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Acute Cholecystitis Caused by Clonorchis Sinensis: Sonographic Findings
Ultrasound in Med. & Biol., Vol. 39, No. 5S, pp. S1–S96, 2013 Copyright Ó 2013 World Federation for Ultrasound in Medicine & Biology Printed in the USA. All rights reserved 0301-5629/$ - see front matter
Scientific Papers
radiofrequency ablation of intrahepatic cholangiocarcinoma occurs one case. Importance of the Conclusions: Laparoscopic ultrasonography is helpful in choosing an appropriate treatment protocols.
1 - Abdomen Ultrasound PA.01.001 Acute Cholecystitis Caused by Clonorchis Sinensis: Sonographic Findings C. Tana, P. D’Alessandro, F. Santilli, M. Tana, A. Mezzetti, C. Schiavone Departmental Unit of Internistic Ultrasound, ‘‘G. D’Annunzio’’ University, Chieti, Italy
PA.01.003
Brief Description of the Purpose of the Report: The aim of our report is to describe the typical ultrasonographic features of gallbladder infestation by Clonorchis sinensis. Medical History: A 34 year-old-man, recently returned from China, was hospitalized for fever, jaundice and epigastralgia. He reported an ingestion of "Yusheng", a Chinese raw fish salad. Objectively, he had fever and positive Murphy’s sign. Laboratory workout documented an increase of inflammatory and cholestasis markers. Ultrasound showed a distended gallbladder with thickened walls and lumen occupied by stratified material compatible with biliary sludge. In the dependent portion of the gallbladder, a flocculent, nonshadowing and floating group of echos was appreciated. It changed in position in reaction to a light blow with the transducer. Diagnosis: The sonographic aspects were consistent with previous reports of gallbladder infections by Clonorchis sinensis [1]. The report was confirmed by a stool examination, positive for Clonorchis sinensis. After treatment with mebendazole, the patient became asymptomatic. Discussion and Summary of the Case: The gallbladder involvement by parasites is unusual, but should be considered in the differential diagnosis in the presence of a suggestive history and typical sonographic features. Early medical treatment is associated with a rapid clinical improvement, thus avoiding any surgical approach. References 1. Lim JH et al. Am J Roentgenol. 2007;188(6):1596-603. Reference: 1. Lim JH et al. Am J Roentgenol. 2007;188(6):1596-603.
Brief Description of the Purpose of the Study: His aim of this study was to assess the size distribution and the outcome of US follow-up of GB polyps. Methods: US reports from patients examined with abdominal US in our department from January 2008 to the end of December 2009 were reviewed with a view to including all patients with GB polyps. Patients with GB polyps are routinely recommended a 2-year follow-up with US every six months. Main Results: A total of 203 patients with GB polyps were included; 89 (44%) men and 114 (56%) women. The mean polyp size was 5 mm (range 2-40 mm). In 143 patients (70%) the GB polyp diameter was less than 6 mm. The first US follow-up was performed in 120 patients (59%), and only 31 (15%) completed the full 2-year US follow-up programme. Polyp size was stable in 100 patients, decreased in five patients, increased in eight and resolved in 15 patients. A total of 13 patients (6%) underwent cholecystectomy. Of the 203 patients, none showed neoplastic or malignant GB polyps. Importance of the Conclusions: We recommend that follow-up US of patients with GB polyps , 6 mm is avoided. Alternatively, the intervals between US follow-up of GB polyps , 6 mm may be extended.
Polyp Leasions Less Than 6 mm in Gallbladder - Is Follow Up Necessary M. R. Pedersen, C. Dam, C. E. Stovgaard, S. R. Rafaelsen Vejle Hospital SLB. Denmark
PA.01.004 Dual Measurement of Liver and Spleen Stiffness for Non-Invasive Diagnosis of Liver Fibrosis Using ARFI H. Tanaka, J. Nishimura, M. Yoshida, S. Nishiguchi, H. Iijima Hyogo College of Medicine, Nishinomiya, Japan
PA.01.002 Use of Laparoscopic Ultrasonography in Surgical Procedures of Hepatobiliary and Pancreatic Diseases C. H. Xiao Kunming First People’s Hospital
Brief Description of the Purpose of the Study: While spleen stiffness measurement (SSM) is not easily assessed by Fibroscan, SSM could be easily quantified by Acoustic Radiation Force Impulse Imaging (ARFI) because it can conduct the assessment by referring to the B-mode without restriction in the measurement distance. However, some cases of SSM for the prediction of the liver fibrosis stage are different with that of liver stiffness measurement (LSM). The aim of this study was to evaluate the significance of the dual measurement methods of LSM and SSM by ARFI for diagnosis of liver fibrosis. Methods: Of the 803 patients with chronic liver disease confirmed by liver biopsy and evaluated by ARFI for obtaining LSM in our center, 261 patients who were obtained both LSM and SSM were included in this study. Main Results: AUROC of SSM for distinguishing cirrhosis was 0.927 and the highest in all parameters (LSM 0.905; hyaluronic acid 0.866; platelet, 0.808). There were 10 F0-3 chronic hepatitis patients above the LC cutoff level both in LSM and SSM. When 3 sever obesity
Brief Description of the Purpose of the Study: To explore the applied value of laparoscopic ultrasonography in surgical procedures of hepatobiliary and pancreatic disease. Methods: The examination results of laparoscopic ultrasonography in surgery of 43 cases with hepatobiliary and pancreatic diseases were retrospectively analyzed. Main Results: It is found that among 34 cases of patients with cholecystetomy, patients with oledocholithiasis occur 4 cases and 2 lesions which are not displayed through preoperative imaging examination are detected in liver. Leading windowing decompression of liver cyst is four cases, and guiding resection of cholecyst preservation of gallbladder adenomas is one case, resection of insulinoma occurs one case and S1
Scientific Papers
radiofrequency ablation of intrahepatic cholangiocarcinoma occurs one case. Importance of the Conclusions: Laparoscopic ultrasonography is helpful in choosing an appropriate treatment protocols.
