Thursday, December 18, 2008

Primary Choledocholithiasis-MRCP



"Up to 85% of CBD stones are secondary from GB. Primary CBD stones are caused by conditions leading to bile stasis and chronic bactibilia. Up to 90% of patients with brown pigment CBD stones have bile culture results positive for bacteria. Primary duct stones are usually brown pigment stones. Brown stones differ from black pigment stones by having a higher content of cholesterol . In Western population Biliary stasis is secondary to factors such as sphincter of Oddi dysfunction, benign biliary strictures, sclerosing cholangitis, and cystic dilatation of the bile ducts. Bile stasis promotes growth of bacteria, which produce phospholipase A1, thus releasing fatty acids from biliary phospholipids. The duct epithelium and/or bacteria (eg, Escherichia coli) produce beta-glucuronidase in amounts sufficient to deconjugate bilirubin diglucuronide. The presence of free fatty acids, deconjugated bilirubin, and bile acids leads to the formation of insoluble calcium bilirubinate particles. With the loss of bile acids, cholesterol becomes insoluble, resulting in the formation of biliary sludge. The sludge also contains mucin and bacterial cytoskeletons, which further aid in stone formation. In Asian populations, infestation with A lumbricoides and C sinensis may promote stasis by either blocking the biliary ducts or by damaging the duct walls, resulting in stricture formation. Bactibilia is also common in these instances, probably secondary to episodic portal bacteremia. Some authors have suggested that the stones are formed because of the bactibilia alone and that the parasites' presence is just a coincidence. "
Case By Dr MGK Murthy, Sr Consultant Radiologist

4 comments:

products said...

China Wholesale has been described as the world’s factory. This phenomenom is typified by the rise ofbusiness. Incredible range of products available with China Wholesalers “Low Price and High Quality” not only reaches directly to their target clients worldwide but also ensures that wholesale from china from China means margins you cannot find elsewhere and buy products wholesaleChina Wholesale will skyroket your profits.wedding dressescheap naruto cosplayanime cosplay

products said...

Women’s nike tn Shox Rivalry est le modèle féminin le plus tendance de baskets pour le sport. tn chaussuresConcernant la semelle :spyder jacketsCheap Brand Jeans Shop - True Religion Jeans nike shoes & Puma Shoes Online- tn nike,Diesel Jeans le caoutchouc extérieur, l’EVA intermédiaire Levis Jeanset le textile intérieur s’associent pour attribuer à la.ed hardy shirts pretty fitCharlestoncheap columbia jackets. turned a pair of double plays to do the trick.Lacoste Polo Shirts, puma basket, Burberry Polo Shirts.wholesale Lacoste polo shirts and cheap polo shirtswith great price.Thank you so much!!cheap polo shirts men'ssweate,gillette mach3 razor bladesfor men.As for Cheap Evisu JeansCheap Armani Jeanspolo shirtsPuma shoes

bing shen said...

1
http://www.12hot.com

1)
polo shirts

polo shirts supplies.wholesale polo shirts with great price. 12hot.com offers lot of 10 polo shirts and lot of 20 polo shirts. 12hot.com offers classic fit polo shirts.polo clothing All our shirts made in original factory.

2)
spyder jackets

12hot.com offers spyder jackets :
MENS' Spyder white&red REMOVEABLE CAP and SLEEVES SKI SUIT JACK
MEN'S SPYDER GRAY REMOVEABLE CAP SLEEVES SKI SUIT
MEN'S SPYDER BLACK REMOVEABLE CAP SLEEVES SKI SUIT JACKET
MEN'S SPYDER BLUE REMOVEABLE CAP SLEEVES SKI SUIT Jacket
MEN'S SPYDER WHITE REMOVABLE CAP&SLEEVES SKI SUIT Jacket
MEN'S SPYDER RED NEW STYLE SKI SUIT Jacket

3)
north face jackets

north face jackets,north face jacket. Here is a black The North Face Women's mountain jacket .

