correct treatment. The importance of knowing the symptoms like, yellowing of the skin, excessive crying, or abnormal behavior can help save a child’s life. The types of treatment can be tedious but they are helpful in reducing the risk for further complications. Women should be aware of neonatal jaundice and there child’s level of bilirubin in his or her