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Postcholecystectomy syndrome (PCS) describes the presence of abdominal symptoms after a cholecystectomy (gallbladder removal). Symptoms occur in about 5 to 40 percent of patients who undergo cholecystectomy, [1] and can be transient, persistent or lifelong. [2] [3] The chronic condition is diagnosed in approximately 10% of postcholecystectomy ...
Biliary sludge has been associated with pregnancy, rapid weight loss, total parenteral nutrition, drugs such as ceftriaxone and octreotide, solid organ transplantation, and gastric surgery. [1] [2] In many of these conditions, it is thought that the impairment in the contractility of the gallbladder leads to the formation of the sludge. [2]
Biliary microlithiasis refers to the creation of small gallstones less than 3 mm in diameter in the biliary duct or gallbladder. It has been suggested [1] as a cause of postcholecystectomy syndrome, or PCS, the symptoms of which include: Upset stomach, nausea, and vomiting. Gas, bloating, and diarrhea. Persistent pain in the upper right abdomen ...
Patients with cholelithiasis typically present with pain in the right-upper quadrant of the abdomen with the associated symptoms of nausea and vomiting, especially after a fatty meal. The physician can confirm the diagnosis of cholelithiasis with an abdominal ultrasound that shows the ultrasonic shadows of the stones in the gallbladder.
It shows a gallbladder wall that is almost pathologically thickened, at 3 mm. However, there is no apparent edema in the pericholecystic fat. The gallbladder contains biliary sludge, as well as gallstones, which create acoustic shadowing. There is thus gallstones without current cholecystitis.
The presence of gallstones, usually visualized by ultrasound, generally necessitates a surgical treatment (removal of the gall bladder, typically via laparoscopy). [ 27 ] Removal of the gallbladder with surgery, known as a cholecystectomy , is the definitive surgical treatment for biliary colic.
[2] [3] Ceftriaxone has been frequently associated with biliary sludge or biliary pseudolithiasis in subsequent reports. [3] Ceftriaxone is excreted primarily through the urine , but also through the bile, up to 40% of its excretion, with concentrations in the bile 20-150 times higher than in the serum.
A Sonographic Murphy sign is a finding when performing diagnostic medical sonography.It is different from the Murphy sign found on physical examination, but both signs are associated with cholecystitis [1] When the sonographer presses directly over the gallbladder, and the patient expresses pain, more than when the sonographer presses anywhere else, this is said to be a positive sonographic ...