Choledochal Cyst
Jejunostomy
Cysts
Common Bile Duct Diseases
Cholangiopancreatography, Magnetic Resonance
Anastomosis, Roux-en-Y
Common Bile Duct
Hepatic Duct, Common
Cholangiography
Imino Acids
Cholangiopancreatography, Endoscopic Retrograde
Bile Ducts, Extrahepatic
Biliary Atresia
Adenomyoma
Dilatation, Pathologic
Pancreatic Ducts
Biliary Tract Diseases
Lymphangitis
Technetium Tc 99m Disofenin
Biliary Fistula
Bile Ducts
Gallbladder
Portoenterostomy, Hepatic
Common Bile Duct Neoplasms
Epidermal Cyst
Pancreaticojejunostomy
Pancreatitis, Chronic
Pancreatic Juice
Biliary Tract Neoplasms
Pulmonary lymphangitis carcinomatosa and acute pancreatitis: a rare presentation of choledochal cyst. (1/107)
Pulmonary lymphangitis carcinomatosa is an unusual cause of death in a young adult. This case describes an apparently healthy young woman who presented with severe acute pancreatitis, which is a recognized complication of a choledochal cyst. Autopsy examination revealed advanced malignancy with poorly differentiated adenocarcinoma penetrating the wall of the choledochal cyst and metastatic adenocarcinoma in the lymph nodes, lungs and kidneys. This case emphasises the unusual presentation of a choledochal cyst with acute pancreatitis and the aggressive nature of malignancy associated with this congenital anomaly. (+info)Choledochal cyst associated with polycystic kidney disease: report of a case. (2/107)
We report a very rare case of type I choledochal cyst associated with a polycystic kidney disease. A 48-year-old female had been dependent on hemodialysis for chronic renal failure due to polycystic kidney disease and was incidentally diagnosed to have a dilated common bile duct by an ultrasonography. An endoscopic retrograde cholangiopancreatography showed a spindle-shaped, dilated common bile duct (type I choledochal cyst) without visualization of the pancreatic duct. She underwent a resection of the choledochal cyst. Intraoperative cholangiography showed no reflux of contrast medium into the pancreatic duct. Amylase level of the aspirated bile from the bile duct was not elevated. In the case of choledochal cyst combined with renal fibropolycystic disease, pancreaticobiliary maljunction may not contribute to the etiology of choledochal cyst. In such cases, management of choledochal cyst is still controversial and requires further discussion. (+info)Dilatation of the biliary tree in children: sonographic diagnosis and its clinical significance. (3/107)
We evaluated sonographically 162 children who met the criteria for biliary tract dilatation in the past 18 years. Of these, 131 patients were diagnosed as having anomalous dilatations of the biliary tree (including 112 with choledochal cysts and 19 with biliary duct dilatation and biliary atresia). Biliary tract dilatations in the other 31 patients were due to secondary causes or normal variants. All cases of intrahepatic biliary tree dilatation and those with both intra- and extrabiliary duct dilatations were anomalous. In 117 cases of extrahepatic biliary tract dilatation only, the mean diameter was widest in cases of choledochal cyst (21.4 +/- 12.1 mm, compared with cases of biliary tract dilatation with biliary atresia (10 +/- 2.4 mm), secondary biliary duct dilatation (8.5 +/- 1.5 mm), and normal variants (4.4 +/- 1.2 mm) (P < 0.001). Of the 43 infants with biliary tree dilatation, 24 (56%) had choledochal cysts and 19 (44%) had biliary tract dilatation associated with biliary atresia. Excluding cases associated with biliary atresia, the accuracy of diagnosing choledochal cysts in extrahepatic biliary tract dilatation was 71% and 97% using cutoffs of 7 mm and 10 mm as the minimum diameter, respectively. (+info)Congenital choledochal cyst with pancreatitis. (4/107)
OBJECTIVE: To understand the relationship among congenital choledochal cyst, anomalous junction of pancreaticobiliary duct (AJPBD) and pancreatitis. METHODS: 25 children with choledochal cyst treated in our hospital were included in this study. Their ages ranged from 2 months to 14 years. Intraoperative cholangiography was performed in 24 children. Pancreatic samples obtained from the head and body of the pancreas at operation were observed under light and electron microscope. Serum amylase was analyzed one week before and after operation respectively. Bile amylase in the cyst and gallbladder was measured at operation. RESULTS: The incidence of AJPBD was 70%. Inflammatory cell infiltration and fibrous hyperplasia were seen in the pancreatic specimens of 5 children, of whom 4 had AJPBD. No ultrastructural changes were found in 2 children without AJPBD, while different changes were seen in 6 with AJPBD, including those showing no pathological changes under light microscope. All the changes became more severe as the age of the patient increased. The bile and serum amylase levels were higher in children with AJPBD than those without AJPBD (P < 0.05). CONCLUSION: Congenital choledochal cyst has a close relationship with AJPBD and pancreatitis. Pancreatic pathological changes have a long and chronic course from ultrastructural changes to macroscopic changes for the developing of pancreatitis. (+info)Diagnosis and treatment of congenital choledochal cyst: 20 years' experience in China. (5/107)
