Category Archives: Hepatobiliary Surgery

Main Clinical Manifestations of Chronic Cholecystitis

Chronic cholecystitis denotes persistent, low-grade inflammation of the gall-bladder wall, usually in the setting of recurrent mechanical irritation by gallstones or, less commonly, chronic infection or metabolic deposition. Symptoms are episodic and less dramatic than those of acute cholecystitis, but they may culminate in fibrosis, loss of function, or acute exacerbation. Recurrent biliary colicEpisodic, post-prandial right-upper-quadrant or epigastric pain lasting 15–60 min, often precipitated by fatty foods and radiating to the inter-scapular region or right shoulder. Pain is typically self-limiting but becomes more frequent over time. Dyspeptic syndromeEarly satiety, eructation, bloating, and nausea reflect impaired gall-bladder emptying and coexist with... Learn more

Related articles：

  1. Main Clinical Manifestations of Acute Cholecystitis
  2. Main Clinical Manifestations of Hepatic Hydatid Disease
  3. Main Clinical Manifestations of Extrahepatic Bile-Duct Stones
  4. Main Clinical Manifestations of Cholangitis
  5. Main Clinical Manifestations of Bile-Duct Stones
  6. Main Clinical Manifestations of Biliary Tract Diseases

Main Clinical Manifestations of Acute Cholecystitis

Acute cholecystitis is acute inflammation of the gall-bladder wall, initiated most often by cystic-duct obstruction with secondary bacterial infection. The clinical picture evolves over hours, and recognition of its characteristic features guides early imaging, antibiotic therapy, and timely surgical intervention. Right-upper-quadrain painPersistent, often severe pain begins beneath the costal margin, may radiate to the right scapula or inter-scapular region, and is exacerbated by deep inspiration or movement. Pain typically lasts > 6 h and is unrelenting. Murphy signInspiratory arrest elicited by palpation of the right upper quadrant during deep inspiration is a reliable physical finding; a positive Murphy sign has... Learn more

Related articles：

  1. Main Clinical Manifestations of Chronic Cholecystitis
  2. Main Clinical Manifestations of Extrahepatic Bile-Duct Stones
  3. Main Clinical Manifestations of Hepatic Hydatid Disease
  4. Main Clinical Manifestations of Hepatic Abscess
  5. Main Clinical Manifestations of Hepatic Ascites
  6. Main Clinical Manifestations of Lithiasis

Main Clinical Manifestations of Portal Vein Thrombosis

Portal vein thrombosis (PVT) is the partial or complete occlusion of the portal venous system by thrombus. Presentation is determined by the tempo of obstruction (acute vs. chronic), the extent of mesenteric involvement, and the presence of underlying cirrhosis or malignancy. Symptoms range from incidental imaging findings to life-threatening intestinal ischemia. Abdominal painColicky or constant upper-abdominal discomfort is the commonest early feature, reported in up to 90 % of acute cases. Pain may be non-specific, but when disproportionate to physical signs it heralds mesenteric vein extension and impending bowel infarction . Fever and systemic inflammatory responseLow-grade pyrexia, rigors, and elevated... Learn more

Related articles：

  1. Main Clinical Manifestations of Hepatic Ascites
  2. Main Clinical Manifestations of Hilar Cholangiocarcinoma
  3. Main Clinical Manifestations of Cholangitis
  4. Main Clinical Manifestations of Biliary Tract Tumours
  5. Main Clinical Manifestations of Acute Cholecystitis
  6. Main Clinical Manifestations of Chronic Cholecystitis

Main Clinical Manifestations of Biliary Tract Tumours

Biliary tract tumours comprise neoplasms of the gall-bladder, cystic duct, extra-hepatic bile ducts, and intra-hepatic bile ducts. Most are malignant (gall-bladder carcinoma, cholangiocarcinoma) and present late; benign lesions are rare and usually detected incidentally. Symptom patterns reflect anatomical location, growth morphology, and degree of biliary obstruction. Painless obstructive jaundiceProgressive conjugated hyper-bilirubinaemia with scleral icterus, dark urine, and acholic stools is the hallmark of hilar or distal cholangiocarcinoma and of advanced gall-bladder carcinoma. Pruritus is often intense and may precede visible icterus. Right-upper-quadrain painA constant dull ache or vague heaviness is typical of gall-bladder cancer; intermittent colicky pain suggests concomitant cholelithiasis... Learn more

Related articles：

  1. Main Clinical Manifestations of Biliary Tract Diseases
  2. Main Clinical Manifestations of Congenital Biliary Malformations
  3. Main Clinical Manifestations of Hilar Cholangiocarcinoma
  4. Main Clinical Manifestations of Hepatic Ascites
  5. Main Clinical Manifestations of Acute Cholecystitis
  6. Main Clinical Manifestations of Chronic Cholecystitis

Main Clinical Manifestations of Congenital Biliary Malformations

Congenital biliary malformations encompass a spectrum of structural defects in the extra- and intrahepatic bile ducts. The phenotypic expression is determined by the embryologic stage at which development is arrested and by the subsequent impairment of bile flow. Three cardinal symptom complexes dominate the clinical picture: cholestatic jaundice, recurrent cholangitis, and secondary hepatic dysfunction. Cholestatic JaundiceConjugated hyperbilirubinemia is the earliest and most consistent finding. In neonates it is usually recognized after the physiological jaundice window (>2 weeks of life) and is marked by progressive acholic stools and dark urine reflecting absent intra-intestinal bilirubin. In older children jaundice may fluctuate, often... Learn more

Related articles：

  1. Main Clinical Manifestations of Biliary Tract Diseases
  2. Main Clinical Manifestations of Biliary Tract Tumours
  3. Main Clinical Manifestations of Hepatic Hydatid Disease
  4. Main Clinical Manifestations of Hilar Cholangiocarcinoma
  5. Main Clinical Manifestations of Cholangitis
  6. Main Clinical Manifestations of Chronic Cholecystitis