This condition tends to occur in patients in intensive care units and in those whose oral intake is poor (eg, because of total iy alimentation). Symptoms are minimal. Unexplained lever and vague abdominal distress warrant ultrasound examination of the gallbladder, which may show edemaof the gallbladder wall and increasing distention on successive examinations. Either cholecystectomy [...]
A sinus tract between the rectum and the skin. Fistulas form for several reasons. The most common follow inflammation in rectal crypts or glands, progressing to perirectal abscesses that track internally into the rectum and externally to the skin. Other diseases (eg. Crohn’s disease, tuberculosis, and lymphogranuloma) may involve the rectum and cause fistulas. Intraperitoneal [...]
Patients present with symptoms and signs similar to those of acute cholecystitis, except that the pain is more likely to be epigastric and is associated with elevated serum amylase levels and often with increased bilirubin and alkaline phosphatase levels. Initial treatment is conservative with the patient taking nothing by mouth and receiving IV alimentation. Typically, [...]