AIM: To summarize the experience of diagnosis and treatment of congenital choledochal cyst in the past 20 years (1980-2000). METHODS: The clinical data of 108 patients admitted from 1980 to 2000 were analyzed retrospectively. RESULTS: Abdominal pain,jaundice and abdominal mass were presented in most child cases. Clinical symptoms in adult cases were non-specific, resulting in delayed diagnosis frequently. Fifty-seven patients (52.7%) had coexistent pancreatiobiliary disease. Carcinoma of the biliary duct occurred in 18 patients (16.6%). Ultrasonic examination was undertaken in 94 cases, ERCP performed in 46 cases and CT in 71 cases. All of the cases were correctly diagnosed before operation. Abnormal pancreatobiliary duct junction was found in 39 patients. Before 1985 the diagnosis and classification of congenital choledochal cyst were established by ultrasonography preoperatively and confirmed during operation, the main procedures were internal drainage by cyst enterostomy. After 1985, the diagnosis was established by ERCP and CT, and cystectomy with Roux-en-Y hepaticojejunostomy was the conventional procedures.In 1994, we reported a new and simplified operative procedure in order to reduce the risk of choledochal cyst malignancy. Postoperative complication was mainly retrograde infection of biliary tract, which could be controlled by the administration of antibiotics, there was no perioperative mortality. CONCLUSION: The concept in diagnosis and treatment of congenital choledochal cyst has obviously been changed greatly.CT and ERCP were of great help in the classification of the disease.Currently, cystectomy with Roux-en-Y hepaticojejunostomy is strongly recommended as the choice for patients with type I and type IV cysts. Piggyback orthotopic liver transplantation is indicated in type V cysts (Caroli's disease) with frequently recurrent cholangitis. (+info)Proliferative activity of bile from congenital choledochal cyst patients. (6/107)
AIM: To explore the potential carcinogenicity of bile from congenital choledochal cyst (CCC) patients and the mechanism of the carcinogenesis in congenital choledochal cyst patients. METHODS: 20 bile samples from congenital choledochal cyst patients and 10 normal control bile samples were used for this study. The proliferative effect of bile was measured by using Methabenzthiazuron (MTT) assay; Cell cycle and apoptosis were analyzed by using flow cytometry (FCM), and the PGE(2) levels in the supernatant of cultured cholangiocarcinoma cells were quantitated by enzyme-linked immunoabsorbent assay (ELISA). RESULTS: CCC bile could significantly promote the proliferation of human cholangiocarcinoma QBC939 cells compared with normal bile (P=0.001) and negative control group (P=0.002), and the proliferative effect of CCC bile could be abolished by addition of cyclooxygenase-2 specific inhibitor celecoxib (20 microM). The QBC939 cells proliferative index was increased significantly after treated with 1 % bile from CCC patient (P=0.008) for 24 h, the percentage of S phase (29.48+/-3.27)% was increased remarkably (P<0.001) compared with normal bile (11.72+/-2.70) %, and the percentage of G0/G1 phase (54.19+/-9.46) % was decreased remarkably (P=0.042) compared with normal bile (69.16+/-10.88) %, however, bile from CCC patient had no significant influence on apoptosis of QBC939 cells (P=0.719). CONCLUSION: Bile from congenital choledochal cyst patients can promote the proliferation of human cholangiocarcinoma QBC939 cells via COX-2 and PGE(2) pathway. (+info)Congenital choledochal dilatation with emphasis on pathophysiology of the biliary tract. (7/107)
Of 37 patients with congenital choledochal dilatation, aged 8 days to 12 years, who had undergone excision with Roux-en-Y hepaticojejunostomy, 26 patients could be analyzed for morphologic abnormalities and pathophysiology of the biliary tract. Of the 26 patients with congenital choledochal dilatation, 25 (96.2%) had an abnormal choledochopancreaticoductal junction. Of the 12 patients with cystic-type choledochal dilatation, 10 had the C-P type of abnormal choledochopancreaticoductal junction, and of the 13 patients with fusiform-type choledochal dilatation, nine had the P-C type. The amylase levels in the choledochal cyst and the gallbladder were elevated regardless of the form of choledochal dilatation. An adenocarcinoma in a cystic choledochal dilatation was found in one child. Therefore, longstanding inflammation of the biliary tract caused by the reflux of pancreatic juice might be one of the factors in carcinogenesis in the biliary tract. This free reflux of pancreatic juice was demonstrated not only by amylase levels in the biliary tract but also by intraoperative biliary manometry. This reflux might be explained by the lack of sphincter function at the junction of the common bile and pancreatic ducts. (+info)Procedures for congenital choledochal cysts and curative effect analysis in adults. (8/107)
OBJECTIVE: To evaluate the procedures and timing of operation as well as long-term postoperative effect of congenital choledochal cysts (CCC) in adults. METHODS: The procedures and timing of operation, effective rate, re-operation rate and incidence of carcinoma after operation for 70 adult patients with CCC from January 1980 to June 1999 were analyzed retrospectively. RESULTS: The re-operation rate of external drainage was 86% (6/7). The effective rate of internal drainage was significantly lower than that of cyst resection (3/10 vs 45/49, chi2=20.94, P<0.001). The re-operation rate and incidence of carcinoma of internal drainage were higher than those of cyst resection (5/10 vs 3/49, chi2=13.64, P<0.001 and 3/10 vs 3/49, chi2=5.18, P<0.025). The reoperation rate of emergency surgery was higher than that of selective operation (8/10 vs 6/56, chi2=24.37, P<0.001). CONCLUSIONS: External drainage should be the first-aid measure and the therapy of choice on emergency basis. Internal drainage should never be attempted. Cyst resection with Roux-en-Y hepaticojejunostomy is recommended as the treatment of choice in selective operation. (+info)A Choledochal cyst is a congenital dilatation or abnormal enlargement of the bile ducts, which are the tubes that carry bile from the liver to the small intestine. Bile is a digestive juice produced by the liver that helps in the digestion of fats.
Choledochal cysts can be classified into several types based on their location and the anatomy of the biliary tree. The most common type, called Type I, involves dilatation of the common bile duct. Other types include dilatation of the intrahepatic bile ducts (Type II), dilatation of both the intrahepatic and extrahepatic bile ducts (Type III), and multiple cystic dilatations of the bile ducts (Type IV).
