A 56 year old African American female who had a past medical history of transient ischemic attack in 2006 presented in our emergency department with first episode of sudden onset of severe central chest pain radiating to both arms , exaggerated by exertion, without any relieving factors, associated with nausea and sweating. She was taking baby aspirin, folic acid and multivitamin regularly. She...

BACKGROUND & OBJECTIVES Information on gastrointestinal manifestations and then response after curative parathyroid surgery is scarce in symptomatic primary hyperparathyroidism (PHPT). This study was carried out to analyse gastrointestinal manifestations in patients with PHPT and their associations with biochemical parameters. METHODS This retrospective study included 153 patients with sympto...

With prevalence of 10-20% in adults in developed countries, gallstone disease (GSD) is one of the most prevalent and costly gastrointestinal tract disorders in the world. In addition to gallstone disease, chronic liver disease (CLD) is also an important global public health problem. The reported frequency of gallstone in chronic liver disease tends to be higher. The prevalence of gallstone dise...

BACKGROUND The prevalence of cholesterol gallstones is high in Western populations, while pigment gallstones are common in Asian populations. Dietary factors are suggested to be associated with gallstone risk, but their relationship with gallstone type has not been evaluated. This study investigated the association between diet and risk of cholesterol gallstone or pigment gallstone in a Korean ...

To cite: Abukar AA, Leung P, Vulliamy P, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/ bcr-2015-211986 DESCRIPTION A 53-year-old man with a history of hypercholesterolaemia and symptomatic cholelithiasis presented with a 1-day history of bilious vomiting, intermittent abdominal pain, anorexia and absolute constipation. Physical examination revealed a mildly ...

The etiology of gallstone disease is multifactorial; supersaturation of bile with cholesterol is a primary cause for gallstone formation. In previous studies, we found that fibroblast growth factor receptor 4 (FGFR4) plays an important role in maintaining bile acid homeostasis by regulating the expression of cholesterol 7α-hydroxylase (CYP7A1), a rate-limiting enzyme for bile acid biosynth...

We investigated the possible link between liver cirrhosis and gallstone risk in chronic hepatitis C (CHC) patients in China.To analyze the association between liver cirrhosis and gallstone development, we compared outcomes of 133 Chinese CHC patients with gallstones and an age-, sex-, and hepatitis C virus RNA level-matched control group of 431 CHC patients without gallstones.We found that live...

BACKGROUND AND AIMS Cholesterol gallstone disease is a complex process involving both genetic and environmental variables. No information exists regarding what role if any the indigenous gastrointestinal microbiota may play in cholesterol gallstone pathogenesis and whether variations in the microbiota can alter cholesterol gallstone prevalence rates. METHODS Genetically related substrains (BA...

BACKGROUND Our study aimed to assess the nationwide trends in the incidence of severe gallstone disease in Taiwan among adults aged >or=20. METHODS A retrospective longitudinal study was conducted using Taiwan National Health Insurance Research Database collected during 1997-2005. Patients with incident severe gallstone disease (acute cholecystitis, biliary pancreatitis, acute cholangitis) an...

Should persons with symptomatic gallstones (i.e., those that have caused biliary pain) be treated immediately? Or may they be managed expectantly until pain recurs or a biliary complication (i.e., acute cholecystitis or pancreatitis) occurs? To assess the mortality risk of different strategies, we performed a quantitative analysis. For the expectant management strategy that requires surgery onl...