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Matyjas, Tomasz, Lech Pomorski, Henryk Witas, Tomasz Płoszaj, Katarzyna Matyjas, and Krzysztof Kaczka. "Cholelithiasis – always infected?" Polish Journal of Surgery 89, no. 3 (June 30, 2017): 23–26. http://dx.doi.org/10.5604/01.3001.0010.1086.
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This study aims to present results regarding the presence and identification of bacterial strains found in bile and gallstones located in the gallbladder and bile ducts in patients operated on due to cholelithiasis. Materials and Methods. Bacterial culture was evaluated in 92 patients. There were 54 women (59%) and 38 men (41%) who underwent surgery on account of cholelithiasis and /or gallstones in bile ducts between 2013 and 2014. Bile and gallstone samples were cultured intraoperatively for bacteria; bacterial strains were identified, and their sensitivity to antibiotics was determined. Molecular methods (NGS and Sanger method) were used to separate bacterial strains in one of the gallbladder stones and the results were compared with bacterial strains grown from the bile. Results. Bile cultures were positive in 46 patients that is, 50% of the study group. The following bacteria strains were grown: Enterococcus spp. (44%), Escherichia coli (37%) and Klebsiella spp. (35%). Candidiasis accompanied by bacterial infection was detected in 7 patients (15%). Molecular testing of gallstones revealed DNA of Enterococcus spp., Escherichia spp., Streptococcus spp. and Clostridium spp. In the bile culture of the same patient Enterococcus spp. (avium and faecalis) was detected. Conclusion 1. More than one pathogen was grown on samples obtained from 31 patients (70%) with bile infection. 2. The most common pathogens include Enterococcus spp., Escherichia coli and Klebsiella spp. 3. Bacterial infections are often accompanied by a fungal infection (Candida albicans) 4. Bacterial strains grown from a gallstone sample partially corresponded with strains identified in the bile of the same patient.
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Jeyarajah, D. Rohan, Mariusz L. Kielar, Hoosein Saboorian, Prameela Karimi, Nicole Frantz, and Christopher Y. Lu. "Impact of bile duct obstruction on hepatic E. coli infection: role of IL-10." American Journal of Physiology-Gastrointestinal and Liver Physiology 291, no. 1 (July 2006): G91—G94. http://dx.doi.org/10.1152/ajpgi.00095.2004.
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Biliary obstruction in the setting of hepatic bacterial infection has great morbidity and mortality. We developed a novel murine model to examine the effect of biliary obstruction on the clearance of hepatic Escherichia coli infection. This model may allow us to test the hypothesis that biliary obstruction itself adversely affects clearance of hepatic infections even if the bacteria are introduced into the liver by a nonbiliary route. We ligated the bile ducts of C57BL/6 mice on days − 1, 0, or + 1, relative to a day 0 portal venous injection of E. coli. We monitored survival, hepatic bacterial growth, pathology, and IL-10 protein levels. The role of IL-10 in this model was further examined using IL-10 knockout mice. Mice with bile duct ligation at day +1 or 0, relative to portal venous infection at day 0, had decreased survival compared with mice with only portal venous infection. The impaired survival was associated with greater hepatic bacterial growth, hepatic necrosis, and increased production of IL-10. Interestingly, the transgenic knockout of IL-10 resulted in impaired survival in mice with bile duct ligation and portal venous infection. Biliary obstruction had a dramatic detrimental effect on hepatic clearance of portal venous E. coli infection. This impaired clearance is associated with increased IL-10 production. However, transgenic knockout of IL-10 increased mortality after hepatic infection.
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Schreeg, Megan E., Sybille A. Miller, and John M. Cullen. "Choledochal cyst with secondary cholangitis, choledochitis, duodenal papillitis, and pancreatitis in a young domestic shorthair cat." Journal of Veterinary Diagnostic Investigation 33, no. 4 (May 24, 2021): 782–87. http://dx.doi.org/10.1177/10406387211017107.
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Choledochal cysts, congenital segmental dilations of the common bile duct, have been reported in few cats, and histologic characterization is lacking. A 20-mo-old spayed female domestic shorthair cat was presented because of vomiting and weight loss. There was progressive elevation of liver enzyme activity (ALT > ALP, GGT) and hyperbilirubinemia. Diagnostic imaging identified focal cystic dilation of the common bile duct, dilation and tortuosity of adjacent hepatic ducts, and a prominent duodenal papilla. A choledochal cyst was suspected, and the animal was euthanized. On postmortem examination, there was a 2-cm, firm, thickened, cystic dilation of the common bile duct, patent with adjacent ducts. Histologically, the cyst wall was expanded by fibroblasts, collagen, and lymphoplasmacytic inflammation. Adjacent bile ducts were markedly dilated and tortuous, with lymphoplasmacytic inflammation and papillary mucosal hyperplasia that extended to the major duodenal papilla. There was chronic neutrophilic cholangitis, suggesting bacterial infection and/or disturbed bile drainage, extrahepatic obstruction, and lymphoplasmacytic pancreatitis with ductular metaplasia. Prominent lymphoid follicles within biliary ducts and duodenum suggested chronic antigenic stimulation. Choledochal cysts can be associated with chronic neutrophilic cholangitis, extrahepatic obstruction, choledochitis, duodenal papillitis, and pancreatitis, and should be a differential for increased hepatic enzymes and hyperbilirubinemia in young cats.
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Sasaki, J., M. Goryo, J. Honda, N. Okoshi, K. Okada, and H. Furukawa. "CHOLANGIOHEPATITIS IN BROILER CHICKENS IN JAPAN: HISTOPATHOLOGICAL, IMMUNOHISTOCHEMICAL AND MICROBIOLOGICAL STUDIES OF SPONTANEOUS DISEASE." Acta Veterinaria Hungarica 48, no. 1 (February 1, 2000): 59–67. http://dx.doi.org/10.1556/avet.48.2000.1.7.
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Forty-five broiler arcasses from 6 different flocks were condemned due to liver lesions at processing meat inspection, and collected for pathological and bacterial examination. All affected chickens showed liver enlargement with distrahepatic bile ducts contained yellow inspissated cream-coloured material. Histopathologically, extensive proliferation of bile ductules with fibrosis was observed in interlobular connective tissue, and it spread to form bridges with adjoining triads. Destruction and obstruction of portal bile ducts with multiple granulomas due to bacterial infection and outflow of the bile were frequently observed.Many-Gram-positive bacilli were seen in the lesions, and they were identified asClostridium perfringensby indirect immunofluores en ecstaining technique.Clostridium perfringenswas isolated from affected livers. These findings are consistent with cholangiohepatitis. Therefore, it is suggested thatC. perfringensmight be important in the pathogenesis of cholangiohepatitis in broiler chickens.
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Strohäker, Jens, Lisa Wiegand, Christian Beltzer, Alfred Königsrainer, Ruth Ladurner, and Anke Meier. "Clinical Presentation and Incidence of Anaerobic Bacteria in Surgically Treated Biliary Tract Infections and Cholecystitis." Antibiotics 10, no. 1 (January 13, 2021): 71. http://dx.doi.org/10.3390/antibiotics10010071.
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(1) Background: Cholecystitis and cholangitis are among the most common diseases treated by general surgery. Gallstones lead to inflammation and bacterial infection of the biliary tract. Biliary infections can lead to live threatening bacteremia and liver abscesses. The true role of anaerobes remains unclear. (2) Methods: We retrospectively analyzed bacterial cultures from biliary samples obtained from bile ducts and gallbladders at our tertiary care center. Patient characteristics and clinical outcomes were analyzed. (3) Results: In our database of 1719 patients, 365 patients had microbial testing, of which 42 grew anaerobic bacteria. Anaerobes were more frequently cultured in patients with hepatic abscesses and gallbladder perforation. These patients were older and had more comorbidities than the control group. The overall outcomes of all patients were favorable and the resistance rate to commonly used antibiotics remained low. (4) Conclusions: Anaerobes in biliary tract infections appear to be underdiagnosed and more prevalent in the elderly with advanced disease. Due to low antibiotic resistance, the combination of source control and adjunct anti-infective treatment leads to favorable outcomes.
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Pohl, Juergen, Axel Ring, Wolfgang Stremmel, and Adolf Stiehl. "The role of dominant stenoses in bacterial infections of bile ducts in primary sclerosing cholangitis." European Journal of Gastroenterology & Hepatology 18, no. 1 (January 2006): 69–74. http://dx.doi.org/10.1097/00042737-200601000-00012.
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Choe, Jung Wan, Jae Min Lee, Jong Jin Hyun, and Hong Sik Lee. "Analysis on Microbial Profiles & Components of Bile in Patients with Recurrent CBD Stones after Endoscopic CBD Stone Removal: A Preliminary Study." Journal of Clinical Medicine 10, no. 15 (July 27, 2021): 3303. http://dx.doi.org/10.3390/jcm10153303.
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Background/Aim: Common bile duct (CBD) stone recurrence after endoscopic treatment is a major concern as a late complication. Biliary bacterial factors and biochemical factors determine the path of gallstone formation. The aim of this preliminary study was to investigate the microbial profile and components of bile in patients with and without recurrent CBD stones after endoscopic CBD stone removal. Methods: Among patients who had undergone an initial endoscopic procedure for the removal of CBD stones and were followed up for >2 years, 11 patients who experienced at least two CBD stone recurrences, six months after endoscopic retrograde cholangiopancreatography (ERCP), were categorized into the recurrence group. Nine patients without CBD recurrence events were matched. Results: Polymicrobial infections are generally seen in all patients who have biliary sphincteroplasty. Microbial richness, measured by the numbers of operational taxonomic units (OTUs), was reduced in the recurrence group. The microbial evenness was also significantly lower than in the non-recurrence group. The overall microbial communities in the recurrence group deviated from the non-recurrence group. Infection with bacteria exhibiting β-glucuronidase activity was more frequent in the recurrence group, but there was no statistical significance. In an analysis of the bile components, the bile acid concentration was higher in the non-recurrence group than in the recurrence group. However, the other metabolites were not significantly different. Conclusions: Microbiota dysbiosis and altered bacterial community assembly in bile duct and decreased bile acid in bile juice were associated with recurrence of bile duct stone.
