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Rotter A, Granat N, Koslowsky B, Bdolah-Abram T, Schwartz AD, Alpert EA. The association between sonographic common bile duct dilatation and outcomes in emergency department patients with cholangitis. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1264-1269. [PMID: 37462670 DOI: 10.1002/jcu.23526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/11/2023] [Accepted: 07/08/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND The presentation of the patient with acute cholangitis (AC) ranges from mild illness to life-threatening shock. Therefore, prompt diagnosis and treatment are critical. Abdominal ultrasound (US) is the imaging of choice to locate bile duct dilatation. Other modalities include abdominal computed tomography (CT) or endoscopic retrograde cholangiopancreatography (ERCP). OBJECTIVES To determine whether sonographic common bile duct dilatation in emergency department (ED) patients with AC predicts outcomes including sepsis, hospital length of stay (LOS), admission to the intensive care unit (ICU), time to ERCP, and mortality. METHODS Electronic medical records of all patients hospitalized in a tertiary care medical center between July 2012-February 2021 with a discharge diagnosis of cholangitis were assessed. Patients were dichotomously classified as CBD dilated or CBD non-dilated based on ultrasound. Dilation was defined as CBD larger than 6 mm in patients younger than 60 or larger than 6 mm + 1 mm per decade in patients over 60. RESULTS The study included 271 patients- 172 with CBD dilation versus 99 without. Mean LOS was 9.92 days for those with a dilated CBD versus 13.4 days without. The mean time to ERCP was 4.26 days for those with a dilated CBD versus 6.56 days without. Sepsis, mortality, and ICU admission were scarce and there was no statistically significant difference between the cohorts. CONCLUSION Patients with a dilated CBD per the abdominal US performed during the patient's ED stay, underwent ERCP earlier, and were hospitalized fewer days than patients without CBD dilation.
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Affiliation(s)
- Ayelet Rotter
- Department of Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Nadav Granat
- Department of Emergency Medicine, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Benjamin Koslowsky
- Digestive Diseases Institute, Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tali Bdolah-Abram
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Alon D Schwartz
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Evan Avraham Alpert
- Department of Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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2
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Findings of cholangitis in a kidney transplant patient with Caroli disease on FDG PET/CT and MRI. Radiol Case Rep 2023; 18:1700-1704. [PMID: 36895893 PMCID: PMC9989281 DOI: 10.1016/j.radcr.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 03/03/2023] Open
Abstract
Caroli disease is a rare congenital disorder of segmental cystic dilatations of the intrahepatic biliary ducts that maintain communication with the rest of the biliary tree. Its typical clinical presentation is recurrent episodes of cholangitis. The diagnosis is usually made using abdominal imaging modalities. We present a patient with Caroli disease showing atypical presentation of acute cholangitis with ambiguous labs and initial negative imaging findings, which was later diagnosed by [18F]-fluorodeoxyglucose positron emission tomography/computed tomography and confirmed by magnetic resonance imaging and tissue pathology. The use of such imaging modalities in moments of doubt or clinical suspicion provide the patient with accurate diagnosis, proper management, and better clinical outcome, thus obviating the need for further invasive investigations.
