exudates and Gallstones

Coronavirus disease 2019 (COVID-19) is a highly contagious, severe acute respiratory syndrome that poses significant health risks to healthcare providers. A delicate balance is needed between timely intervention for ill patients without apparent COVID-19 infection and the safety of healthcare personnel who provide essential treatment in the midst of the pandemic. We report our experience managing a 70-year-old man who presented with acute gallstone pancreatitis at our hospital during the COVID-19 outbreak in Malaysia. We also describe the safety protocol measures that have been implemented in our institution to protect the healthcare personnel from this disease during endoscopic retrograde cholangiopancreatography. This case illustrates the importance of meticulous planning, risk assessment, effective team communication and strict adherence to recommendations when providing treatment during an unprecedented pandemic.

Topics: Acute Disease; Aged; Cholangiopancreatography, Endoscopic Retrograde; Comorbidity; COVID-19; Gallstones; Humans; Malaysia; Male; Pancreatitis; Pandemics; SARS-CoV-2

An audit of 1122 cholecystectomies for a 6-year period from 2000 to 2005 was done to review cases of primary carcinoma of gallbladder. There were nine cases of primary carcinoma of gallbladder. Six were females and 3 males. Their ages ranged from 27 to 81 years. Pre-operatively, only 2 (11.1%) were clinically suspected of carcinoma while 3 were diagnosed as cholecystitis, two as cholelithiasis and one case each of ovarian cyst and intestinal obstruction. Intra-operatively, an additional four cases were suspected as gallbladder carcinoma with the remaining three cases diagnosed as only having gallstones. Altogether only 5 (55.6%) cases were associated with gallstones. Six (66.67%) cases of gallbladder carcinoma had abnormal macroscopical lesions noted; either papillary lesions or polypoid masses. The remaining 3 cases had thickening of the wall, consistent with chronic cholecystitis. Seven cases were found histologically to be adenocarcinoma. Of these, two were papillary carcinoma and one signet ring cell type adenocarcinoma. One case of squamous cell carcinoma and one case of adenosquamous carcinoma were noted. This study highlights the importance of careful macroscopical and microscopical evaluation of a routine pathological examination of gallbladder removed for cholecystitis or cholelithiasis. It provides the incidence of gallbladder carcinoma in patients who underwent cholecystectomies in a government hospital in Johor, Malaysia.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma; Cholecystectomy; Cholecystitis; Diagnosis, Differential; Female; Gallbladder Neoplasms; Gallstones; Humans; Malaysia; Male; Middle Aged; Retrospective Studies

Topics: Animals; Ascariasis; Ascaris lumbricoides; Endemic Diseases; Female; Gallstones; Humans; Malaysia; Mass Screening; Middle Aged; Sphincterotomy, Endoscopic

Topics: Adult; Aged; Aged, 80 and over; Animals; Ascariasis; Ascaris lumbricoides; Cholangitis; Cholelithiasis; Female; Gallstones; Humans; Malaysia; Male; Middle Aged; Rural Health