Choledochal cysts are more common in females than males, and they can present at any age. Symptoms may include abdominal pain, jaundice, vomiting, and fever. Complications of choledochal cysts can include bile duct stones, infection, and cancer. Treatment typically involves surgical removal of the cyst, followed by reconstruction of the biliary tree.
A jejunostomy is a surgical procedure where an opening (stoma) is created in the lower part of the small intestine, called the jejunum. This stoma allows for the passage of nutrients and digestive enzymes from the small intestine into a tube or external pouch, bypassing the mouth, esophagus, stomach, and upper small intestine (duodenum).
Jejunostomy is typically performed to provide enteral nutrition support in patients who are unable to consume food or liquids by mouth due to various medical conditions such as dysphagia, gastroparesis, bowel obstruction, or after certain surgical procedures. The jejunostomy tube can be used for short-term or long-term nutritional support, depending on the patient's needs and underlying medical condition.
A cyst is a closed sac, having a distinct membrane and division between the sac and its surrounding tissue, that contains fluid, air, or semisolid material. Cysts can occur in various parts of the body, including the skin, internal organs, and bones. They can be caused by various factors, such as infection, genetic predisposition, or blockage of a duct or gland. Some cysts may cause symptoms, such as pain or discomfort, while others may not cause any symptoms at all. Treatment for cysts depends on the type and location of the cyst, as well as whether it is causing any problems. Some cysts may go away on their own, while others may need to be drained or removed through a surgical procedure.
Common bile duct diseases refer to conditions that affect the common bile duct, a tube that carries bile from the liver and gallbladder into the small intestine. Some common examples of common bile duct diseases include:
1. Choledocholithiasis: This is the presence of stones (calculi) in the common bile duct, which can cause blockage, inflammation, and infection.
2. Cholangitis: This is an infection or inflammation of the common bile duct, often caused by obstruction due to stones, tumors, or strictures.
3. Common bile duct cancer (cholangiocarcinoma): This is a rare but aggressive cancer that arises from the cells lining the common bile duct.
4. Biliary strictures: These are narrowing or scarring of the common bile duct, which can be caused by injury, inflammation, or surgery.
5. Benign tumors: Non-cancerous growths in the common bile duct can also cause blockage and other symptoms.
Symptoms of common bile duct diseases may include abdominal pain, jaundice (yellowing of the skin and eyes), fever, chills, nausea, vomiting, and dark urine or light-colored stools. Treatment depends on the specific condition and severity but may include medications, endoscopic procedures, surgery, or a combination of these approaches.
Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive medical imaging technique that uses magnetic resonance imaging (MRI) to visualize the bile ducts and pancreatic duct. This diagnostic test does not use radiation like other imaging techniques such as computed tomography (CT) scans or endoscopic retrograde cholangiopancreatography (ERCP).
During an MRCP, the patient lies on a table that slides into the MRI machine. Contrast agents may be used to enhance the visibility of the ducts. The MRI machine uses a strong magnetic field and radio waves to produce detailed images of the internal structures, allowing radiologists to assess any abnormalities or blockages in the bile and pancreatic ducts.
MRCP is often used to diagnose conditions such as gallstones, tumors, inflammation, or strictures in the bile or pancreatic ducts. It can also be used to monitor the effectiveness of treatments for these conditions. However, it does not allow for therapeutic interventions like ERCP, which can remove stones or place stents.
Roux-en-Y anastomosis is a type of surgical connection between two parts of the gastrointestinal tract, typically performed during gastric bypass surgery for weight loss. In this procedure, a small pouch is created from the upper stomach, and the remaining portion of the stomach is bypassed. The Roux limb, a segment of the small intestine, is then connected to both the pouch and the bypassed stomach, creating two separate channels for food and digestive juices to mix. This surgical technique helps to reduce the amount of food that can be consumed and absorbed, leading to weight loss.
The common bile duct is a duct that results from the union of the cystic duct (which drains bile from the gallbladder) and the common hepatic duct (which drains bile from the liver). The common bile duct transports bile, a digestive enzyme, from the liver and gallbladder to the duodenum, which is the first part of the small intestine.
The common bile duct runs through the head of the pancreas before emptying into the second part of the duodenum, either alone or in conjunction with the pancreatic duct, via a small opening called the ampulla of Vater. The common bile duct plays a crucial role in the digestion of fats by helping to break them down into smaller molecules that can be absorbed by the body.
The common hepatic duct is a medical term that refers to the duct in the liver responsible for carrying bile from the liver. More specifically, it is the duct that results from the convergence of the right and left hepatic ducts, which themselves carry bile from the right and left lobes of the liver, respectively. The common hepatic duct then joins with the cystic duct from the gallbladder to form the common bile duct, which ultimately drains into the duodenum, a part of the small intestine.
The primary function of the common hepatic duct is to transport bile, a digestive juice produced by the liver, to the small intestine. Bile helps break down fats during the digestion process, making it possible for the body to absorb them properly. Any issues or abnormalities in the common hepatic duct can lead to problems with bile flow and potentially cause health complications such as jaundice, gallstones, or liver damage.
Biliary tract surgical procedures refer to a range of operations that involve the biliary system, which includes the liver, gallbladder, and bile ducts. These procedures can be performed for various reasons, including the treatment of gallstones, bile duct injuries, tumors, or other conditions affecting the biliary tract. Here are some examples of biliary tract surgical procedures:
1. Cholecystectomy: This is the surgical removal of the gallbladder, which is often performed to treat symptomatic gallstones or chronic cholecystitis (inflammation of the gallbladder). It can be done as an open procedure or laparoscopically.