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Silva Garcia, Juberlan, Raquel de Oliveira Simões, Ester Mota, Incerlande Soares dos Santos, and Arnaldo Maldonado Júnior. "Pathological effects of ECHINOSTOMA PARAENSEI infection associated with pyogenic abscesses caused by PSEUDOMONAS AERUGINOSA in swiss mice." Revista de Patologia Tropical / Journal of Tropical Pathology 50, no. 1 (February 22, 2021): 40–48. http://dx.doi.org/10.5216/rpt.v50i1.66670.
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The trematode Echinostoma paraensei is an intestinal parasite transmitted by ingestion of the infectious stage of metacercariae. For scientific purposes, its life cycle has been maintained in the laboratory, allowing analysis using various biological approaches. Different parasite isolates have revealed atypical patterns of migration and establishment in ectopic sites in Swiss-Webster mice. During the investigation of the biological life cycle of an E. paraensei isolate from the silvatic rodent Nectomys squamipes collected in the municipality of Rio Bonito (State of Rio de Janeiro), a bacterial coinfection with Pseudomonas aeruginosa was observed, which produced anatomopathological alterations, mainly in the liver, bile ducts, pancreas, and small intestine. The main macroscopic signs were the whitish suppurative pyogenic punctual lesions. The histological sections stained by hematoxylin-eosin showed an intense inflammatory reaction formed by mononuclear cells and macrophages surrounding the bile ducts, although the hepatic parenchyma still presented its normal aspect. Thus, pyogenic abscesses can be associated with E. paraensei infection depending on the strain and aggravating pathogenesis in the definitive host.KEY WORDS: Liver abscess; Swiss mice; trematode infection.
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Yang, Qin, Zhenru Wu, Fei Liu, Junke Wang, Wenjie Ma, Haijie Hu, Fuyu Li, and Qiuwei Pan. "Effective Treatment of Chronic Proliferative Cholangitis by Local Gentamicin Infusion in Rabbits." BioMed Research International 2018 (July 24, 2018): 1–6. http://dx.doi.org/10.1155/2018/6751952.
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Background. Hepatolithiasis is highly prevalent in East Asia characterized by the presence of gallstones in the biliary ducts of the liver. Surgical resection is the potentially curative treatment but bears a high risk of stone recurrence and biliary restenosis. This is closely related to the universal presence of chronic proliferative cholangitis (CPC) in the majority of patients. Recent evidence has indicated the association of bacterial infection with the development of CPC in hepatolithiasis. Thus, this study aims to investigate the feasibility and efficacy of local infusion of gentamicin (an antibiotic) for the treatment of CPC in a rabbit model. Methods. The rabbit CPC model was established based on previously published protocols. Bile duct samples were collected from gentamicin-treated or control animals for pathological and molecular characterization. Results. Histologically, the hyperplasia of biliary epithelium and submucosal glands were inhibited and the thickness of the bile duct wall was significantly decreased after gentamicin therapy. Consistently, the percentage of proliferating cells marked by ki67 was significantly reduced by the treatment. More importantly, this treatment inhibited interleukin 2 production, an essential inflammatory cytokine, and the enzyme activity of endogenous β-Glucuronidase, a key factor in the formation of bile pigment. Conclusions. Local gentamicin infusion effectively inhibits the inflammation, cell proliferation, and lithogenesis in a rabbit model of CPC. This approach represents a potential treatment for CPC and thus prevents recurrent hepatolithiasis.
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Ninomiya, Masashi, Yoshiyuki Ueno, and Tooru Shimosegawa. "PBC: Animal Models of Cholangiopathies and Possible Endogenous Viral Infections." International Journal of Hepatology 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/649290.
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Primary Biliary Cirrhosis (PBC) is considered an autoimmune disease characterized by immune-mediated destruction of the intrahepatic bile ducts and its characteristic serologic marker, the anti-mitochondrial antibody (AMA). Several factors were proposed to clarify the pathological and immunological mechanisms of PBC. Immunological reaction with a bacterial or a viral association was identified in the previous report, and it seems probable that PBC was thought to have such an etiology. The majority of patients with PBC was reported to have both RT-PCR and immunohistochemistry evidence of human betaretrovirus infection in lymph nodes or in 2008, the patient who developed PBC with high HIV viral load had an antiviral therapy and recovered. To understand the etiology of PBC associated with infection, several factors should be considered and especially animal models may be useful. In this paper, we introduce three typical animal models of PBC: the dominant-negative form of transforming growth factor-βreceptor type II (dnTGFβRII) mouse, IL-2Rα−/−mouse and NOD.c3c4 mouse, are enumerated and described, and we discuss previous reports of viral infection associated with PBC and consider the etiology of PBC from our analysis of results in NOD.c3c4 mouse.
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Hackstein, Carl-Philipp, Lisa Mareike Assmus, Meike Welz, Sabine Klein, Timo Schwandt, Joachim Schultze, Irmgard Förster, et al. "Gut microbial translocation corrupts myeloid cell function to control bacterial infection during liver cirrhosis." Gut 66, no. 3 (July 18, 2016): 507–18. http://dx.doi.org/10.1136/gutjnl-2015-311224.
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ObjectivePatients with liver cirrhosis suffer from increased susceptibility to life-threatening bacterial infections that cause substantial morbidity.MethodsExperimental liver fibrosis in mice induced by bile duct ligation or CCl4application was used to characterise the mechanisms determining failure of innate immunity to control bacterial infections.ResultsIn murine liver fibrosis, translocation of gut microbiota induced tonic type I interferon (IFN) expression in the liver. Such tonic IFN expression conditioned liver myeloid cells to produce high concentrations of IFN upon intracellular infection withListeriathat activate cytosolic pattern recognition receptors. Such IFN-receptor signalling caused myeloid cell interleukin (IL)-10 production that corrupted antibacterial immunity, leading to loss of infection-control and to infection-associated mortality. In patients with liver cirrhosis, we also found a prominent liver IFN signature and myeloid cells showed increased IL-10 production after bacterial infection. Thus, myeloid cells are both source and target of IFN-induced and IL-10-mediated immune dysfunction. Antibody-mediated blockade of IFN-receptor or IL-10-receptor signalling reconstituted antibacterial immunity and prevented infection-associated mortality in mice with liver fibrosis.ConclusionsIn severe liver fibrosis and cirrhosis, failure to control bacterial infection is caused by augmented IFN and IL-10 expression that incapacitates antibacterial immunity of myeloid cells. Targeted interference with the immune regulatory host factors IL-10 and IFN reconstitutes antibacterial immunity and may be used as therapeutic strategy to control bacterial infections in patients with liver cirrhosis.
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Ortega-Hernandez, Oscar-Danilo, Nancy-Agmon Levin, Arie Altman, and Yehuda Shoenfeld. "Infectious Agents in the Pathogenesis of Primary Biliary Cirrhosis." Disease Markers 29, no. 6 (2010): 277–86. http://dx.doi.org/10.1155/2010/923928.
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Primary biliary cirrhosis (PBC) is a chronic progressive cholestatic liver disease which is characterized by the breakdown of self-tolerance to the highly conserved pyruvate dehydrogenase complex, specially the pyruvate dehydrogenase E2 complex (PDC-E2). The breakdown of the tolerance to such antigens leads to an autoimmune process characterized by portal inflammation and immune-mediated destruction of the intrahepatic bile ducts. Epidemiological studies have suggested that infections agents can trigger or even exacerbate the disease. Among other gram negative bacteria,Escherichia Coli, andNosphingobium aromaticivoransare the most associated agents reported hitherto. Epidemiological and molecular evidence points towards molecular mimicry between some components of these microorganisms and specific amino-acid sequences that are present in proteins on normal cells of the biliary tract. In this review, we revisit all reports suggesting that infectious agents might be associated with the autoimmune pathogenesis of PBC. We also retrieve the immune molecular mimicry mechanisms that are likely involved with the autoimmune process in PBC.
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Pereira, Fausto E. L., Carlos Musso, and Jane S. Castelo. "Pathology of Pyogenic Liver Abscess in Children." Pediatric and Developmental Pathology 2, no. 6 (November 1999): 537–43. http://dx.doi.org/10.1007/s100249900159.
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Little is known about preexisting lesions in livers of children with pyogenic liver abscess (PLA). Study of these lesions may elucidate possible predisposing factors for the disease. In Vitória, state of Espirito Santo, Brazil, PLA in children is frequently associated with helminthic infections and eosinophilia. We hypothesize that nematode infection with larvae migrating through the liver is a predisposing factor for PLA, because the infection induces immunomodulation and likely trapping of bacteria in liver granulomas. In this report, we describe observations of 22 cases of PLA in children studied at autopsy (16 cases) or in surgical biopsies (6 cases), including 17 boys and 5 girls ranging in age from 1 to 13 years (mean 4.6 years, median 3.5 years). Multiple abscesses in both lobes were found in 13 cases and a single abscess was found in the right lobe in 10 cases. All cases showed histologically classical pyogenic inflammation without morphological evidence of amoebiasis. In six cases there were granulomas similar to those caused by larva migrans visceralis (from Toxocara or other nematodes) in liver tissue not affected by the abscess. Nematode antigens in central areas of necrosis of granuloma in all six cases and fragments of a larva, possibly of Toxocara, were found on samples immunohistochemically stained with polyclonal anti- Toxocara antibodies. There were numerous eosinophils in abscesses with Charcot-Leyden crystals. Eosinophils were found frequently in portal triads far from the abscess wall. In four cases, in which bile duct ascariasis was found, worms were noted in the bile ducts, and eggs were found in liver parenchyma surrounding the abscess in two cases. Foreign-body granulomas were found in one case in which penetrating trauma was the cause of abscess. In one case there was one histiocytic granuloma whose origin was not determined. The observation of six cases of granuloma similar to larva migrans visceralis (or produced by other nematode larva) in liver tissue not directly affected by the abscess supports the hypothesis that helminth infections with larva migrating through the liver are a predisposing factor for pyogenic hepatic abscess in children.
