Hilary Hertan

Bile leak after laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is commonly performed as the treatment of choice for symptomatic gallstone diseases. Bile leak is a potential complication of this procedure and the cystic duct stump is the most common site of leakage. Early diagnosis and treatment of bile leak is crucial in decreasing the morbidity and mortality related to this complication. Endoscopic retrograde cholangiopancreatography with stent placement and/or sphincterotomy is highly effective in the diagnosis and treatment of this problem.

Giant true diverticulum of sigmoid colon

A case of giant true diverticulum of the sigmoid colon, manifesting as pain and abdominal mass is presented. The patient is asymptomatic after resection of the diverticulum and end-to-end anastomosis of the colon.

Isolated intrahepatic biliary dilatation in a patient with acquired immune deficiency syndrome (AIDS): AIDS cholangiopathy versus incidental unilobar Caroli's disease.

We describe a case of possible monolobar Carolis disease in a patient with acquired immune deficiency syndrome (AIDS) who presented with features of cholangitis. Diagnostic workup, which included endoscopic retrograde cholangiography, revealed focal intrahepatic biliary dilatation confined to the right lobe. The patient subsequently underwent right hepatic lobectomy. Pathology revealed multiple cysts filled with calculi and inflammation in the cyst walls. Special stain results for fungi and acid-fast organisms were negative. The presence of advanced AIDS in this patient raised the possibility of this being a possible manifestation of AIDS cholangiopathy.

Laboratory Parameters May Help Predict In-Hospital Mortality After Percutaneous Endoscopic Gastrostomy (PEG)

Laboratory Parameters May Help Predict In-Hospital Mortality After Percutaneous Endoscopic Gastrostomy (PEG) Uma Kantamneni, Ajit Kokkat, Mario Ricci, Hatef Massoumi, Edward Norkus, Nejat Kiyici, Hilary Hertan Background: Although PEG has been touted as a safe procedure, given the seriously ill population the procedure is performed on,mortality prior to discharge is not uncommon. Aim: To identify laboratory parameters predicting the inhospital mortality after PEG. Methods: A retrospective chart review was conducted of 96 patients undergoing PEG in a university teaching hospital over six months. Multiple factors were studied in patients who were discharged and those who died in the hospital. Results were obtained using student t-tests and logistic regression. Results: The study group had 40 men and 56 women, and average age was 82 + 13. Five out of ninety-six (5.21%) patients died in the hospital after PEG prior to discharge. Conclusion: Laboratory studies should guide patient selection for PEG and the above-mentioned factors may predict inhospital mortality after PEG.

Is melanosis coli a red flag|[quest]|

Purpose: To determine the possible association between melanosis coli and colorectal neoplasia.