2. Bile duct exploration: This procedure involves opening the common bile duct to remove stones, strictures, or tumors. It is often performed during a cholecystectomy if there is suspicion of common bile duct involvement.
3. Hepaticojejunostomy: This operation connects the liver's bile ducts directly to a portion of the small intestine called the jejunum, bypassing a damaged or obstructed segment of the biliary tract. It is often performed for benign or malignant conditions affecting the bile ducts.
4. Roux-en-Y hepaticojejunostomy: This procedure involves creating a Y-shaped limb of jejunum and connecting it to the liver's bile ducts, bypassing the common bile duct and duodenum. It is often performed for complex biliary tract injuries or malignancies.
5. Whipple procedure (pancreaticoduodenectomy): This extensive operation involves removing the head of the pancreas, the duodenum, a portion of the jejunum, the gallbladder, and the common bile duct. It is performed for malignancies involving the pancreas, bile duct, or duodenum.
6. Liver resection: This procedure involves removing a portion of the liver to treat primary liver tumors (hepatocellular carcinoma or cholangiocarcinoma) or metastatic cancer from other organs.
7. Biliary stenting or bypass: These minimally invasive procedures involve placing a stent or creating a bypass to relieve bile duct obstructions caused by tumors, strictures, or stones. They can be performed endoscopically (ERCP) or percutaneously (PTC).
8. Cholecystectomy: This procedure involves removing the gallbladder, often for symptomatic cholelithiasis (gallstones) or cholecystitis (inflammation of the gallbladder). It can be performed laparoscopically or open.
9. Biliary drainage: This procedure involves placing a catheter to drain bile from the liver or bile ducts, often for acute or chronic obstructions caused by tumors, strictures, or stones. It can be performed endoscopically (ERCP) or percutaneously (PTC).
10. Bilioenteric anastomosis: This procedure involves connecting the biliary tract to a portion of the small intestine, often for benign or malignant conditions affecting the bile ducts or pancreas. It can be performed open or laparoscopically.
Duodenostomy is a surgical procedure that creates an opening (stoma) into the duodenum, which is the first part of the small intestine. This procedure is typically performed to divert the flow of digestive secretions and contents away from a diseased or obstructed area of the gastrointestinal tract.
A duodenostomy may be created as a temporary measure to allow a portion of the intestine to heal or as a permanent solution for conditions such as chronic inflammatory bowel disease, cancer, or congenital abnormalities. The stoma can be located on the abdominal wall, allowing for the external drainage of digestive secretions and contents into a collection bag.
It is important to note that the specific medical definition and indications for duodenostomy may vary based on individual clinical context and patient needs. Therefore, it is always best to consult with a healthcare professional or medical expert for accurate information.
Cholangiography is a medical procedure that involves taking X-ray images of the bile ducts (the tubes that carry bile from the liver to the small intestine). This is typically done by injecting a contrast dye into the bile ducts through an endoscope or a catheter that has been inserted into the body.
There are several types of cholangiography, including:
* Endoscopic retrograde cholangiopancreatography (ERCP): This procedure involves inserting an endoscope through the mouth and down the throat into the small intestine. A dye is then injected into the bile ducts through a small tube that is passed through the endoscope.
* Percutaneous transhepatic cholangiography (PTC): This procedure involves inserting a needle through the skin and into the liver to inject the contrast dye directly into the bile ducts.
* Operative cholangiography: This procedure is performed during surgery to examine the bile ducts for any abnormalities or blockages.
Cholangiography can help diagnose a variety of conditions that affect the bile ducts, such as gallstones, tumors, or inflammation. It can also be used to guide treatment decisions, such as whether surgery is necessary to remove a blockage.
Imino acids are organic compounds that contain a nitrogen atom as part of an amide-like structure. They are structurally similar to amino acids, which contain a carboxyl group and an amino group, but instead of the amino group, imino acids have a structural unit known as an imine or Schiff base, which is a carbon-nitrogen double bond with a hydrogen atom attached to the nitrogen atom.
One example of an imino acid is proline, which is a cyclic imino acid that plays important roles in protein structure and function. Proline is unique among the 20 standard amino acids because its side chain is linked to the nitrogen atom of the backbone, forming a ring-like structure. This structural feature gives proline unique properties, such as restricted rotation around the bond between the nitrogen and alpha carbon atoms, which can affect protein folding and stability.
Other imino acids may be formed through chemical reactions or enzymatic processes, and they can play important roles in various biological pathways, including the biosynthesis of amino acids, nucleotides, and other biomolecules. However, imino acids are not typically considered to be part of the standard set of 20 amino acids that make up proteins.
Endoscopic retrograde cholangiopancreatography (ERCP) is a medical procedure that combines upper gastrointestinal (GI) endoscopy and fluoroscopy to diagnose and treat certain problems of the bile ducts and pancreas.
During ERCP, a flexible endoscope (a long, thin, lighted tube with a camera on the end) is passed through the patient's mouth and throat, then through the stomach and into the first part of the small intestine (duodenum). A narrow plastic tube (catheter) is then inserted through the endoscope and into the bile ducts and/or pancreatic duct. Contrast dye is injected through the catheter, and X-rays are taken to visualize the ducts.
ERCP can be used to diagnose a variety of conditions affecting the bile ducts and pancreas, including gallstones, tumors, strictures (narrowing of the ducts), and chronic pancreatitis. It can also be used to treat certain conditions, such as removing gallstones from the bile duct or placing stents to keep the ducts open in cases of stricture.
