cholelithiasis is a common disease, usually young and otherwise healthy individuals. Risk factors include obesity, diabetes, female sex, pregnancy, family, weight loss fast protein liquid diet, and racial or ethnic origin. The typical symptoms of right upper side abdominal pain, nausea, vomiting, flatulence and occur within 15-90 minutes to eat, especially a high fat meal are usually suspected gallstones. Ultrasonography of the gallbladder is the first testordered and the presence or absence of gallstones is confirmed. If a calculation then surgical removal of the gallbladder confirmed recommended.

However, if ultrasound is negative or normal, and still suspected gallbladder disease called biliary scintography or a nuclear test is often called a HIDA scan ordered. The basis of this test is that a radioactive chemical is administered intravenously to the liver where bile is concentrated before being released stored in the gallbladder between meals. When the gallbladder is sick, can not be empty to scan blocking or not, as expected, when a hormone called cholecystokinin are seen (CCK) is administered intravenously. CCK is released in the body and with meals to stimulate the emptying of the gallbladder bile into the intestine for digestion. Typically, the third empty gallbladder or more of its volume, if, during a CCK HIDA scan, but usually no more than 70-80% is specified. The> Fraction of the volume of gallbladder emptying fraction as defined as expulsion. A low ejection fraction is typical of a diseased gallbladder. Reproduce the typical pain of gallbladder disease and low ejection fraction are considered diagnostic of gallbladder disease in the absence of gallstones and results in a recommendation that the gallbladder be surgically removed.

An unusual phenomenon was observed in some celiac patients. GallbladderType of abdominal pain without gallstones and a "paranormal gallbladder fraction" of expulsion. Gallbladder surgery so relieves the pain and the disease has found a gall bladder. Imaging studies in the literature that shed light on this phenomenon have been reported, although its importance has been largely missed by the medical community.

Several sonographic findings have been reported in celiac disease, especially in European literature. Colli et al. are in Italy, found elevated fastingVolume of the gallbladder with ultrasound in untreated celiac patients and Mariciani et al. al. in Great Britain found increased quantities and an increase in gallbladder gallbladder ejection fraction by MRI. Low concentrations of CCK in celiac patients (Deprez et al, 2002, were reported Rehfeld 2004). This doctor has a number of celiac patients, high gallbladder ejection fraction (typically> 90%), along with classic symptoms, which was dissolved after surgery gallbladder gallbladder.chronic gallbladder disease was confirmed histologically.

gallbladder disease and should be examined pain in CD patients, despite normal ultrasound and Hida test, especially if a "supernormal ejection fraction" was the remark quoted by CCK. Patients with abnormally high ejection fraction gallbladder was possible undiagnosed celiac disease should be considered and blood tests for celiac disease and consideration of upper endoscopy with small bowel subjectedBiopsy.

Before Fraquelli M, Colli A, Colucci A, Bardella MT, Trovato C; Pometta R, Pagliarulo M, Conte D. Accuracy of ultrasonography in predicting celiac disease. Arch Intern Med 2004; 164 (2) :169-74.

According Marciani L, Coleman NS, Dunlop SP, Singh G, Marsden CA, Holmes GK, Spiller RC, Gowland PA. Gallbladder contraction, gastric emptying and antral motility: single visit assessment of upper GI function in untreated celiac disease using echo-planar MRI. J Magn Reson Imaging. 2005;22 (5) :634-8.

Third Deprez P; Sempoux C, Van Beers BE, Jouret A, Robert A, Rahier J Geubel A, Pauwels S, Mainguet P. Persistent decreased plasma cholecystokinin in celiac patients on gluten-free diet: the respective roles of histological changes and nutrient hydrolysis. Regul PEPT. 2002, 110 (1) :55-63

Fourth Rehfeld JF. Clinical Endocrinology and Metabolism. Cholecystokinin. Best pract Res Clin Endocrinol Metab. 2004, 18 (4) :569-86.

Thanks To : Student Loan Digital Frame Insurance, Auto Insurance Car Supermarket West Midlands University Of Toledo Pharmacy School Herniated Disk L4 L5

This entry was posted on Saturday, May 8th, 2010 at 9:20 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.