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Sandomenico F, Sanduzzi L, La Verde E, Vicenzo E, Pirolo L, Maione S, Setola FR, Macchia V, Dello Iacono U, Barbato D, Peluso G, Santangelo M, Brunetti A. Multidetector Computed Tomography (MDCT) Findings of Complications of Acute Cholecystitis. A Pictorial Essay. Tomography 2022; 8:1159-1171. [PMID: 35448729 PMCID: PMC9025054 DOI: 10.3390/tomography8020095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 12/19/2022] Open
Abstract
Acute cholecystitis stands out as one of the most common surgical pathologies that should always be considered in a right-upper abdominal pain emergency. For this, the importance of a correct diagnosis is well described. However, it has been demonstrated that the simple combination of clinical (pain, Murphy’s sign) and laboratory (leukocytosis) parameters alone does not provide for ruling in or ruling out the diagnosis of this condition, unless accompanied by a radiological exam. For a long time, and still today, ultrasonography (US) is by far the first-to-proceed radiologic exam to perform, thanks to its rapidity and very high sensibility and specificity for the diagnosis of simple acute cholecystitis. However, acute cholecystitis can undergo some complications that US struggles to find. In addition to that, studies suggest that multidetector computed tomography (MDCT) is superior in showing complicated forms of cholecystitis in relation to sensibility and specificity and for its capability of reformatting multiplanar (MPR) reconstructions that give a more detailed view of complications. They have shown to be useful for a precise evaluation of vascular complications, the anatomy of the biliary tree, and the extension of inflammation to surrounding structures (i.e., colitis). Therefore, based also on our experience, in patients with atypical presentation, or in cases with high suspicion for a complicated form, a MDCT abdomen scan is performed. In this review, the principal findings are listed and described to create a CT classification of acute complications based on anatomical and topographic criteria.
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Affiliation(s)
- Fabio Sandomenico
- Radiology Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy; (E.V.); (L.P.); (S.M.); (F.R.S.); (V.M.); (U.D.I.)
- Correspondence: ; Tel.: +39-0815981470 or +39-3356368805
| | - Luca Sanduzzi
- Diagnostic Imaging and Radiotherapy Department, Azienda Ospedaliera Universitaria “Federico II”, 80131 Naples, Italy; (L.S.); (E.L.V.); (A.B.)
| | - Emilia La Verde
- Diagnostic Imaging and Radiotherapy Department, Azienda Ospedaliera Universitaria “Federico II”, 80131 Naples, Italy; (L.S.); (E.L.V.); (A.B.)
| | - Emilio Vicenzo
- Radiology Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy; (E.V.); (L.P.); (S.M.); (F.R.S.); (V.M.); (U.D.I.)
| | - Luigi Pirolo
- Radiology Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy; (E.V.); (L.P.); (S.M.); (F.R.S.); (V.M.); (U.D.I.)
| | - Salvatore Maione
- Radiology Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy; (E.V.); (L.P.); (S.M.); (F.R.S.); (V.M.); (U.D.I.)
| | - Francesca Rosa Setola
- Radiology Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy; (E.V.); (L.P.); (S.M.); (F.R.S.); (V.M.); (U.D.I.)
| | - Valeria Macchia
- Radiology Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy; (E.V.); (L.P.); (S.M.); (F.R.S.); (V.M.); (U.D.I.)
| | - Umberto Dello Iacono
- Radiology Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy; (E.V.); (L.P.); (S.M.); (F.R.S.); (V.M.); (U.D.I.)
| | - Domenico Barbato
- Surgery Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy; (D.B.); (G.P.); (M.S.)
| | - Gaia Peluso
- Surgery Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy; (D.B.); (G.P.); (M.S.)
| | - Michele Santangelo
- Surgery Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy; (D.B.); (G.P.); (M.S.)
| | - Arturo Brunetti
- Diagnostic Imaging and Radiotherapy Department, Azienda Ospedaliera Universitaria “Federico II”, 80131 Naples, Italy; (L.S.); (E.L.V.); (A.B.)