ERCP is an invasive procedure that carries a risk of complications, including pancreatitis, infection, bleeding, and perforation (a tear in the lining of the GI tract). It should only be performed by experienced medical professionals in a hospital setting.
Extrahepatic bile ducts refer to the portion of the biliary system that lies outside the liver. The biliary system is responsible for producing, storing, and transporting bile, a digestive fluid produced by the liver.
The extrahepatic bile ducts include:
1. The common hepatic duct: This duct is formed by the union of the right and left hepatic ducts, which drain bile from the corresponding lobes of the liver.
2. The cystic duct: This short duct connects the gallbladder to the common hepatic duct, allowing bile to flow into the gallbladder for storage and concentration.
3. The common bile duct: This is the result of the fusion of the common hepatic duct and the cystic duct. It transports bile from the liver and gallbladder to the duodenum, the first part of the small intestine, where it aids in fat digestion.
4. The ampulla of Vater (or hepatopancreatic ampulla): This is a dilated area where the common bile duct and the pancreatic duct join and empty their contents into the duodenum through a shared opening called the major duodenal papilla.
Extrahepatic bile ducts can be affected by various conditions, such as gallstones, inflammation (cholangitis), strictures, or tumors, which may require medical or surgical intervention.
Biliary atresia is a rare, progressive liver disease in infants and children, characterized by the inflammation, fibrosis, and obstruction of the bile ducts. This results in the impaired flow of bile from the liver to the intestine, leading to cholestasis (accumulation of bile in the liver), jaundice (yellowing of the skin and eyes), and eventually liver cirrhosis and failure if left untreated.
The exact cause of biliary atresia is not known, but it is believed to be a combination of genetic and environmental factors. It can occur as an isolated condition or in association with other congenital anomalies. The diagnosis of biliary atresia is typically made through imaging studies, such as ultrasound and cholangiography, and confirmed by liver biopsy.
The standard treatment for biliary atresia is a surgical procedure called the Kasai portoenterostomy, which aims to restore bile flow from the liver to the intestine. In this procedure, the damaged bile ducts are removed and replaced with a loop of intestine that is connected directly to the liver. The success of the Kasai procedure depends on several factors, including the age at diagnosis and surgery, the extent of liver damage, and the skill and experience of the surgeon.
Despite successful Kasai surgery, many children with biliary atresia will eventually develop cirrhosis and require liver transplantation. The prognosis for children with biliary atresia has improved significantly over the past few decades due to earlier diagnosis, advances in surgical techniques, and better postoperative care. However, it remains a challenging condition that requires close monitoring and multidisciplinary management by pediatric hepatologists, surgeons, and other healthcare professionals.
Adenomyoma is a benign (non-cancerous) growth that occurs when the glands and muscle tissue from the lining of the uterus (endometrium) become embedded in the muscular wall of the uterus (myometrium). This condition most commonly affects women in their 40s and 50s, and it can cause symptoms such as heavy menstrual bleeding, painful periods, and pelvic pain or discomfort.
The term "adenomyoma" is derived from two words: "adeno," which means gland, and "myoma," which refers to a benign muscle tumor. Therefore, an adenomyoma can be thought of as a benign growth that contains both glandular tissue and muscle tissue.
Adenomyomas are typically found in the lower part of the uterus, near the cervix, and they can vary in size from small nodules to larger masses. In some cases, adenomyomas may cause no symptoms at all, while in other cases, they can lead to significant discomfort and pain.
The exact cause of adenomyoma is not fully understood, but it is thought to be related to hormonal factors, as well as trauma or injury to the uterus. Treatment options for adenomyoma may include medication to manage symptoms, such as pain relievers or hormone therapy, or surgical intervention, such as a hysterectomy (removal of the uterus).
Pathologic dilatation refers to an abnormal and excessive widening or enlargement of a body cavity or organ, which can result from various medical conditions. This abnormal dilation can occur in different parts of the body, including the blood vessels, digestive tract, airways, or heart chambers.
In the context of the cardiovascular system, pathologic dilatation may indicate a weakening or thinning of the heart muscle, leading to an enlarged chamber that can no longer pump blood efficiently. This condition is often associated with various heart diseases, such as cardiomyopathy, valvular heart disease, or long-standing high blood pressure.
In the gastrointestinal tract, pathologic dilatation may occur due to mechanical obstruction, neuromuscular disorders, or inflammatory conditions that affect the normal motility of the intestines. Examples include megacolon in Hirschsprung's disease, toxic megacolon in ulcerative colitis, or volvulus (twisting) of the bowel.
Pathologic dilatation can lead to various complications, such as reduced organ function, impaired circulation, and increased risk of infection or perforation. Treatment depends on the underlying cause and may involve medications, surgery, or other interventions to address the root problem and prevent further enlargement.
The pancreatic ducts are a set of tubular structures within the pancreas that play a crucial role in the digestive system. The main pancreatic duct, also known as the duct of Wirsung, is responsible for transporting pancreatic enzymes and bicarbonate-rich fluid from the pancreas to the duodenum, which is the first part of the small intestine.
The exocrine portion of the pancreas contains numerous smaller ducts called interlobular ducts and intralobular ducts that merge and ultimately join the main pancreatic duct. This system ensures that the digestive enzymes and fluids produced by the pancreas are effectively delivered to the small intestine, where they aid in the breakdown and absorption of nutrients from food.
In addition to the main pancreatic duct, there is an accessory pancreatic duct, also known as Santorini's duct, which can sometimes join the common bile duct before emptying into the duodenum through a shared opening called the ampulla of Vater. However, in most individuals, the accessory pancreatic duct usually drains into the main pancreatic duct before entering the duodenum.