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Vitetta, Luis, and Avni Sali. "Primary Bile Duct Stones and Bacterial Activity." HPB Surgery 6, no. 1 (January 1, 1992): 23–33. http://dx.doi.org/10.1155/1992/81017.
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The results of this study suggest that infection with beta-glucuronidase active bacteria is the initial event in the nucleation of primary bile duct stones (PBDS).PBDS from five patients were morphologically fragile and “earthy” with alternating light and dark brown pigment layers with no evidence of a distinct central nucleus that may have been reminiscent of a different structure. Chemically, calcium bilirubinate and calcium palmitate were prominent throughout their structure. All bile duct biles had a positive culture and were always associated with at least one bacterial species which was beta-glucuronidase active. Moreover, fragments of PBDS nuclear areas had positive cultures that were comparable with those present in their individual bile duct bile. Microscopic examination of bile showed abundant precipitation of calcium bilirubinate granules in all samples.Thus, bile duct bile infection with beta-glucuronidase active bacteria (e.g. E. coli, C. perfringens) appears to be a key factor in PBDS pathogenesis, having a precursor role, rather than being a consequence. Bile stasis is likely to be a co-factor which must have a supportive role in subsequent stone growth.
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Albu, Sorin, Septimiu Voidăzan, and Dragoș Popa. "Gallbladder Hydrops Associated with an Episode of Acute Liver Toxicity in the Adult: May It Be Considered a Surgical Emergency or Not?" Journal of Interdisciplinary Medicine 1, no. 2 (September 1, 2016): 180–82. http://dx.doi.org/10.1515/jim-2016-0027.
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Abstract Introduction: Gallbladder hydrops is an increase in the volume of the gallbladder without any inflammatory sign, bacterial infection or the presence of any abnormalities of the biliary ducts or of the gallbladder. Case presentation: A 52-year-old man presented at the Department of Internal Medicine complaining of moderate intensity pain in the right upper quadrant, low fever, fatigue, general weakness, symptoms stemming from an excessive intake of food (a meal abundant in animal proteins, fats, and alcohol) which appeared following a 6-week period of food restriction. On examination, the patient presented a globular abdomen, sensitive to deep palpation in the right upper quadrant, the liver and spleen being impalpable. Blood tests performed on admission showed liver-specific pathological changes. Abdominal ultrasound revealed hepatomegaly with homogeneous echostructure, slightly increased echogenicity with rear attenuation, with no focal images, intrahepatic biliary duct dilatation, or dilated suprahepatic veins. The gallbladder looked dropsical, with slender walls, with images of hyperechoic infundibular calculi with a posterior shadow cone, the largest having 14 mm. The portal vein and bile duct were normal in appearance. Conclusions: Gallbladder hydrops is a disorder commonly seen in children. Its occurrence in adults is uncommon, moreover since it occurs simultaneously with an episode of acute toxic hepatitis. Surgery for this patient was possible only after normalization of liver function tests, on admission there being no subjective complaints of marked intensity that required immediate surgery.
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Avenaud, Philippe, Brigitte Le Bail, Kathryn Mayo, Armelle Marais, Rabia Fawaz, Paulette Bioulac-Sage, and Francis Megraud. "Natural History of Helicobacter hepaticus Infection in Conventional A/J Mice, with Special Reference to Liver Involvement." Infection and Immunity 71, no. 6 (June 2003): 3667–72. http://dx.doi.org/10.1128/iai.71.6.3667-3672.2003.
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ABSTRACT It has been reported that Helicobacter hepaticus infection of mice leads to chronic hepatitis and hepatocarcinoma. Our aim was to monitor a cohort of 80 conventional A/J mice in which half of the mice were infected by H. hepaticus in order to study the evolution of the infection and the pathological changes in comparison to uninfected mice. H. hepaticus was detected by culture only in some colon and cecum specimens after 17 months of age, while PCR detected H. hepaticus in the intestines of all inoculated mice after only 5 months of infection. The percentage of mice in which H. hepaticus was detected in the gallbladder, bile ducts, and liver by PCR, as well as the number of bacteria present in the liver, tended to increase with increasing age and longer infection time. Anti-H. hepaticus immunoglobulin G antibodies were positive by enzyme-linked immunosorbent assay only in inoculated mice. Pathological findings were also more frequent as the mice grew older: fibrosis was present (especially in the peripheral part of the liver), and significant portal inflammation including lymphoid nodules was present in almost all infected animals. Biliary lesions of neutrophilic acute cholangitis or lymphocytic cholangitis were noted. However, lesions were also observed in uninfected animals, although at a significantly lower level, and the only hepatocellular carcinoma occurred in an uninfected mouse. The evolution towards hepatocarcinoma is not always the endpoint and may depend on the bacterial strain and on the environmental conditions.
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Jeyarajah, D. Rohan, Mariusz L. Kielar, Nicole Frantz, Guy Lindberg, and Christopher Y. Lu. "Infection by Gram-Negative Organisms via the Biliary Route Results in Greater Mortality than Portal Venous Infection." Clinical Diagnostic Laboratory Immunology 10, no. 4 (July 2003): 664–69. http://dx.doi.org/10.1128/cdli.10.4.664-669.2003.
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ABSTRACT Cholangitis requires bile duct obstruction and infection. Patients with cholangitis are often more affected than those with infections that reach the liver through the portal vein. We will attempt to study the influences of (i) route of entry and (ii) presence of bile duct obstruction on hepatic infection. C57BL/6 mice received injections of Escherichia coli or lipopolysaccharide into the obstructed bile duct or portal vein and were monitored for survival. Livers were assayed for bacteria, and cytokine mRNA was measured. In order to examine the effect of biliary obstruction on hepatic infection, animals were subjected to bile duct ligation 1 day prior to portal vein injection and were monitored for survival. The 50% lethal dose (LD50) for E. coli injected into the bile duct was 50 CFU/animal; the LD50 for E. coli injected into the portal vein was 5 × 107 CFU/animal. Initial hepatic delivery of bacteria was equivalent 1 h after injection into the bile duct or portal vein. However, by 24 h, a significantly greater amount of bacteria was recovered from the livers of the bile duct-injected group. Interleukin 10 (IL-10) and IL-1RA mRNA was expressed at greater levels in the bile duct-injected group. Prior bile duct ligation followed by portal vein injection resulted in a higher incidence of death than when sham operation was performed prior to portal vein injection. Our data suggest that the increased mortality from cholangitis, compared with that from other hepatic infections, is related to the different route of delivery of pathogen and the maladaptive response (possibly involving IL-10 and IL-1RA) to biliary obstruction itself.
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Hrubnyk, V. V. "Errors and dangers in laparoscopic surgery." Infusion & Chemotherapy, no. 3.2 (December 15, 2020): 69–71. http://dx.doi.org/10.32902/2663-0338-2020-3.2-69-71.
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Background. About 46.5 million of surgical procedures and 5 million of gastrointestinal endoscopies are performed annually in the United States alone. Each procedure involves contact of the medical equipment with sterile tissues of the patient, so transmission of infection is the main risk of such procedures.
Objective. To describe the main errors and dangers in laparoscopic surgery.
Materials and methods. Analysis of literature data and own research on this topic.
Results and discussion. Endoscopic examinations in gastroenterology can transmit more than 300 types of infections, 70 % of which are salmonella and Pseudomonas aeruginosa. During bronchoscopy 90 types of infections are transferred. Different hospital facilities undergo different decontamination procedures. Objects that penetrate the skin or mucous membranes, or into sterile tissues or the circulatory system, require sterilization. Endoscopes are subject to pre-cleaning, leak testing, manual cleaning, rinsing and disinfection. Ideally, laparoscopes and arthroscopes should be sterilized between procedures in different patients. Such devices are difficult to clean and disinfect due to their complex structure. In the absence of adequate disinfection, infection of the patients occurs in cases where the number and virulence of the introduced bacteria or fungi is sufficient to overcome their own immune defenses. Prevention of infectious complications includes preoperative antiseptic treatment of the operating field and appropriate antibiotic prophylaxis (ABP). Abdominal drainage should be performed only when blood or bile accumulates in the operating field. Regular use of drainage in uncomplicated laparoscopic cholecystectomy (CE) increases the likelihood of infection. Examination of 65 laparoscopic operations for postoperative ventral hernias revealed that the reinforcement of preoperative ABP by the means of 7-day course of fluoroquinolones or cephalosporins significantly reduced the volume and rate of seroma formation. The strategy for the prevention of postoperative complications includes delicate tissue handling, thorough sterilization of instruments, abdominal lavage with Dekasan (“Yuria-Pharm”), the use of broad-spectrum antibiotics, the use of plastic containers for removed organs and pathological formations, etc. In laparoscopic surgery, more than half of intestinal and vascular injuries are the access complication (pneumoperitoneum, the introduction of the first trocar). A significant proportion of such injuries is not diagnosed during injury. Thermal injuries are also possible during laparoscopic interventions. To prevent them, it is advisable to check the instruments for damage, use plastic trocars, use bipolar coagulation methods, use safe methods of dissection and coagulation (ultrasound scissors, vessel sealing technology).
The frequency of damage to the bile ducts during laparoscopic CE is 0.26-0.30 %. The author’s study evaluated the effectiveness of laparoscopic subtotal CE in performing technically complex CE. Dekasan was used as an antiseptic for external and intraabdominal lavage during the interventions. Properties of Dekasan are the following: bactericidal, fungicidal, virocidal, sporocidal effects; lack of resorptive action; enhancing of the antibiotics’ effect; reducing the adhesion of microorganisms. In the first period (2005-2008) complex CE (1.5 %) was switched to the open operations. The frequency of postoperative complications was 28 %. In the second period, subtotal CE were used. The average operation time was 95 minutes; the average blood loss was 80 ml. Postoperative complications occurred in 14.6 % of patients. Mortality in the first period was 0.1 %, in the second – 0 %.