4)
Women's Sky Blue The North Face Original Twinset Parka/Jacket

This is a style of sky blue The Women's North Face outdoor and mountaineering apparel .The North Face offers advanced fabrics and technologies for all-weather performance and protection during demanding outdoor action. The design adds darts at the elbow, allowing for easier arm movement and a full range of motion. The internal wind skirt effectively keeps snow and wind out.
100% Omni-Tech!
100% SATISFIDE YOU!

2
http://www.polocart.com

1)
polo shirts

new polo shirts,polo shirts,polo shirt,Ralph Lauren polo shirts,polos .Paypal payment. we have best price.Welcome to wholesale Lacoste polo shirts

3
http://www.polosales.com/

1)
cheap polo shirts

Buy cheap polo shirts,polo shirt,lacoste polo shirts,ralph lauren polo shirts,wholesale polo shirts

4
http://www.superpolos.com/

1)
Lacoste Polo Shirts

Retail and Wholesale Lacoste Polo Shirts Cheap Lacoste Polo Shirts Polo Shirts Cheap Polo Shirts at cheap price with PayPal free shipping



6
http://www.bootsboots.co.uk

ugg boots

UGG short Boots
UGG 5245 tall Boots
UGG 5325 classic Boots
UGG 5359 womens Boots
UGG 5815 tall Boots
UGG 5819 womens Boots
UGG 5825 short Boots

7
http://www.chiflatiron.us

chi flat iron

chi flat iron
InStyler rotating hot iron with a heat resistant carrying bag
New BLUE CAMO CHI Camo Colletion 1" flat iron
New CHI Turbo 2 Big Flat Iron
New GREEN CAMO CHI Camo Colletion 1" flat iron
Black CHI Ceramic Flat Iron Original Farouk Hair Straightener
8
http://www.thehairstraighteners.com

CHI hair straightener

Very Cheap! www.thehairstraighteners.com is a professional supplier to supply CHI hair straightener Welcome to wholesale hair straighteners at www.thehairstraighteners.com.
CHI Straightener Blue Camo
CHI Straightener Green Camo
CHI Straightener Pink Camo
Original CHI Hair Straightener
CHI Turbo Big 2-Inch Hair Straightener


9)
http://www.jacketscart.com
jacketscart

spyder jackets
new discount spyder women's insulated ski jacket in orange
2009 new women's syder jackets insulated in white and red
women's discount spyder ski jacket insulated in red
women's cheap spyder ski suit insulated in pink
brand new men's spyder ski jackets in gray

season said...

Once upon a time, there was a mouse father.He wanted to marry his daughter to the greatest person in the world.But, who was the greatest person in the world?Oh!
puma ferrari shoes
cheap nike shoesThe sun! He must be the greatest person in the world.The mouse father went to talk to the sun."Hello! Mr. Sun.
puma shoes
ferrari shoes
I know you are the greatest person in the world.Would you marry my daughter?""What? I'm not the greatest person in the world. The greatest person is the cloud.If he comes out, I’ll be covered."
nike shox nz
Ugg Boots
The mouse father went to talk to the cloud. “Hello! Mr. Cloud. I know you are the greatest person in the world. Would you marry my daughter?”
nike 360 air max
nike shox shoes
“What? I’m not the greatest person in the world. The greatest person is the wind.If he comes out, I’ll be blown away.”
cheap puma shoes
puma drift cat
The mouse father went to talk to the wind. “Hello! Mr. Wind. I know you are the greatest person in the world.Would you marry my daughter?” “What? I’m not the greatest person in the world. The greatest person is the wall. If he comes out, I’ll be stopped.”
cheap nike shox
nike air max 360
The mouse father went to talk to the wall. “Hello! Mr. Wall. I know you are the greatest person in the world. Would you marry my daughter?” “What? I’m not the greatest person in the world. The greatest person is YOU, the mouse.” “The greatest person in the world is … mouse?” “Yes, the greatest person in the world is mouse. See? If mouse comes out, I’ll be bit!”
nike air max
pumas shoes
The mouse father was very happy. He finally knew mouse was the greatest person in the world. He would marry his daughter to the handsome mouse next door.
cheap jeans
cheap levis jeans
ed hardy jeans

Blog Archive