Cyst fluid refers to the fluid accumulated within a cyst, which is a closed sac-like or capsular structure, typically filled with liquid or semi-solid material. Cysts can develop in various parts of the body for different reasons, and the composition of cyst fluid may vary depending on the type of cyst and its location.
In some cases, cyst fluid might contain proteins, sugars, hormones, or even cells from the surrounding tissue. Infected cysts may have pus-like fluid, while cancerous or precancerous cysts might contain abnormal cells or tumor markers. The analysis of cyst fluid can help medical professionals diagnose and manage various medical conditions, including infections, inflammatory diseases, genetic disorders, and cancers.
It is important to note that the term 'cyst fluid' generally refers to the liquid content within a cyst, but the specific composition and appearance of this fluid may vary significantly depending on the underlying cause and type of cyst.
Biliary tract diseases refer to a group of medical conditions that affect the biliary system, which includes the gallbladder, bile ducts, and liver. Bile is a digestive juice produced by the liver, stored in the gallbladder, and released into the small intestine through the bile ducts to help digest fats.
Biliary tract diseases can cause various symptoms such as abdominal pain, jaundice, fever, nausea, vomiting, and changes in stool color. Some of the common biliary tract diseases include:
1. Gallstones: Small, hard deposits that form in the gallbladder or bile ducts made up of cholesterol or bilirubin.
2. Cholecystitis: Inflammation of the gallbladder, often caused by gallstones.
3. Cholangitis: Infection or inflammation of the bile ducts.
4. Biliary dyskinesia: A motility disorder that affects the contraction and relaxation of the muscles in the biliary system.
5. Primary sclerosing cholangitis: A chronic autoimmune disease that causes scarring and narrowing of the bile ducts.
6. Biliary tract cancer: Rare cancers that affect the gallbladder, bile ducts, or liver.
Treatment for biliary tract diseases varies depending on the specific condition and severity but may include medications, surgery, or a combination of both.
The biliary tract is a system of ducts that transport bile from the liver to the gallbladder and then to the small intestine. Bile is a digestive fluid produced by the liver that helps in the breakdown and absorption of fats in the small intestine. The main components of the biliary tract are:
1. Intrahepatic bile ducts: These are the smaller branches of bile ducts located within the liver that collect bile from the liver cells or hepatocytes.
2. Gallbladder: A small pear-shaped organ located beneath the liver, which stores and concentrates bile received from the intrahepatic bile ducts. The gallbladder releases bile into the small intestine when food is ingested, particularly fats, to aid digestion.
3. Common hepatic duct: This is a duct that forms by the union of the right and left hepatic ducts, which carry bile from the right and left lobes of the liver, respectively.
4. Cystic duct: A short duct that connects the gallbladder to the common hepatic duct, forming the beginning of the common bile duct.
5. Common bile duct: This is a larger duct formed by the union of the common hepatic duct and the cystic duct. It carries bile from the liver and gallbladder into the small intestine.
6. Pancreatic duct: A separate duct that originates from the pancreas, a gland located near the liver and stomach. The pancreatic duct joins the common bile duct just before they both enter the duodenum, the first part of the small intestine.
7. Ampulla of Vater: This is the dilated portion where the common bile duct and the pancreatic duct join together and empty their contents into the duodenum through a shared opening called the papilla of Vater.
Disorders related to the biliary tract include gallstones, cholecystitis (inflammation of the gallbladder), bile duct stones, bile duct strictures or obstructions, and primary sclerosing cholangitis, among others.
Pancreatic diseases refer to a group of medical conditions that affect the structure and function of the pancreas, a vital organ located in the abdomen. The pancreas has two main functions: an exocrine function, which involves the production of digestive enzymes that help break down food in the small intestine, and an endocrine function, which involves the production of hormones such as insulin and glucagon that regulate blood sugar levels.
Pancreatic diseases can be broadly classified into two categories: inflammatory and non-inflammatory. Inflammatory pancreatic diseases include conditions such as acute pancreatitis, which is characterized by sudden inflammation of the pancreas, and chronic pancreatitis, which is a long-term inflammation that can lead to scarring and loss of function.
Non-inflammatory pancreatic diseases include conditions such as pancreatic cancer, which is a malignant tumor that can arise from the cells of the pancreas, and benign tumors such as cysts or adenomas. Other non-inflammatory conditions include pancreatic insufficiency, which can occur when the pancreas does not produce enough digestive enzymes, and diabetes mellitus, which can result from impaired insulin production or action.
Overall, pancreatic diseases can have serious consequences on a person's health and quality of life, and early diagnosis and treatment are essential for optimal outcomes.
Lymphangitis is a medical condition characterized by the inflammation and infection of the lymphatic vessels, which are the tubular structures that transport lymph fluid from various tissues to the bloodstream. This condition typically occurs as a complication of a bacterial or fungal skin infection that spreads to the nearby lymphatic vessels.
The inflammation in lymphangitis can cause symptoms such as red streaks along the affected lymphatic vessels, swelling, warmth, and pain. Fever, chills, and fatigue may also accompany these localized symptoms. In severe cases, lymphangitis can lead to more widespread infection, sepsis, or abscess formation if left untreated.
The diagnosis of lymphangitis typically involves a physical examination and laboratory tests such as blood cultures or skin lesion cultures to identify the causative organism. Treatment usually consists of antibiotics or antifungal medications to eradicate the infection, along with supportive care such as warm compresses, elevation, and pain management. In some cases, surgical intervention may be necessary to drain any abscesses that have formed.
Technetium Tc 99m Disofenin is not a medical condition, but rather a radiopharmaceutical used in diagnostic imaging. It is a radioactive tracer used in nuclear medicine scans, specifically for liver and biliary system imaging. The compound consists of the radioisotope Technetium-99m (Tc-99m) bonded to the pharmaceutical Disofenin.