Conclusions. 1. Endoscopes should be thoroughly disinfected to minimize the risk of infections transmission. 2. Prevention of infectious complications also includes preoperative antiseptic treatment of the operating field and appropriate ABP. 3. In laparoscopic surgery, more than half of intestinal and vascular injuries are the complications of access. 4. Performing laparoscopic subtotal CE is an alternative to conversion in cases where it is impossible to laparoscopically identify anatomical structures.
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Magri, Vittorio, Matteo Boltri, Tommaso Cai, Roberto Colombo, Salvatore Cuzzocrea, Pieter De Visschere, Rosanna Giuberti, et al. "Multidisciplinary approach to prostatitis." Archivio Italiano di Urologia e Andrologia 90, no. 4 (January 18, 2019): 227–48. http://dx.doi.org/10.4081/aiua.2018.4.227.
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The modern clinical research on prostatitis started with the work of Stamey and coworkers who developed the basic principles we are still using. They established the segmented culture technique for localizing the infections in the males to the urethra, the bladder, or the prostate and to differentiate the main categories of prostatitis. Such categories with slight modifications are still used according to the NIH classification: acute bacterial prostatitis, chronic bacterial prostatitis, Chronic Pelvic Pain Syndrome (CPPS) and asymptomatic prostatitis. Prostatic inflammation is considered an important factor in influencing both prostatic growth and progression of symptoms of benign prostatic hyperplasia and prostatitis. Chronic inflammation/neuroinflammation is a result of a deregulated acute phase response of the innate immune system affecting surrounding neural tissue at molecular, structural and functional levels. Clinical observations suggest that chronic inflammation correlates with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and benign prostatic hyperplasia (BPH) and an history of clinical chronic prostatitis significantly increases the odds for prostate cancer. The NIHNIDDK classification based on the use of the microbiological 4- glasses localization test or simplified 2-glasses test, is currently accepted worldwide. The UPOINT system identifies groups of clinicians with homogeneous clinical presentation and is used to recognize phenotypes to be submitted to specific treatments. The UPOINTS algorithm implemented the original UPOINT adding to the urinary domains (U), psycho-social (P), organspecific (O), infection (I), neurological (N), muscle tension and tenderness (T) a further domain related to sexuality (S). In fact sexual dysfunction (erectile, ejaculatory, libido loss) has been described in 46-92% of cases with a high impact on the quality of life of patients with CP/CPPS. Prostatic ultrasound represents the most popular imaging test in the work-up of either acute and chronic prostatitis although no specific hypo-hyperechoic pattern has been clearly associated with chronic bacterial prostatitis and CPPS. Use of a digital-processing software to calculate the extension of prostatic calcification area at ultrasound demonstrated a higher percentage of prostatic calcification in patients with chronic bacterial prostatitis. Multiparametric Magnetic Resonance Imaging (mpMRI) is the current state-of-the art imaging modality in the assessment of patients with prostate cancer although a variety of benign conditions, including inflammation, may mimic prostate cancer and act as confounding factors in the discrimination between neoplastic and non-neoplastic lesions. Bacteria can infect prostate gland by: ascending the urethra, reflux of urine into the prostatic ducts, direct inoculation of bacteria through inserted biopsy needles or hematogenous seeding. Enterobacteriaceae are the predominant pathogens in acute and chronic bacterial prostatitis, but an increasing role of Enterococci has been reported. Many strains of these uropathogens exhibit the ability to form biofilm and multidrug- resistance. Sexually Transmitted Infections (STI) agents, in particular Chlamydia trachomatis and Mycoplasma genitalium, have been also considered as causative pathogens of chronic bacterial prostatitis. On the contrary the effective role in genital diseases of other "genital mycoplasmas" is still a much debated issue. Sexually Transmitted Infections agents should be investigated by molecular methods in both patient and sexual partner. “Next generation” investigations, such as cytokine analysis, cytological typing of immune cells could help stratifying the immune response. Epigenetic dysregulation of inflammatory factors should be investigated according to systemic and compartment-specific signals. The search for biomarkers should also include evaluation of hormonal pathways, as measurement of estrogen levels in semen. Antimicrobials are the first line agents for the treatment of bacterial prostatitis. The success of antimicrobial treatment depends on the antibacterial activity and the pharmacokinetic characteristics of the drug which must reach high concentrations in prostate secretion and prostate tissue. Acute bacterial prostatitis can be a serious infection with a potential risk for urosepsis For iInitial treatment of severely ill patients, intravenous administration of high doses of bactericidal antimicrobials, such as broad-spectrum penicillins, third-generation cephalosporins or fluoroquinolones, is recommended in combination with an aminoglycoside. Use of piperacillin-tazobactam and meropenem is justified in presence of multiresistant gramnegative pathogens. The antibiotic treatment of chronic prostatitis is currently based on the use of fluoroquinolones that, given for 2 to 4 weeks, cured about 70% of men with chronic bacterial prostatitis. For the treatment of Chlamydial prostatitis macrolides were shown to be more effective than fluoroquinolones, whereas no differences were observed in microbiological and clinical efficacy between macrolides and tetracyclines for the treatment of infections caused by intracellular pathogens. Aminoglycosides and fosfomycin could be considered as a therapeutic alternative for the treatment of quinolone resistant prostatitis. Use of alpha-blockers in CP/CPPS patients with urinary symptoms and analgesics +/- non steroidal anti-inflammatory drugs (NSAID), in presence of pain demonstrated a reduction of symptoms reduction and an improvement of quality of life, although long term use of NSAID is limited by side effect profile. However, the multimodal therapeutic regimen by contemporary use of alphablockers, antibiotics and anti-inflammatory showed a better control of prostatitis symptoms than single drug treatment. Novel therapeutic substances for the treatment of pain, such as the cannabinoid anandamide would be highly interesting to test. An alternative for the treatment of chronic prostatitis/chronic pelvic pain syndrome is phytotherapy, as primary therapy or in association with other drugs. Quercetin, pollen extract, extract of Serenoa repens and other mixtures of herbal extracts showed a positive effect on symptoms and quality of life without side effects. The association of CP/CPPS with alterations of intestinal function has been described. Diet has its effects on inflammation by regulation of the composition of intestinal flora and direct action on the intestinal cells (sterile inflammation). Intestinal bacteria (microbiota) interacts with food influencing the metabolic, immune and inflammatory response of the organism. The intestinal microbiota has protective function against pathogenic bacteria, metabolic function by synthesis of vitamins, decomposition of bile acids and production of trophic factors (butyrate), and modulation of the intestinal immune system. The alteration of the microbiota is called “dysbiosis” causing invasive intestinal diseases pathologies (leaky gut syndrome and food intolerances, irritable bowel syndrome or chronic inflammatory bowel diseases) and correlating with numerous systemic diseases including acute and chronic prostatitis. Administration of live probiotics bacteria can be used to regulate the balance if intestinal flora. Sessions of hydrocolontherapy can represent an integration to this therapeutic approach. Finally, microbiological examination of sexual partners can offer supplementary information for treatment.
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Miranda-Díaz, A. G., H. Alonso-Martínez, J. Hernández-Ojeda, O. Arias-Carvajal, A. D. Rodríguez-Carrizalez, and L. M. Román-Pintos. "Toll-Like Receptors in Secondary Obstructive Cholangiopathy." Gastroenterology Research and Practice 2011 (2011): 1–10. http://dx.doi.org/10.1155/2011/265093.
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Secondary obstructive cholangiopathy is characterized by intra- or extrahepatic bile tract obstruction. Liver inflammation and structural alterations develop due to progressive bile stagnation. Most frequent etiologies are biliary atresia in children, and hepatolithiasis, postcholecystectomy bile duct injury, and biliary primary cirrhosis in adults, which causes chronic biliary cholangitis. Bile ectasia predisposes to multiple pathogens: viral infections in biliary atresia; Gram-positive and/or Gram-negative bacteria cholangitis found in hepatolithiasis and postcholecystectomy bile duct injury. Transmembrane toll-like receptors (TLRs) are activated by virus, bacteria, fungi, and parasite stimuli. Even though TLR-2 and TLR-4 are the most studied receptors related to liver infectious diseases, other TLRs play an important role in response to microorganism damage. Acquired immune response is not vertically transmitted and reflects the infectious diseases history of individuals; in contrast, innate immunity is based on antigen recognition by specific receptors designated as pattern recognition receptors and is transmitted vertically through the germ cells. Understanding the mechanisms for bile duct inflammation is essential for the future development of therapeutic alternatives in order to avoid immune-mediated destruction on secondary obstructive cholangiopathy. The role of TLRs in biliary atresia, hepatolithiasis, bile duct injury, and primary biliary cirrhosis is described in this paper.
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Cetta, Francesco. "The Possible Role of Sphincteroplasty and Surgical Sphincterotomy in the Pathogenesis of Recurrent Common Duct Brown Stones." HPB Surgery 4, no. 4 (January 1, 1991): 261–70. http://dx.doi.org/10.1155/1991/89069.
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The hypothesis has been tested that postcholecystectomy common duct stones of the brown subtype are a consequence of three factors: bile infection, old age and previous sphincterotomy. It was found that: (i) 27 of 39 consecutive patients with recurrent common duct stones had brown stones. Nineteen of these 27 patients (70.3%) had previous sphincterotomy or sphincteroplasty: (ii) six of 15 patients with stone and bile analysis both at the time of cholecystectomy and at the second operation and who had sterile operative bile and non brown stones at the first operation, formed brown stones after T-tube drainage and after the onset of bile infection; (iii) patients with both intra and postoperative negative bile culture (n = 39 out of 137) had a lower mean age (50.5 years) and less frequently had a sphincterotomy than did individuals with a negative culture at operation, who subsequently had bile infection (n = 37; mean age 58.5 years; sphincterotomy in 88.8% of cases).In addition, in a follow up study of 105 patients with sphincterotomy and with sphincteroplasty (including ERCP or i.v. cholangiography in all cases), mean follow-up interval 6.1 years, 11.3 % of patients had brown recurrent common duct stones.It is suggested that, since brown recurrent common duct stones are secondary to bile stasis and infection and the duodenum is going to be colonized by bacteria with increasing age, sphincterotomy (and subsequent stricture), facilitating bile contamination and bacterial overgrowth, could be one of the major determinants of brown recurrent common duct stones (RCS) formation. In particular, more than 11% of the patients with a sphincterotomy are going to form in the future RCS of the brown subtype.