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4
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See T. Acute biliary interventions. Clin Radiol 2020; 75:398.e9-398.e18. [DOI: 10.1016/j.crad.2019.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/13/2019] [Indexed: 02/06/2023]
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Ko A, Lee ES, Park HJ, Park SB, Kim HS, Choi BI. Added value of 2D shear wave imaging of the gallbladder bed of the liver for acute cholecystitis. Ultrasonography 2020; 39:384-393. [PMID: 32962334 PMCID: PMC7515659 DOI: 10.14366/usg.19060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/23/2020] [Indexed: 12/07/2022] Open
Abstract
Purpose The purpose of this study was to evaluate whether shear wave elastography (SWE) and the shear wave dispersion slope (SWD) obtained from 2-dimensional shear wave imaging (2D-SWI) of the gallbladder (GB) bed of the liver could be helpful in the diagnosis of acute cholecystitis. Methods We included 44 patients referred for abdominal ultrasonography (US) under the impression of acute cholecystitis from April 2018 to March 2019. Patients with chronic liver disease were excluded from this study. In addition to routine upper abdominal US, we performed 2D-SWI including liver stiffness measurements by SWE and SWD, which reflects tissue viscosity. 2D-SWI was performed at the GB bed of the liver through the right intercostal approach at least 3 times with different frames. We assessed typical US findings and the added value of 2D-SWI in diagnosing acute cholecystitis. Histopathologic results of surgical specimens were used as the standard of reference. If a surgical specimen was unavailable, a bile fluid test or clinical follow-up for more than 3 months served as the reference standard. Results The optimal cutoff values for SWE and SWD were 8 kPa and 10.9 (m/sec)/kHz, respectively. In the univariate analysis, SWE, GB distension, and sludge were predictive factors of acute cholecystitis. In the multivariate analysis, categorized SWE was the only significant predictor (P<0.01). By using 2D-SWI, the diagnostic performance of two readers did not significantly increase, although the inter-reader agreement improved (k=0.654-0.778). Conclusion 2D-SWI of the GB bed of the liver could be helpful for diagnosing acute cholecystitis.
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Affiliation(s)
- Ara Ko
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Eun Sun Lee
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyun Jeong Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hee Sung Kim
- Department of Pathology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Byung Ihn Choi
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
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Kiriyama S, Kozaka K, Takada T, Strasberg SM, Pitt HA, Gabata T, Hata J, Liau KH, Miura F, Horiguchi A, Liu KH, Su CH, Wada K, Jagannath P, Itoi T, Gouma DJ, Mori Y, Mukai S, Giménez ME, Huang WSW, Kim MH, Okamoto K, Belli G, Dervenis C, Chan ACW, Lau WY, Endo I, Gomi H, Yoshida M, Mayumi T, Baron TH, de Santibañes E, Teoh AYB, Hwang TL, Ker CG, Chen MF, Han HS, Yoon YS, Choi IS, Yoon DS, Higuchi R, Kitano S, Inomata M, Deziel DJ, Jonas E, Hirata K, Sumiyama Y, Inui K, Yamamoto M. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos). JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2018; 25:17-30. [PMID: 29032610 DOI: 10.1002/jhbp.512] [Citation(s) in RCA: 335] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Although the diagnostic and severity grading criteria on the 2013 Tokyo Guidelines (TG13) are used worldwide as the primary standard for management of acute cholangitis (AC), they need to be validated through implementation and assessment in actual clinical practice. Here, we conduct a systematic review of the literature to validate the TG13 diagnostic and severity grading criteria for AC and propose TG18 criteria. While there is little evidence evaluating the TG13 criteria, they were validated through a large-scale case series study in Japan and Taiwan. Analyzing big data from this study confirmed that the diagnostic rate of AC based on the TG13 diagnostic criteria was higher than that based on the TG07 criteria, and that 30-day mortality in patients with a higher severity based on the TG13 severity grading criteria was significantly higher. Furthermore, a comparison of patients treated with early or urgent biliary drainage versus patients not treated this way showed no difference in 30-day mortality among patients with Grade I or Grade III AC, but significantly lower 30-day mortality in patients with Grade II AC who were treated with early or urgent biliary drainage. This suggests that the TG13 severity grading criteria can be used to identify Grade II patients whose prognoses may be improved through biliary drainage. The TG13 severity grading criteria may therefore be useful as an indicator for biliary drainage as well as a predictive factor when assessing the patient's prognosis. The TG13 diagnostic and severity grading criteria for AC can provide results quickly, are minimally invasive for the patients, and are inexpensive. We recommend that the TG13 criteria be adopted in the TG18 guidelines and used as standard practice in the clinical setting. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.