The Tc-99m is a gamma emitter with a half-life of 6 hours, making it ideal for diagnostic imaging. When administered to the patient, the compound is taken up by the liver and excreted into the bile ducts and gallbladder, allowing medical professionals to visualize these structures using a gamma camera. This can help detect various conditions such as tumors, gallstones, or obstructions in the biliary system.
It's important to note that Technetium Tc 99m Disofenin is used diagnostically and not for therapeutic purposes. The radiation exposure from this compound is generally low and considered safe for diagnostic use. However, as with any medical procedure involving radiation, the benefits and risks should be carefully weighed and discussed with a healthcare professional.
A biliary fistula is an abnormal connection or passage between the biliary system (which includes the gallbladder, bile ducts, and liver) and another organ or structure, usually in the abdominal cavity. This connection allows bile, which is a digestive fluid produced by the liver, to leak out of its normal pathway and into other areas of the body.
Biliary fistulas can occur as a result of trauma, surgery, infection, or inflammation in the biliary system. Symptoms may include abdominal pain, fever, jaundice (yellowing of the skin and eyes), nausea, vomiting, and clay-colored stools. Treatment typically involves addressing the underlying cause of the fistula, such as draining an infection or repairing damaged tissue, and diverting bile flow away from the site of the leak. In some cases, surgery may be necessary to repair the fistula.
Bile ducts are tubular structures that carry bile from the liver to the gallbladder for storage or directly to the small intestine to aid in digestion. There are two types of bile ducts: intrahepatic and extrahepatic. Intrahepatic bile ducts are located within the liver and drain bile from liver cells, while extrahepatic bile ducts are outside the liver and include the common hepatic duct, cystic duct, and common bile duct. These ducts can become obstructed or inflamed, leading to various medical conditions such as cholestasis, cholecystitis, and gallstones.
The gallbladder is a small, pear-shaped organ located just under the liver in the right upper quadrant of the abdomen. Its primary function is to store and concentrate bile, a digestive enzyme produced by the liver, which helps in the breakdown of fats during the digestion process. When food, particularly fatty foods, enter the stomach and small intestine, the gallbladder contracts and releases bile through the common bile duct into the duodenum, the first part of the small intestine, to aid in fat digestion.
The gallbladder is made up of three main parts: the fundus, body, and neck. It has a muscular wall that allows it to contract and release bile. Gallstones, an inflammation of the gallbladder (cholecystitis), or other gallbladder diseases can cause pain, discomfort, and potentially serious health complications if left untreated.
A hepatic portoenterostomy, also known as Kasai procedure, is a surgical operation performed on infants with extrahepatic biliary atresia. This condition is characterized by the absence or abnormal formation of the bile ducts that carry bile from the liver to the small intestine, leading to obstruction and damage to the liver.
During a hepatic portoenterostomy, the surgeon creates an anastomosis (connection) between the portal vein, which brings blood to the liver, and a loop of intestine. This connection allows bile to flow directly from the liver into the intestine, bypassing the blocked or absent bile ducts. The goal of the procedure is to restore bile flow and prevent further damage to the liver.
The success of the procedure varies, but it can help improve the child's quality of life and delay or prevent the need for a liver transplant in some cases. However, many children with biliary atresia will eventually require a liver transplant as the disease progresses.
An enterostomy is a surgical procedure that creates an opening from the intestine to the abdominal wall, which allows for the elimination of waste from the body. This opening is called a stoma and can be temporary or permanent, depending on the individual's medical condition. There are several types of enterostomies, including colostomy, ileostomy, and jejunostomy, which differ based on the specific location in the intestine where the stoma is created.
The purpose of an enterostomy may vary, but it is often performed to divert the flow of waste away from a diseased or damaged section of the intestine, allowing it to heal. Common reasons for an enterostomy include inflammatory bowel disease, cancer, trauma, and birth defects.
After the surgery, patients will need to wear a pouching system over the stoma to collect waste. They will also require specialized care and education on how to manage their stoma and maintain their overall health. With proper care and support, individuals with an enterostomy can lead active and fulfilling lives.
An ovarian cyst is a sac or pouch filled with fluid that forms on the ovary. Ovarian cysts are quite common in women during their childbearing years, and they often cause no symptoms. In most cases, ovarian cysts disappear without treatment over a few months. However, larger or persistent cysts may require medical intervention, including surgical removal.
There are various types of ovarian cysts, such as functional cysts (follicular and corpus luteum cysts), which develop during the menstrual cycle due to hormonal changes, and non-functional cysts (dermoid cysts, endometriomas, and cystadenomas), which can form due to different causes.
While many ovarian cysts are benign, some may have malignant potential or indicate an underlying medical condition like polycystic ovary syndrome (PCOS). Regular gynecological check-ups, including pelvic examinations and ultrasounds, can help detect and monitor ovarian cysts.
Common bile duct neoplasms refer to abnormal growths that can occur in the common bile duct, which is a tube that carries bile from the liver and gallbladder into the small intestine. These growths can be benign or malignant (cancerous).
Benign neoplasms of the common bile duct include papillomas, adenomas, and leiomyomas. Malignant neoplasms are typically adenocarcinomas, which arise from the glandular cells lining the duct. Other types of malignancies that can affect the common bile duct include cholangiocarcinoma, gallbladder carcinoma, and metastatic cancer from other sites.
Symptoms of common bile duct neoplasms may include jaundice (yellowing of the skin and eyes), abdominal pain, dark urine, and light-colored stools. Diagnosis may involve imaging tests such as CT scans or MRCP (magnetic resonance cholangiopancreatography) and biopsy to confirm the type of neoplasm. Treatment options depend on the type and stage of the neoplasm and may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.