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Gabriela, Bonţea Mihaela, Voiţă Gh Florin, Mekeres Gabriel Mihai, Gavra Alexandra Simina, and Maghiar Octavian Adrian. "Clinical and Paraclinical Considerations Regarding Acute Cholecystitis." Internal Medicine 16, no. 5 (October 1, 2019): 53–57. http://dx.doi.org/10.2478/inmed-2019-0084.
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AbstractThe gallbladder represents a vast pathological subject, vastly disputed because of the many diseases and conditions that can develop. One of the diseases of the bladder is acute cholecystitis, a pathological entity that is induced by the acute inflammation of the gallbladder. It is of particular interest to the patients that present gallstones, with a prevalence of 10 to 25% of the total surgical interventions regarding the gallbladder diseases.The objective of this article is to analyze the diagnosis and treatment of acute cholecystitis and highlight the importance of diet in this pathology.The incriminating factor of acute cholecystitis is the biliary stasis, along with bacterial infections that also intervene and the possible ischemia of the bladder wall. In about 90 to 95% cases the biliary stasis is a follow up to the calculous obstruction of the cystic duct, context in which patients are diagnosed with acute lithiasic cholecystitisUnder antibiotic therapy clinical improvement occurs rarely, most often a stationary phase of acute cholecystitis settles in. The unfavorable evolutions refer to patients who develop complications. Bile peritonitis which may be generalized or localized, most often a localized peritonitis occurs, which will develop a plastron in a few days that acts as an armor, is even to touch and presents a dull percussionConclusions. Acute cholecystitis is a common disease in clinical practice, and most often it represents a surgical emergency. The quality of life of a patient that suffers from gallbladder diseases may be affected, as they must follow a certain diet.
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Kosowski, K., E. Karczewska, A. Kasprowicz, J. Andziak, and P. B. Heczko. "Bacteria in bile of patients with bile duct inflammation." European Journal of Clinical Microbiology 6, no. 5 (October 1987): 575–78. http://dx.doi.org/10.1007/bf02014251.
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Schmitz, Daniel, Ulrich Eigner, Torsten Schmidt-Wieland, Petra Weber, Richard Magdeburg, Peter Kienle, and Jochen Rudi. "Gallbladder Cancer Presenting as Mirizzi Syndrome Complicated by Rapidly Evolving 23 rRNA Gene-Linezolid Resistance with Vancomycin-Resistant Enterococcus Infection Resulting in Fatal Cholangial Sepsis." Case Reports in Gastroenterology 14, no. 3 (October 28, 2020): 540–46. http://dx.doi.org/10.1159/000508851.
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We describe the case of a 71-year-old woman who presented with obstructive jaundice and subhilar bile duct stenosis. MRI showed extensive cholecystolithiasis with an impacted bile stone in the cystic duct suggesting Mirizzi syndrome. Delayed enhancement of the thickened gallbladder wall suggested inflammation instead of carcinoma. After drainage of the obstructed bile duct via ERCP, the patient developed liver abscesses with a nosocomial vancomycin-resistant enterococcus infection treated by linezolid. After 4 weeks, the VRE infection was complicated by a new-onset 23 rRNA gene-mediated linezolid resistance in the same bacterial strain, which was proven via core genome multilocus sequencing. Meropenem and tigecycline were administered according to a resistogram. Furthermore, percutaneous transhepatic biliary drainage of both sides of the liver was necessary. After demission, the patient had to be admitted again due to septic shock. An emergency operation revealed extended, inoperable gallbladder cancer. The patient died a few days later in the intensive care unit. An earlier diagnosis of bile duct infiltrating gallbladder cancer by cholangioscopy or laparoscopy and treatment of vancomycin-resistant enterococcus infection with daptomycin may have changed the clinical course of the disease.
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Hatta, Muhammad Nur Adam, Ezanee Azlina Mohamad Hanif, Siok-Fong Chin, and Hui-min Neoh. "Pathogens and Carcinogenesis: A Review." Biology 10, no. 6 (June 15, 2021): 533. http://dx.doi.org/10.3390/biology10060533.
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Cancer is a global health problem associated with genetics and unhealthy lifestyles. Increasingly, pathogenic infections have also been identified as contributors to human cancer initiation and progression. Most pathogens (bacteria, viruses, fungi, and parasites) associated with human cancers are categorized as Group I human carcinogens by the International Agency for Research on Cancer, IARC. These pathogens cause carcinogenesis via three known mechanisms: persistent infection that cause inflammation and DNA damage, initiation of oncogene expression, and immunosuppression activity of the host. In this review, we discuss the carcinogenesis mechanism of ten pathogens, their implications, and some future considerations for better management of the disease. The pathogens and cancers described are Helicobacter pylori (gastric cancer), Epstein-Barr virus (gastric cancer and lymphoma), Hepatitis B and C viruses (liver cancer), Aspergillus spp. (liver cancer), Opisthorchis viverrine (bile duct cancer), Clonorchis sinensis (bile duct cancer), Fusobacterium nucleatum (colorectal cancer), Schistosoma haematobium (bladder cancer); Human Papillomavirus (cervical cancer), and Kaposi’s Sarcoma Herpes Virus (Kaposi’s sarcoma).
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Michalska, Korina, Michał Gesek, Rajmund Sokół, Daria Murawska, Mateusz Mikiewicz, and Agnieszka Chłodowska. "Effective Microorganisms (EM) Improve Internal Organ Morphology, Intestinal Morphometry and Serum Biochemical Activity in Japanese Quails under Clostridium perfringens Challenge." Molecules 26, no. 9 (May 8, 2021): 2786. http://dx.doi.org/10.3390/molecules26092786.
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The effect of effective microorganisms (EM) on internal organ morphology, intestinal morphometry, and serum biochemical activity in Japanese quails under Clostridium perfringens challenge was determined. After 30 days of EM addition, one group of quails was orally inoculated with Clostridium perfringens. The second group did not receive EM and was inoculated with C. perfringens. In the gut, EM supplementation reduced the number of lesions, enhanced gut health, and protected the mucosa from pathogenic bacteria. EM showed an anti-inflammatory effect and fewer necrotic lesions in villi. In the internal organs, EM showed a protective effect against a typical lesion of C. perfringens infection. Necrosis and degeneration of the hepatocytes, necrosis of bile ducts, and bile duct proliferation were more severe in the infected group without EM. Morphometric evaluation showed significantly higher villi in the jejunum after EM addition. A greater crypt depth was observed in the C. perfringens group. Biochemical analysis of the blood indicated lower cholesterol on the 12th day of the experiment and between-group differences in total protein, lactate dehydrogenase (LDH), and albumin levels in the EM group. Further studies are needed to improve EM activity against pathologic bacteria as a potential alternative to antibiotics and to develop future natural production systems.
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Klabukov, I. D., A. V. Lyundup, T. G. Dyuzheva, and A. V. Tyakht. "BILIARY MICROBIOTA AND BILE DUCT DISEASES." Annals of the Russian academy of medical sciences 72, no. 3 (June 16, 2017): 172–79. http://dx.doi.org/10.15690/vramn787.
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Traditionally, the biliary tract has been considered to be normally sterile, and the presence of microorganisms in bile is a marker of a pathological process. This assumption was confirmed by failure in allocation of bacterial strains from the normal bile duct. The paper provides rationale for a phenomenon of the normal biliary microbiota as a separate functional layer which protects a biliary tract from colonization by exogenous microorganisms. We revealed the potential of metagenomic data for prevention of infectious diseases, post-operative complications of reconstructive interventions including bile duct stenting and implantation the tissue-engineered structures exposed to the risks of colonization with pathogenic / exogenous microorganisms. The methods based on preserving homeostasis of normal biliary microbiota ecosystem can be used for prevention of hepatobiliary diseases and treatment of biliary tract inflammatory diseases.
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Ohta, T., T. Nagakawa, Y. Tsukioka, H. Sanada, I. Miyazaki, and T. Terada. "Proliferative Activity of Bile Duct Epithelium after Bacterial Infection in Dogs." Scandinavian Journal of Gastroenterology 27, no. 10 (January 1992): 845–51. http://dx.doi.org/10.3109/00365529209000152.
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Rowe, Melissah, Gábor Árpád Czirják, Kevin J. McGraw, and Mathieu Giraudeau. "Sexual ornamentation reflects antibacterial activity of ejaculates in mallards." Biology Letters 7, no. 5 (April 13, 2011): 740–42. http://dx.doi.org/10.1098/rsbl.2011.0276.
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Bacteria present in ejaculates can impair sperm function and reduce male reproductive success. Thus, selection should favour the evolution of antimicrobial defences to limit the detrimental effects of sperm-associated bacteria. Additionally, current hypotheses suggest that ornamental traits may signal information about the infection status of an individual or the ability of an individual to resist bacterial-induced sperm damage. However, despite the evolutionary implications of ejaculate antimicrobials, and the putative importance of pathogens for the evolution of male ornamentation, tests of these hypotheses are lacking. We examined the antibacterial activity of semen from mallard ducks ( Anas platyrhynchos ) and tested whether the bactericidal capacity of semen was associated with bill coloration, a sexually selected trait. We show that mallard semen exhibits significant antibacterial activity, as measured by the in vitro capacity to kill Escherichia coli and Staphylococcus aureus . Furthermore, we demonstrate that males with more colourful bills have semen with superior bacterial-killing ability. These results suggest that females could use male phenotypic traits to avoid sexually transmitted pathogens and acquire partners whose sperm suffer less bacteria-induced damage.
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Rujeerapaiboon, Natthapat, and Apichat Kaewdech. "Massive biliary ascariasis: an unusual cause of acute cholangitis." BMJ Case Reports 14, no. 3 (March 2021): e239784. http://dx.doi.org/10.1136/bcr-2020-239784.