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Affiliation(s)
- Seiki Kiriyama
- Department of Gastroenterology, Ogaki Municipal Hospital, Gifu, Japan
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Tadahiro Takada
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Steven M Strasberg
- Section of Hepato-Pancreato-Biliary Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Henry A Pitt
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | | | - Jiro Hata
- Department of Endoscopy and Ultrasound, Kawasaki Medical School, Okayama, Japan
| | - Kui-Hin Liau
- Mt Elizabeth Novena Hospital Singapore and Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Fumihiko Miura
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Akihiko Horiguchi
- Department of Gastroenterological Surgery, Fujita Health University School of Medicine, Aichi, Japan
| | - Keng-Hao Liu
- Division of General Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Cheng-Hsi Su
- Department of Surgery, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Keita Wada
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Palepu Jagannath
- Department of Surgical Oncology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Takao Itoi
- Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Tokyo, Japan
| | - Dirk J Gouma
- Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Yasuhisa Mori
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shuntaro Mukai
- Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Tokyo, Japan
| | - Mariano Eduardo Giménez
- General Surgery and Minimal Invasive Surgery "Taquini", University of Buenos Aires, Buenos Aires, Argentina.,DAICIM Foundation, Buenos Aires, Argentina
| | | | - Myung-Hwan Kim
- Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea
| | - Kohji Okamoto
- Department of Surgery, Center for Gastroenterology and Liver Disease, Kitakyushu City Yahata Hospital, Fukuoka, Japan
| | - Giulio Belli
- Department of General and HPB Surgery, Loreto Nuovo Hospital, Naples, Italy
| | | | - Angus C W Chan
- Surgery Centre, Department of Surgery, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong
| | - Wan Yee Lau
- Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Harumi Gomi
- Center for Global Health, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan
| | - Masahiro Yoshida
- Department of Hemodialysis and Surgery, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan.,Department of EBM and Guidelines, Japan Council for Quality Health Care, Tokyo, Japan
| | - Toshihiko Mayumi
- Department of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Todd H Baron
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eduardo de Santibañes
- Department of Surgery, Hospital Italiano, University of Buenos Aires, Buenos Aires, Argentina
| | | | - Tsann-Long Hwang
- Division of General Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chen-Guo Ker
- Department of Surgery, Yuan's General Hospital, Kaohsiung, Taiwan
| | - Miin-Fu Chen
- Division of General Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ho-Seong Han
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo-Seok Yoon
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - In-Seok Choi
- Department of Surgery, Konyang University Hospital, Daejeon, Korea
| | - Dong-Sup Yoon
- Department of Surgery, Yonsei University Gangnam Severance Hospital, Seoul, Korea
| | - Ryota Higuchi
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Masafumi Inomata
- Department of Gastroenterolgical and Pediatric Surgery, Oita University, Faculty of Medicine, Oita, Japan
| | - Daniel J Deziel
- Department of Surgery, Rush University Medical Center, Chicago, USA
| | - Eduard Jonas
- Surgical Gastroenterology /Hepatopancreatobiliary Unit, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Koichi Hirata
- Department of Surgery, JR Sapporo Hospital, Hokkaido, Japan
| | | | - Kazuo Inui
- Department of Gastroenterology, Second Teaching Hospital, Fujita Health University, Aichi, Japan
| | - Masakazu Yamamoto
- Department of Surgery, Yonsei University Gangnam Severance Hospital, Seoul, Korea
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Ely R, Long B, Koyfman A. The Emergency Medicine−Focused Review of Cholangitis. J Emerg Med 2018; 54:64-72. [DOI: 10.1016/j.jemermed.2017.06.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 06/10/2017] [Accepted: 06/29/2017] [Indexed: 02/07/2023]
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8
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Tomizawa M, Shinozaki F, Hasegawa R, Shirai Y, Motoyoshi Y, Sugiyama T, Yamamoto S, Ishige N. Comparison of acute cholangitis with or without common bile duct dilatation. Exp Ther Med 2017; 13:3497-3502. [PMID: 28587432 DOI: 10.3892/etm.2017.4401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 02/17/2017] [Indexed: 12/24/2022] Open
Abstract
To improve the management of patients with acute cholangitis, the present study compared laboratory test variables between acute cholangitis patients with or without common bile duct (CBD) dilatation [CBDdil(+) and CBDdil(-), respectively]. The medical records of patients diagnosed with acute cholangitis and subjected to endoscopic retrograde cholangiopancreatography between February 2008 and May 2015 were retrospectively analyzed. The present study consisted of 40 men (aged 69.4±8.8 years) and 37 women (aged 68.8±11.6 years). It was observed that CBDdil(-) patients were slightly younger than CBDdil(+) patients (P=0.0976), and levels of C-reactive protein (CRP) were significantly higher in CBDdil(-) patients than in CBDdil(+) patients (P=0.0392). In addition, logistic regression analysis indicated that CRP levels were associated with the presence of CBD dilatation (P=0.0392). These data indicate that patients with acute cholangitis without CBD dilatation tend to be younger and have higher levels of CRP. Thus, in acute cholangitis patients without CBD dilatation, diagnosis should be determined using clinical symptoms and laboratory data.
