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51.
Rui Ito Asami Yoshida Kazuaki Taguchi Yuki Enoki Yuta Yokoyama Kazuaki Matsumoto 《Journal of infection and chemotherapy》2019,25(12):972-978
Ceftriaxone (CTRX) forms salts with calcium (Ca) in the gall bladder and bile duct, and induces the formation of gallstones. In this study, factors of CTRX-induced gallstone formation were extracted from the results of a retrospective survey using the Japanese Adverse Drug Event Report (JADER), and the causal relationship between the factors and gallstone formation was investigated. From JADER, 136 patients who developed ‘gallstone-related disorder’ with CTRX as a suspected drug were extracted. The incidence of gallstone-induced adverse effects was high in patients treated with CTRX at a dose exceeding the normal daily dose and in children younger than 10 years old, suggesting that CTRX at a high level is a factor for gallstone formation. Thus, after mixing CTRX and Ca2+ at different concentrations under different pH condition, the number of particles in the solutions was measured using a Coulter counter. As a result, the number of minute particles significantly increased at all pH values when Ca2+ and CTRX were mixed at a concentration of 10 mEq/L or higher and 1.5 g/L or higher, respectively. At pH 6.5 or 7.0, visible crystals were detected when 25 mEq/L of Ca2+ and 2.0 g/L of CTRX were mixed. Based on these findings, attention should be sufficiently paid to the development of ‘gallstone-related disorder’ in pediatric patients and in patients treated with CTRX at a dose exceeding the normal dose. Furthermore, gallstone formation and growth may be promoted when CTRX and Ca2+ coexist at high concentrations under low pH conditions. 相似文献
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熊友仙 《实用中医内科杂志》2009,23(3)
[目的]观察行气活血通腑汤治疗慢性肠黏连性肠梗阻的临床疗效。[方法]运用行气活血通腑汤治疗疗效分析。[结果]治愈19例(82.61%),有效3例(13.04%),无效1例(4.35%),总有效率95.65%。[结论]行气活血通腑汤治疗慢性肠黏连性肠梗阻疗效满意。 相似文献
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胆囊结石伴急性胆源性胰腺炎的腹腔镜胆囊切除术 总被引:5,自引:0,他引:5
目的探讨胆囊结石伴急性胆源性胰腺炎(acute biliary pancreatitis,ABP)实施腹腔镜胆囊切除术(laparoscopiccholecystectomy,LC)的可行性及手术时机。方法1999年1月~2007年8月,行LC治疗72例胆囊结石伴ABP。56例经非手术治疗胰腺炎缓解后早期(≤2周)行LC,8例延期(1~3个月)行LC,8例非手术治疗效果不佳而急诊行LC。结果72例LC均获成功。手术时间30~135min,平均63min。术中出血量20~230ml,平均50ml。术中胆道造影5例,均成功。造影发现4例胆总管下段结石,术后行逆行性胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)联合内镜下十二指肠括约肌切开术(endoscopic sphincterotomy,EST)取石成功。中转开腹1例,无围手术期死亡,无术后出血及胆漏并发症。2例术后4d急性胰腺炎复发,保守治愈。72例随访2个月~8年,平均19个月,无胰腺炎、胆总管结石复发。结论对胆囊结石伴急性胆源性胰腺炎患者,如能慎重选择病例,做好必要的围手术处理,早期实... 相似文献
58.
Mandeep Kumar Garg Ram Prakash Galwa Deepak Goyal N. Khandelwal 《Journal of gastrointestinal surgery》2009,13(4):821-823
Introduction Gallstone ileus is a life-threatening surgical emergency where characteristic imaging can be diagnostic. Jejunum is the one
of the rare sites of gallstone impaction.
Materials and Methods We hereby emphasize the role of multidetector computed tomography (MDCT) by describing a case of jejunal gallstone ileus with
cholecystoduodenal fistula in a 59-year-old lady who presented with symptoms and signs of proximal small bowel obstruction.
Conclusion MDCT of the abdomen established the diagnosis, and the patient managed surgically. 相似文献
59.
We present the case of a recurrent gallstone ileus in a 76-year old female patient, which presented at our emergency department on January 15th 2015. In both episodes (January 16th and February 1st, 2015), only a simple enterotomy with stone extraction was performed. One year later, she is fully recovered and in good health. Recurrent gallstone ileus most often occurs in elderly patients with multiple co-morbidities. In our aging population, its prevalence is expected to increase. Because of the vague, intermittent symptoms, diagnosis of gallstone ileus is often delayed, contributing to its high mortality rate. CT-scan has become the preferred diagnostic imaging modality. Treatment should be individualized, with stone removal by enterotomy alone being the most commonly used strategy. For symptomatic patients, a two-stage procedure with urgent enterotomy followed by a delayed cholecystectomy can be considered. The one-stage procedure, in which enterotomy is combined with cholecystectomy and fistula closure, should be reserved for those few patients with minimal cholecystitis and in good overall condition. 相似文献
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目的:探讨腹腔镜联合经肛肠梗阻导管在左半结直肠肿瘤急性梗阻中的治疗价值。方法:将126例左半结直肠肿瘤急性梗阻病例随机分为2组,治疗组应用经肛肠梗阻导管行梗阻近段结肠减压、灌洗等治疗后,行腹腔镜手术并一期切除吻合;对照组按常规准备后手术治疗。结果:术后吻合口瘘发生率治疗组(1.6%)低于对照组(11.1%),治疗组住院时间、总住院费用和术后第7 d血清白蛋白水平与对照组比较有显著性差异(P<0.01)。结论:腹腔镜联合肠梗阻导管置入冲洗减压,在左半结直肠肿瘤急性梗阻中的应用安全、有效。 相似文献