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Acute cholangitis is a condition of bacterial infection following hepatobiliary tract obstruction, which signifies poor prognosis unless adequately drained. The most common cause of bile duct obstruction is choledocholithiasis, in contrast to parasitic infestation, a rare entity causing acute cholangitis nowadays. Therefore, we reported the case of a 68-year-old Thai man who presented with acute fever, intense right upper quadrant abdominal pain and jaundice for 2 days. His medical history was normal except for the history of intermittent biliary colic for a year. Endoscopic retrograde cholangiography was performed and demonstrated multiple, creamy-coloured roundworms coming out from the ampulla of Vater as well as a tubular filling defect in dilated common bile duct from cholangiography. He was diagnosed with acute cholangitis by biliary ascariasis and underwent endoscopic parasitic removal, which subsequently improved symptoms.
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Chen, Bingrong, Seng Wang Fu, Lungen Lu, and Hang Zhao. "A Preliminary Study of Biliary Microbiota in Patients with Bile Duct Stones or Distal Cholangiocarcinoma." BioMed Research International 2019 (September 25, 2019): 1–12. http://dx.doi.org/10.1155/2019/1092563.
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Background and Objective. The distal cholangiocarcinoma (dCCA) is associated with many factors: genes, environment, infection, etc. The current changes in biliary flora are thought to be involved in the formation of many gastrointestinal tract (GIT) diseases, like colon adenocarcinoma. Therefore we want to investigate whether the dCCA has a certain correlation with biliary microecology, and to detect specific strains. Methods. A total of 68 adults were enrolled, of whom 8 with dCCA, 16 with recurrent choledocholithiasis, and 44 with the onset of common bile duct stones. Endoscopic Retrograde Cholangiopancretography (ERCP) was utilized to collect bile samples for DNA extraction and 16S rRNA gene sequencing, followed by analysis of bile microbiota composition. Results. First, Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria are the most dominant phyla in the bile of patients with dCCA and the onset of common bile duct stoes. Secondly, compared with the onset of common bile duct stones patients, we got a significant increase in the phylum Gemmatimonadetes, Nitrospirae, Chloroflexi, Latescibacteria, and Planctomycetes in dCCA patients. Finally, at the genus level, we obtained sequencing results of 252 bacterial genera from patients with dCCA, recurrent choledocholithiasis, and the new onset of common bile duct stones, revealing heterogeneity among individuals. Conclusion. To the best of our knowledge, this is the first study of the dysbiosis of bile flora in patients with dCCA. This micro-ecological disorder may be a decisive factor in the formation of dCCA. At the same time, for the first time, this study provides a test chart of biliary microbial populations that may be associated with recurrent choledocholithiasis. The compositional changes of the core microbial group of the biliary tract have potentially important biological and medical significance for the microbiological biliary disorders of dCCA.
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Karamarkovic, Aleksandar, Nada Popovic, Djordje Bajec, Vasilije Jeremic, Vladimir Djukic, Dejan Radenkovic, Vesna Bumbasirevic, and Pavle Gregoric. "Relation of pathoanatomic substrate and incidence of bacterial infection in the acute biliary pathology." Srpski arhiv za celokupno lekarstvo 133, no. 1-2 (2005): 52–57. http://dx.doi.org/10.2298/sarh0502052k.
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Acute biliary diseases have become the most common indication for major abdominal surgery. We investigated 60 patients who underwent surgery for the acute biliary diseases, within 48 hours from the onset of the illness (group I), and over longer preoperative interval (48 h up to 5 days) (group II). Surgical specimen (gallbladder) was histologically examined. Samples for microbiological exams were obtained from gallbladder, common bile duct, Lund's node, gallbladder bed and peritoneal cavity. Positive bile cultures were found in 43% of group I, and in 70% of group II (p<0.05). Microbiological analysis revealed 13 different species, mostly Gram negative aerobic rods (69%). The incidence of bacteriobilia was in correlation with HP of lesions (79% in the acute and 18% in chronic lesions; p<0.01), what testified the importance of time interval and role of bacterial factor in the acute biliary pathology. Septic complications strictly occurred in patients with positive biliary findings. Early surgical treatment eliminates focus, and stops further development of intraabdominal and systemic septic complications. Correlation between bacteriobilia and septic sequelae calls for prophylactic use of antibiotics.
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Kojima, Saori, Masayuki Nadai, Kiyoyuki Kitaichi, Li Wang, Toshitaka Nabeshima, and Takaaki Hasegawa. "Possible Mechanism by Which the Carbapenem Antibiotic Panipenem Decreases the Concentration of Valproic Acid in Plasma in Rats." Antimicrobial Agents and Chemotherapy 42, no. 12 (December 1, 1998): 3136–40. http://dx.doi.org/10.1128/aac.42.12.3136.
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ABSTRACT There is evidence indicating that the carbapenem antibiotic panipenem decreases plasma concentrations of valproic acid (VPA) in epileptic patients during VPA therapy. The mechanism for panipenem-induced changes in the pharmacokinetics of VPA was investigated in rats with and without bile duct cannulation. The effect of panipenem on the pharmacokinetics of diclofenac, which undergoes extensive enterohepatic recirculation, was also examined. VPA (50 mg/kg of body weight) or diclofenac (10 mg/kg of body weight) was administered intravenously under the steady-state plasma panipenem concentration of 4 μg/ml, which had been achieved by a constant infusion rate. Panipenem decreased the plasma VPA concentrations in rats without bile duct cannulation but did not change the volume of the initial space and protein binding of VPA. However, panipenem had no effect on the plasma VPA concentrations and the biliary excretion of VPA in rats with bile duct cannulation. The secondary increase in plasma diclofenac concentration observed in the absence of panipenem was diminished in the presence of panipenem. These findings suggest that panipenem decreases plasma VPA concentrations by suppressing its enterohepatic recirculation, probably due to a panipenem-induced decrease in the numbers of enteric bacteria.
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Mahler, Manuel Alejandro, Federico Marcaccio, Jean-Marc Dumonceau, and Carlos Macías Gómez. "Successful Endoscopic Management of Late Biliary Cast Syndrome in a Liver Transplant Recipient: A Case Report." Case Reports in Gastroenterology 11, no. 1 (April 10, 2017): 207–11. http://dx.doi.org/10.1159/000468509.
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Biliary cast syndrome (BCS) is an unusual complication of liver transplantation (LT). The pathophysiology is not known, and it is thought to develop because of mucosal damage in the bile duct related to obstruction, ischemia, or bacterial infection. It occurs in 2.5–18% of LT patients and is associated with increased graft failure, need for retransplantation, and mortality. Here we report on a case of BCS of late appearance after LT who was successfully treated by endoscopic means.
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Hardy, Jonathan, Jeffrey J. Margolis, and Christopher H. Contag. "Induced Biliary Excretion of Listeria monocytogenes." Infection and Immunity 74, no. 3 (March 2006): 1819–27. http://dx.doi.org/10.1128/iai.74.3.1819-1827.2006.
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ABSTRACT Listeria monocytogenes is a ubiquitous gram-positive bacterium that can cause systemic and often life-threatening disease in immunocompromised hosts. This organism is largely an intracellular pathogen; however, we have determined that it can also grow extracellularly in animals, in the lumen of the gallbladder. The significance of growth in the gallbladder with respect to the pathogenesis and spread of listeriosis depends on the ability of the bacterium to leave this organ and be disseminated to other tissues and into the environment. Should this process be highly inefficient, growth in the gallbladder would have no impact on pathogenesis or spread, but if it occurs efficiently, bacterial growth in this organ may contribute to listeriosis and dissemination of this organism. Here, we use whole-body imaging to determine the efficacy and kinetics of food- and hormone-induced biliary excretion of L. monocytogenes from the murine gallbladder, demonstrating that transit through the bile duct into the intestine can occur within 5 min of induction of gallbladder contraction by food or cholecystokinin and that movement of bacteria through the intestinal lumen can occur very rapidly in the absence of fecal material. These studies demonstrate that L. monocytogenes bacteria replicating in the gallbladder can be expelled from the organ efficiently and that the released bacteria move into the intestinal tract, where they pass into the environment and may possibly reinfect the animal.
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Ohta, T., T. Nagakawa, N. Ueda, T. Nakamura, M. Kayahara, K. Ueno, I. Miyazaki, T. Terada, and Y. Nakanuma. "Adenomatous Hyperplasia of the Bile Duct Epithelium of the Canine Liver, Caused by Bacterial Infection." Scandinavian Journal of Gastroenterology 26, no. 10 (January 1991): 1107–14. http://dx.doi.org/10.3109/00365529109003963.
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Headley, S. A., M. A. Gillen, A. W. D. Sanches, and M. Z. Satti. "Platynosomum fastosum-induced chronic intrahepatic cholangitis and Spirometra spp. infections in feral cats from Grand Cayman." Journal of Helminthology 86, no. 2 (June 1, 2011): 209–14. http://dx.doi.org/10.1017/s0022149x11000265.
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AbstractThe occurrence of platynosomiasis and intestinal sparganosis is described in feral cats from Grand Cayman, Cayman Islands. Spirometra spp. was observed within the intestine of 18.18% (10/55) of cats; 1.18% (1/55) of cats demonstrated gross and histological manifestation of parasitism by Platynosomum fastosum, but 14.5% (8/55) of cats had the characteristic pathological manifestations of P. fastosum-induced intrahepatic cholangitis without the concomitant presence of the intraductal trematode. Combined parasitism (Spirometra spp. and P. fastosum) was observed in 9.09% (5/55) of feral cats. Significant pathological findings were only associated with the hepatic fluke, P. fastosum, and were grossly characterized by moderate hepatomegaly with enlarged and dilated bile ducts. Examples of cestodes with morphological features characteristic of Spirometra spp. were observed within the small intestine without any associated pathological lesion. The histopathological evaluation of liver fragments revealed chronic intrahepatic cholangitis with and without the associated intraductal trematode, and was characterized by marked periductal fibrosis, adenomatous proliferation of bile duct epithelium, dilation of intrahepatic bile ducts and portal accumulations of inflammatory cells. The occurrence of the cestode in feral cats coupled with factors that are unique to Grand Cayman makes this island the ideal location for sporadic cases of human sparganosis.