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Affiliation(s)
- Minoru Tomizawa
- Department of Gastroenterology, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Fuminobu Shinozaki
- Department of Radiology, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Rumiko Hasegawa
- Department of Surgery, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Yoshinori Shirai
- Department of Surgery, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Yasufumi Motoyoshi
- Department of Neurology, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Takao Sugiyama
- Department of Rheumatology, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Shigenori Yamamoto
- Department of Pediatrics, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Naoki Ishige
- Department of Neurosurgery, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
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Kim HS, Lee CM, Ko BS, Park SH, Jung W, Kim MC, Ko YG. Association Between Extrahepatic Duct Diameter on Abdominal Computed Tomography and Severity Classified Using Tokyo Guidelines 2013 in Elderly Patients With Cholangitis. Ann Geriatr Med Res 2016. [DOI: 10.4235/agmr.2016.20.4.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Hyeon Song Kim
- Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Emergency Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Chang Min Lee
- Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Emergency Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Byuk Sung Ko
- Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sung Hyuk Park
- Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Emergency Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Woong Jung
- Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Emergency Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Myung Chun Kim
- Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Emergency Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Young Gwan Ko
- Department of Emergency Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
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Sugishita T, Higuchi R, Morita S, Ota T, Yamamoto M. Diagnostic accuracy of transient hepatic attenuation differences on computed tomography scans for acute cholangitis in patients with malignant disease. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2014; 21:669-75. [DOI: 10.1002/jhbp.112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Toshiya Sugishita
- Department of Surgery; Institute of Gastroenterology; Tokyo Women's Medical University; 8-1 Kawada-cho Shinjuku-ku Tokyo 162-8666 Japan
| | - Ryota Higuchi
- Department of Surgery; Institute of Gastroenterology; Tokyo Women's Medical University; 8-1 Kawada-cho Shinjuku-ku Tokyo 162-8666 Japan
| | - Satoru Morita
- Department of Surgery; Institute of Gastroenterology; Tokyo Women's Medical University; 8-1 Kawada-cho Shinjuku-ku Tokyo 162-8666 Japan
| | - Takehiro Ota
- Department of Surgery; Institute of Gastroenterology; Tokyo Women's Medical University; 8-1 Kawada-cho Shinjuku-ku Tokyo 162-8666 Japan
| | - Masakazu Yamamoto
- Department of Surgery; Institute of Gastroenterology; Tokyo Women's Medical University; 8-1 Kawada-cho Shinjuku-ku Tokyo 162-8666 Japan
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11
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Akaike G, Ishiyama M, Suzuki S, Fujita Y, Ohde S, Saida Y. Significance of peribiliary oedema on computed tomography in diagnosis and severity assessment of acute cholangitis. Eur J Radiol 2013; 82:e429-33. [DOI: 10.1016/j.ejrad.2013.04.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 04/24/2013] [Accepted: 04/26/2013] [Indexed: 12/21/2022]
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