Bile duct neoplasms, also known as cholangiocarcinomas, refer to a group of malignancies that arise from the bile ducts. These are the tubes that carry bile from the liver to the gallbladder and small intestine. Bile duct neoplasms can be further classified based on their location as intrahepatic (within the liver), perihilar (at the junction of the left and right hepatic ducts), or distal (in the common bile duct).
These tumors are relatively rare, but their incidence has been increasing in recent years. They can cause a variety of symptoms, including jaundice, abdominal pain, weight loss, and fever. The diagnosis of bile duct neoplasms typically involves imaging studies such as CT or MRI scans, as well as blood tests to assess liver function. In some cases, a biopsy may be necessary to confirm the diagnosis.
Treatment options for bile duct neoplasms depend on several factors, including the location and stage of the tumor, as well as the patient's overall health. Surgical resection is the preferred treatment for early-stage tumors, while chemotherapy and radiation therapy may be used in more advanced cases. For patients who are not candidates for surgery, palliative treatments such as stenting or bypass procedures may be recommended to relieve symptoms and improve quality of life.
An epidermal cyst is a common benign skin condition characterized by the growth of a sac-like structure filled with keratin, a protein found in the outermost layer of the skin (epidermis). These cysts typically appear as round, firm bumps just under the surface of the skin, often on the face, neck, trunk, or scalp. They can vary in size from a few millimeters to several centimeters in diameter.
Epidermal cysts usually develop as a result of the accumulation of dead skin cells that become trapped within a hair follicle or a pilosebaceous unit (a structure that contains a hair follicle and an oil gland). The keratin produced by the skin cells then collects inside the sac, causing it to expand gradually.
These cysts are generally slow-growing, painless, and rarely cause any symptoms. However, they may become infected or inflamed, leading to redness, tenderness, pain, or pus formation. In such cases, medical attention might be necessary to drain the cyst or administer antibiotics to treat the infection.
Epidermal cysts can be removed surgically if they cause cosmetic concerns or become frequently infected. The procedure typically involves making an incision in the skin and removing the entire sac along with its contents to prevent recurrence.
Pancreaticojejunostomy is a surgical procedure that involves connecting the pancreas to a portion of the small intestine called the jejunum. This connection is typically created after the head of the pancreas has been removed, as in the case of a pancreaticoduodenectomy (or "Whipple") procedure. The purpose of this anastomosis is to allow digestive enzymes from the pancreas to flow into the small intestine, where they can aid in the digestion of food.
The connection between the pancreas and jejunum can be created using several different techniques, including a hand-sewn anastomosis or a stapled anastomosis. The choice of technique may depend on various factors, such as the patient's individual anatomy, the surgeon's preference, and the reason for the surgery.
Pancreaticojejunostomy is a complex surgical procedure that requires significant skill and expertise to perform. It carries risks such as leakage of pancreatic enzymes into the abdominal cavity, which can lead to serious complications such as infection, bleeding, or even organ failure. As such, it is typically performed by experienced surgeons in specialized medical centers.
Chronic pancreatitis is a long-standing inflammation of the pancreas that leads to irreversible structural changes and impaired function of the pancreas. It is characterized by recurrent or persistent abdominal pain, often radiating to the back, and maldigestion with steatorrhea (fatty stools) due to exocrine insufficiency. The pancreatic damage results from repeated episodes of acute pancreatitis, alcohol abuse, genetic predisposition, or autoimmune processes. Over time, the pancreas may lose its ability to produce enough digestive enzymes and hormones like insulin, which can result in diabetes mellitus. Chronic pancreatitis also increases the risk of developing pancreatic cancer.
Pancreatic juice is an alkaline fluid secreted by the exocrine component of the pancreas, primarily containing digestive enzymes such as amylase, lipase, and trypsin. These enzymes aid in the breakdown of carbohydrates, fats, and proteins, respectively, in the small intestine during the digestion process. The bicarbonate ions present in pancreatic juice help neutralize the acidic chyme that enters the duodenum from the stomach, creating an optimal environment for enzymatic activity.
Biliary tract neoplasms refer to abnormal growths or tumors that develop in the biliary system, which includes the gallbladder, bile ducts inside and outside the liver, and the ducts that connect the liver to the small intestine. These neoplasms can be benign (non-cancerous) or malignant (cancerous).
Malignant biliary tract neoplasms are often referred to as cholangiocarcinoma if they originate in the bile ducts, or gallbladder cancer if they arise in the gallbladder. These cancers are relatively rare but can be aggressive and difficult to treat. They can cause symptoms such as jaundice (yellowing of the skin and eyes), abdominal pain, weight loss, and dark urine.
Risk factors for biliary tract neoplasms include chronic inflammation of the biliary system, primary sclerosing cholangitis, liver cirrhosis, hepatitis B or C infection, parasitic infections, and certain genetic conditions. Early detection and treatment can improve outcomes for patients with these neoplasms.
Spontaneous rupture in medical terms refers to the sudden breaking or tearing of an organ, tissue, or structure within the body without any identifiable trauma or injury. This event can occur due to various reasons such as weakening of the tissue over time because of disease or degeneration, or excessive pressure on the tissue.
For instance, a spontaneous rupture of the appendix is called an "appendiceal rupture," which can lead to peritonitis, a serious inflammation of the abdominal cavity. Similarly, a spontaneous rupture of a blood vessel, like an aortic aneurysm, can result in life-threatening internal bleeding.
Spontaneous ruptures are often medical emergencies and require immediate medical attention for proper diagnosis and treatment.