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Yang, Runkuan, Keita Miki, Niku Oksala, Atsunori Nakao, Leena Lindgren, Meaghan E. Killeen, Ari Mennander, Mitchell P. Fink, and Jyrki Tenhunen. "Bile high-mobility group box 1 contributes to gut barrier dysfunction in experimental endotoxemia." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 297, no. 2 (August 2009): R362—R369. http://dx.doi.org/10.1152/ajpregu.00184.2009.
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Lipopolysaccharide (LPS) is an important factor in sepsis. LPS given by intraperitoneal injection induces intestinal hyperpermeability and bacterial translocation in animals and stimulates hepatic Kupffer cells to release TNF-α into the bile. This study aims to test the hypothesis that in response to LPS stimulation, hepatic Kupffer cells and extrahepatic macrophages release a large amount of the inflammatory cytokine high-mobility group box 1 (HMGB1) into the bile and that bile containing HMGB1 contributes to gut barrier dysfunction in experimental endotoxemia. To test this, rat common bile ducts were catheterized and bile flow rate was monitored before and during the LPS administration. Eight hours after LPS challenge, anti-HMGB1 neutralizing antibody or nonimmune (sham) IgG was injected into the duodenal lumen of endotoxemic rats; normal mice were also gavaged with normal or endotoxemic rat bile (bile collected from LPS-treated rats). We found that after LPS challenge, the bile flow rate in rats was significantly decreased at the 4- to 12-h time points, TNF-α concentration in the bile was markedly elevated at the 3- to 4-h time points, and bile HMGB1 levels were significantly increased at the 8- to 12-h time points. Duodenal injection with anti-HMGB1 antibody reversed LPS-induced gut barrier dysfunction in rats. In addition, feeding endotoxemic rat bile to normal mice significantly increased both mucosal permeability and bacterial translocation. The increase in permeability and bacterial translocation was reversible following removal of HMGB1 from the endotoxemic rat bile. These findings document that bile HMGB1 mediates gut barrier dysfunction in experimental endotoxemia.
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Černá, Petra, Scott Kilpatrick, and Danielle A. Gunn-Moore. "Feline comorbidities: What do we really know about feline triaditis?" Journal of Feline Medicine and Surgery 22, no. 11 (October 25, 2020): 1047–67. http://dx.doi.org/10.1177/1098612x20965831.
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Practical relevance: Feline triaditis describes concurrent pancreatitis, cholangitis and inflammatory bowel disease (IBD). The reported prevalence is 17–39% in ill referral patients. While the aetiology is poorly understood, it is known to include infectious, autoimmune and physical components. What is not known is whether different organs are affected by different diseases, or the same process; indeed, triaditis may be part of a multiorgan inflammatory disease. Feline gastrointestinal tract anatomy plays its role too. Specifically, the short small intestine, high bacterial load and anatomic feature whereby the pancreatic duct joins the common bile duct before entering the duodenal papilla all increase the risk of bacterial reflux and parenchymal inflammation. Inflammation may also be a sequela of bowel bacterial translocation and systemic bacteraemia. Diagnostic challenges: Cholangitis, pancreatitis and IBD manifest with overlapping, vague and non-specific clinical signs. Cholangitis may be accompanied by increased serum liver enzymes, total bilirubin and bile acid concentrations, and variable ultrasonographic changes. A presumptive diagnosis of pancreatitis is based on increased serum pancreatic lipase immunoreactivity or feline pancreas-specific lipase, and/or abnormal pancreatic changes on ultrasonography, though these tests have low sensitivity. Diagnosis of IBD is challenging without histopathology; ultrasound findings vary from normal to mucosal thickening or loss of layering. Triaditis may cause decreased serum folate or cobalamin (B12) concentrations due to intestinal disease and/or pancreatitis. Triaditis can only be confirmed with histopathology; hence, it remains a presumptive diagnosis in most cases. Evidence base: The literature on feline triaditis, pancreatitis, cholangitis and IBD is reviewed, focusing on histopathology, clinical significance and diagnostic challenges. Current management recommendations are provided. Further studies are needed to understand the complex pathophysiology, and in turn improve diagnosis and treatment.
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Boldizsár, Szandra, János Rottek, Tamás Schneider, Fatima Varga, and Erika Szaleczky. "Hodgkin-lymphomához társult eltűnőepeút-szindróma." Orvosi Hetilap 162, no. 22 (May 30, 2021): 884–88. http://dx.doi.org/10.1556/650.2021.32093.
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Összefoglaló. Az eltűnőepeút-szindróma ritka, rossz prognózisú kórkép. Az epeutak progresszív destrukciójával, az intrahepaticus epeutak eltűnésével jár, epepangáshoz, biliaris cirrhosishoz, végül májelégtelenséghez vezet. A háttérben álló kiváltó okok között infekciók, ischaemia, gyógyszermellékhatások, illetve daganatos megbetegedések szerepelhetnek. A malignitások közül a leggyakrabban a Hodgkin-lymphomához társult formájával találkozhatunk. Cikkünkben egy fiatal, Hodgkin-lymphomás betegünk esetét szeretnénk bemutatni, akinél az icterus hátterében eltűnőepeút-szindróma igazolódott, melyet egyéb okok kizárását követően szövettani mintavétellel igazoltunk. A két ciklus ABVD-protokoll szerinti kezelést követő PET/CT az alapbetegség tekintetében komplett metabolikus remissziót igazolt. A klinikai javuláshoz azonban hosszú hónapokra volt szükség. Végül az epeúteltűnés esetünkben reverzibilis folyamatnak bizonyult, az alapbetegség tekintetében a komplett metabolikus remisszió elérésével az epeút-károsodás megállítható volt. Orv Hetil. 2021; 162(22): 884–888. Summary. destruction and loss of the intrahepatic bile ducts leading to cholestatis, biliar chirrosis and finally liver failure. It has been described in different pathologic conditions including infections, ischemia, adverse drug reactions and malignancies. The Hodgkin’s lymphoma-associated type occurs most frequently among the forms of the disease of malignant origin. In this report, we introduce the case of a 32-year-old male patient with Hodgkin’s lymphoma, diagnosed with vanishing bile duct syndrome upon liver biopsy as a root cause behind his icterus. The PET/CT has proven complete metabolic remission after 2 cycles of ABVD chemoterapy. Clinical improvement, however, occurred only after several months. Finally the loss of bile ducts proved to be a reversible process, the complete metabolic remission of Hodgkin’s lymphoma resulted in the regeneration of the bile ducts. Orv Hetil. 2021; 162(22): 884–888.
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Hashimoto, Masao, Motoshi Ouchi, Jun Norose, Syoko Futami-Suda, Kazunari Suzuki, Norifumi Matsumura, Yoshimasa Igari, et al. "Bile duct hamartomas (von Meyenburg complexes) associated with a bacterial infection: Case report of elderly diabetic patient." Geriatrics & Gerontology International 11, no. 4 (September 27, 2011): 534–36. http://dx.doi.org/10.1111/j.1447-0594.2011.00700.x.
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Lewis, Ronald T. "Biliary Bacteria, Antibiotic Use, and Wound Infection in Surgery of the Gallbladder and Common Bile Duct." Archives of Surgery 122, no. 1 (January 1, 1987): 44. http://dx.doi.org/10.1001/archsurg.1987.01400130050007.
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Ganiuk, V., V. Khil, V. Kondratiuk, A. Francishco, and L. Polishchuk. "The species composition of microflora of health care associated infections in the intensive care unit." Reports of Vinnytsia National Medical University 24, no. 1 (May 18, 2020): 20–24. http://dx.doi.org/10.31393/reports-vnmedical-2020-24(1)-04.
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Annotation. The aim of the study was to identify the predominant microorganisms that caused health care associated infections in the intensive care unit (for surgical patients) National Military Medical Center “Main Military Clinical Hospital” in 2018. Identification of microorganisms was carried out in the laboratory department (microbiological), clinic of laboratory diagnostics the same hospital, which has national accreditation for work with microorganisms of the III – IV class of pathogenicity. The results of 631 bacteriological examinations were analyzed, namely 240 samples of blood from 88 patients, 269 urine samples from 77 patients, 97 samples of endotracheal content/sputum, obtained from 16 patients and another 25 samples from other anatomical sites (the bile ductus drains, pleural fluids) from 8 patients. Statistical processing was performed using Microsoft Excel 2016. The significance of the difference was checked by the method of χ2. The number of samples without growth was 206 (33 %). There were founded that the leading microorganism was K. pneumoniae 105 (25 %) isolates, followed by P. aeruginosa with 80 isolates (19 %), P. mirabilis 19 (4 %), E. coli 18 (4 %). The fraction of gram-positive bacteria was 31 % (118 isolates). There is a prominent difference among predominant microorganisms that caused health care associated infections corresponding to the anatomic site infection (p˂0.05). In blood cultures the K. pneumoniae (26 %) were leading microorganism, while P. aeruginosa (24 %) was found predominant in the respiratory tract, and Enterococcus spp (23 %) were the main isolates from the urine. Any isolates of A. baumannii were cultured. Formalizing the process of bacteriological observation, careful selection of patients for research and collection of epidemiological information featuring health care associated infections in the intensive care unit will systematize the process of infection control and allow to apply a quality control system.
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Singla, Poonam, Priyanka Dalal, Mahaldeep Kaur, Geeta Arya, Surendra Nimesh, Rachna Singh, and Deepak B. Salunke. "Bile Acid Oligomers and Their Combination with Antibiotics To Combat Bacterial Infections." Journal of Medicinal Chemistry 61, no. 22 (November 2, 2018): 10265–75. http://dx.doi.org/10.1021/acs.jmedchem.8b01433.