1 - Abdomen Ultrasound PA.01.001 Acute Cholecystitis Caused by Clonorchis Sinensis: Sonographic Findings C. Tana, P. D’Alessandro, F. Santilli, M. Tana, A. Mezzetti, C. Schiavone Departmental Unit of Internistic Ultrasound, ‘‘G. D’Annunzio’’ University, Chieti, Italy
PA.01.003
Brief Description of the Purpose of the Report: The aim of our report is to describe the typical ultrasonographic features of gallbladder infestation by Clonorchis sinensis. Medical History: A 34 year-old-man, recently returned from China, was hospitalized for fever, jaundice and epigastralgia. He reported an ingestion of "Yusheng", a Chinese raw fish salad. Objectively, he had fever and positive Murphy’s sign. Laboratory workout documented an increase of inflammatory and cholestasis markers. Ultrasound showed a distended gallbladder with thickened walls and lumen occupied by stratified material compatible with biliary sludge. In the dependent portion of the gallbladder, a flocculent, nonshadowing and floating group of echos was appreciated. It changed in position in reaction to a light blow with the transducer. Diagnosis: The sonographic aspects were consistent with previous reports of gallbladder infections by Clonorchis sinensis [1]. The report was confirmed by a stool examination, positive for Clonorchis sinensis. After treatment with mebendazole, the patient became asymptomatic. Discussion and Summary of the Case: The gallbladder involvement by parasites is unusual, but should be considered in the differential diagnosis in the presence of a suggestive history and typical sonographic features. Early medical treatment is associated with a rapid clinical improvement, thus avoiding any surgical approach. References 1. Lim JH et al. Am J Roentgenol. 2007;188(6):1596-603. Reference: 1. Lim JH et al. Am J Roentgenol. 2007;188(6):1596-603.
Brief Description of the Purpose of the Study: His aim of this study was to assess the size distribution and the outcome of US follow-up of GB polyps. Methods: US reports from patients examined with abdominal US in our department from January 2008 to the end of December 2009 were reviewed with a view to including all patients with GB polyps. Patients with GB polyps are routinely recommended a 2-year follow-up with US every six months. Main Results: A total of 203 patients with GB polyps were included; 89 (44%) men and 114 (56%) women. The mean polyp size was 5 mm (range 2-40 mm). In 143 patients (70%) the GB polyp diameter was less than 6 mm. The first US follow-up was performed in 120 patients (59%), and only 31 (15%) completed the full 2-year US follow-up programme. Polyp size was stable in 100 patients, decreased in five patients, increased in eight and resolved in 15 patients. A total of 13 patients (6%) underwent cholecystectomy. Of the 203 patients, none showed neoplastic or malignant GB polyps. Importance of the Conclusions: We recommend that follow-up US of patients with GB polyps , 6 mm is avoided. Alternatively, the intervals between US follow-up of GB polyps , 6 mm may be extended.
Polyp Leasions Less Than 6 mm in Gallbladder - Is Follow Up Necessary M. R. Pedersen, C. Dam, C. E. Stovgaard, S. R. Rafaelsen Vejle Hospital SLB. Denmark
PA.01.004 Dual Measurement of Liver and Spleen Stiffness for Non-Invasive Diagnosis of Liver Fibrosis Using ARFI H. Tanaka, J. Nishimura, M. Yoshida, S. Nishiguchi, H. Iijima Hyogo College of Medicine, Nishinomiya, Japan
PA.01.002 Use of Laparoscopic Ultrasonography in Surgical Procedures of Hepatobiliary and Pancreatic Diseases C. H. Xiao Kunming First People’s Hospital
Brief Description of the Purpose of the Study: While spleen stiffness measurement (SSM) is not easily assessed by Fibroscan, SSM could be easily quantified by Acoustic Radiation Force Impulse Imaging (ARFI) because it can conduct the assessment by referring to the B-mode without restriction in the measurement distance. However, some cases of SSM for the prediction of the liver fibrosis stage are different with that of liver stiffness measurement (LSM). The aim of this study was to evaluate the significance of the dual measurement methods of LSM and SSM by ARFI for diagnosis of liver fibrosis. Methods: Of the 803 patients with chronic liver disease confirmed by liver biopsy and evaluated by ARFI for obtaining LSM in our center, 261 patients who were obtained both LSM and SSM were included in this study. Main Results: AUROC of SSM for distinguishing cirrhosis was 0.927 and the highest in all parameters (LSM 0.905; hyaluronic acid 0.866; platelet, 0.808). There were 10 F0-3 chronic hepatitis patients above the LC cutoff level both in LSM and SSM. When 3 sever obesity
Brief Description of the Purpose of the Study: To explore the applied value of laparoscopic ultrasonography in surgical procedures of hepatobiliary and pancreatic disease. Methods: The examination results of laparoscopic ultrasonography in surgery of 43 cases with hepatobiliary and pancreatic diseases were retrospectively analyzed. Main Results: It is found that among 34 cases of patients with cholecystetomy, patients with oledocholithiasis occur 4 cases and 2 lesions which are not displayed through preoperative imaging examination are detected in liver. Leading windowing decompression of liver cyst is four cases, and guiding resection of cholecyst preservation of gallbladder adenomas is one case, resection of insulinoma occurs one case and S1