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Silva, L. C. da, M. Regina Vianna, C. P. Abrantes, D. M. C. Lima, A. L. Falavigna, R. H. Antonelli-Cardoso, S. D. Deperon Gallucci, and T. de Brito. "Liver morphology with emphasis on bile ducts changes and survival analysis in mice submitted to multiple Schistosoma mansoni infections and chemotherapy." Revista do Instituto de Medicina Tropical de São Paulo 32, no. 5 (October 1990): 328–37. http://dx.doi.org/10.1590/s0036-46651990000500004.
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In an attempt to be as close as possible to the infected and treated patients of the endemic areas of schistosomiasis (S. mansoni) and in order to achieve a long period of follow-up, mice were repeatedly infected with a low number of cercariae. Survival data and histological variables such as schistosomal granuloma, portal changes, hepatocellular necrosis, hepatocellular regeneration, schistosomotic pigment, periductal fibrosis and chiefly bile ducts changes were analysed in the infected treated and non treated mice. Oxamniquine chemotherapy in repeatedly infected mice prolonged survival significantly when compared to non-treated animals (chi-square 9.24, p = 0.0024), thus confirming previous results with a similar experimental model but with a shorter term follow-up. Furthermore, mortality decreased rapidly after treatment suggesting an abrupt reduction in the severity of hepatic lesions. A morphological and immunohistochemical study of the liver was carried out. Portal fibrosis, with a pattern resembling human Symmers fibrosis was present at a late phase in the infected animals. Bile duct lesions were quite close to those described in human Mansonian schistosomiasis. Schistosomal antigen was observed in one isolated altered bile duct cell. The pathogenesis of the bile duct changes and its relation to the parasite infection and/or their antigens are discussed.
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Chen, F., M. Aguero-Rosenfeld, A. Simsir, and T. C. Brandler. "Identification Of Liver Fluke Eggs In Bile Duct Brush Cytology In An 82 Year Old Man With A Hepatic Mass: Report Of A Case." American Journal of Clinical Pathology 154, Supplement_1 (October 2020): S92—S93. http://dx.doi.org/10.1093/ajcp/aqaa161.203.
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Abstract Introduction/Objective Clonorchis sinensis infects the liver, gallbladder, and bile ducts in humans. It is acquired via consumption of raw/undercooked fish, crabs, or crayfish in endemic areas. Though majority are asymptomatic, long lasting infections may cause severe disease. Without treatment, human infections may persist for the parasite lifespan (25–30 years). Diagnosis in cytology is challenging with a potentially acellular sample with miniscule eggs that can be overlooked as an artifact. Here we reported a rare case of liver fluke eggs diagnosed in bile duct brush cytology. Methods An 82 year old man who emigrated from China 20 years prior presented to the hospital with worsening jaundice for 2 weeks. Abdominal CT revealed a 4.8 x 2.9 cm central right hepatic lobe mass extending to the hilum, obstructing the bile ducts, resulting in severe intrahepatic ductal dilatation and stricture and focal occlusion of the right anterior portal vein. His CBC revealed eosinophilia. Bile duct brushing was submitted for cytology. Results ThinPrep and cell block showed oval-shaped parasite eggs measuring 10-24 µm. There was no other cellular matter. Eggs had a convex operculum resting on “shoulders” at the smaller end of the egg. At the opposite (abopercular) end, a small knob or hook-like protrusion was often visible. Wet mounts revealed visible miracidium inside the eggs. These findings were compatible with liver fluke eggs. Conclusion Cytologic microbiologic features of fluke eggs confirmed the findings. The most important features are the shape and size of the eggs; The seated operculum with its prominent “shoulders”, a small knob at the abopercular end, which can distinguish them from acellular artifact or a human cell. The cytologic and microbiologic features combined with the travel history and clinical presentation can aid in achieving the diagnosis.
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Harada, Kenichi, and Yasuni Nakanuma. "Biliary Innate Immunity: Function and Modulation." Mediators of Inflammation 2010 (2010): 1–9. http://dx.doi.org/10.1155/2010/373878.
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Biliary innate immunity is involved in the pathogenesis of cholangiopathies in patients with primary biliary cirrhosis (PBC) and biliary atresia. Biliary epithelial cells possess an innate immune system consisting of the Toll-like receptor (TLR) family and recognize pathogen-associated molecular patterns (PAMPs). Tolerance to bacterial PAMPs such as lipopolysaccharides is also important to maintain homeostasis in the biliary tree, but tolerance to double-stranded RNA (dsRNA) is not found. In PBC, CD4-positive Th17 cells characterized by the secretion of IL-17 are implicated in the chronic inflammation of bile ducts and the presence of Th17 cells around bile ducts is causally associated with the biliary innate immune responses to PAMPs. Moreover, a negative regulator of intracellular TLR signaling, peroxisome proliferator-activated receptor-γ(PPARγ), is involved in the pathogenesis of cholangitis. Immunosuppression using PPARγligands may help to attenuate the bile duct damage in PBC patients. In biliary atresia characterized by a progressive, inflammatory, and sclerosing cholangiopathy, dsRNA viruses are speculated to be an etiological agent and to directly induce enhanced biliary apoptosis via the expression of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Moreover, the epithelial-mesenchymal transition (EMT) of biliary epithelial cells is also evoked by the biliary innate immune response to dsRNA.
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Islam, Abul F. M. W., Nathan D. Moss, Yung Dai, Murray S. R. Smith, Andrew M. Collins, and Graham D. F. Jackson. "Lipopolysaccharide-Induced Biliary Factors Enhance Invasion of Salmonella enteritidis in a Rat Model." Infection and Immunity 68, no. 1 (January 1, 2000): 1–5. http://dx.doi.org/10.1128/iai.68.1.1-5.2000.
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ABSTRACT In this study, the role of the hepatobiliary system in the early pathogenesis of Salmonella enteritidis infection was investigated in a rat model. Intravenous (i.v.) challenge with lipopolysaccharide (LPS) has previously been shown to enhance the translocation of normal gut flora. We first confirmed that LPS can similarly promote the invasion of S. enteritidis. Oral infection of outbred Australian Albino Wistar rats with 106to 107 CFU of S. enteritidis led to widespread tissue invasion after days. If animals were similarly challenged after intravenous administration of S. enteritidis LPS (3 to 900 μg/kg of body weight), significant invasion of the livers and mesenteric lymph nodes (MLN) occurred within 24 h, with invasion of the liver increasing in a dose-dependent fashion (P< 0.01). If bile was prevented from reaching the intestine by bile duct ligation or cannulation, bacterial invasion of the liver and MLN was almost totally abrogated (P < 0.001). As i.v. challenge with LPS could induce the delivery of inflammatory mediators into the bile, biliary tumor necrosis factor alpha (TNF-α) concentrations were measured by bioassay. Biliary concentrations of TNF-α rose shortly after LPS challenge, peaked with a mean concentration of 27.0 ng/ml at around 1 h postchallenge, and returned to baseline levels (3.1 ng/ml) after 2.5 h. Although TNF-α cannot be directly implicated in the invasion process, we conclude that the invasiveness of the enteric pathogen S. enteritidis is enhanced by the presence of LPS in the blood and that this enhanced invasion is at least in part a consequence of the delivery of inflammatory mediators to the gastrointestinal tract by the hepatobiliary system.
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Sithithaworn, P., K. Ando, W. Limviroj, S. Tesana, C. Pairojkul, W. Yutanawiboonchai, Y. Chinzei, T. Yoshida, and T. Sakakura. "Expression of tenascin in bile duct cancer of hamster liver by combined treatment of dimethylnitrosamine with Opisthorchis viverrini infections." Journal of Helminthology 76, no. 3 (September 2002): 261–68. http://dx.doi.org/10.1079/joh2002129.
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AbstractTenascin is an extracellular matrix glycoprotein known to be an essential factor for the modulation of reciprocal interactions between the epithelium and mesenchyme during embryogenesis and tumourigenesis. The interactions between the expression of tenascin in the liver of Syrian golden hamster and the development of bile duct cancer in an Opisthorchis viverrini-associated cholangiocarcinoma model were investigated. The tenascin was expressed in connective tissues surrounding the dilated ducts, ductal rims and the stroma of cancers, and strongly in the stroma flame of necrotic cancer nodules. The mRNA signal for tenascin was also recognized in the stroma cells. The potential roles of tenascin as prognostic tumour markers are discussed.
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Dzidzava, I. I., B. N. Kotiv, A. A. Apollonov, A. V. Smorodsky, A. V. Slobodjanik, S. A. Soldatov, A. V. Kudrjavceva, I. V. Dmitrochenko, and A. A. Afanasyev. "Modern approaches to diagnosis and treatment of bacterial liver abscesses." Bulletin of the Russian Military Medical Academy 20, no. 1 (March 15, 2018): 209–15. http://dx.doi.org/10.17816/brmma12323.
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Modern notions about etiology, pathogenesis and microbiological characteristics of bacterial liver abscesses are analyzed. Cholangiogenic abscess is a prevailing type among the incidences of liver abscesses. Today Klebsiella pneumoniae strains are the predominant cause of pyogenic hepatic abscess. Diagnosis of liver abscesses is based on a combination of clinical and laboratory findings and visualization survey methods. Success in the treatment of liver abscesses is provided by a multimodal approach, including sanation of purulent focus, rational antibacterial therapy and elimination of the main etiologic factor. Effective antibiotic therapy is based on the results of permanent microbiological monitoring of the abscess cavity, bile and blood contents. The question remains about what is the optimal time frame for antibiotic therapy. The main method of treatment of liver abscess is surgical. In the vast majority of cases, minimally invasive puncture-drainage under ultrasound or CT guidance proves to be an effective and sufficient method of treatment, regardless of the size, location and number of purulent foci. There is no consensus, however, on a differentiated choice of minimally invasive sanitation techniques, drainage periods and removal criteria in medical literature. An algorithm for treatment of cholangiogenic liver abscesses must include methods that ensure restoration of the bile ducts patency, relief of biliary hypertension and cholangitis. If the minimally invasive drainage techniques proves ineffective, as well as in cases of complicated abscess or presence of large sequesters in the destruction cavity, it is recommended to perform laparoscopic or traditional open surgery (including liver resections).