, Kyu Won Chung, Sun Young Yi To investigate clinicopathologic findings and gallbladder (GB) function in patients with endoscopic bile reflux at outpatients clinic.
We classified endoscopic bile reflux into two groups by bile reflux index (BRI). Those who scored above 14 were the BRI (+) group, and those below 14 were the BRI (-) group. We analyzed clinical characteristics, endoscopic findings including
Endoscopic bile reflux identified in 9.7% of all cases with gastrointestinal symptoms. There are cholecystectomy in 6.7%, gastrectomy in 2.7%, and GB dysfunction in 20.0%. They had prominent gastrointestinal symptoms with variable endoscopic findings. Foveolar hyperplasia is the most common pathologic finding and
Endoscopic bile reflux was common findings with young adults (30's) at outpatients clinic. Foveolar hyperplasia is common pathologic finding. GB dysfunction were identified as significant risk factors for BRI (+) group.
The role of Helicobacter pylori(HP) in benign and malignant pancreatico-biliary tract disease is concerned in recent papers. The urease gene of Hp were found in human bile, and bacteria morphologically resembling Hp were found in resected gallbladder mucosa from patients with gallbladder disease. It was hypothesized that there is an association between the presence of Hp in bile and pancreatico-biliary disease. The aims of this study are to examine if Hp exist in the bile juice and to investigate whether Hp plays a role in the pancreatico-biliary disease.
Thirty-eight patients (18 males and 20 females, mean age 71 ?27yr ; range 45-92yr) with gallstone and malignant pancreatico-biliary disease were enrolled in this study ; 23 cases were gallstone diseases, 10 cases were cholangiocarcinomas, and 5 cases were pancreatic cancers. Thirty-eight controls were age- and sex-matched and enrolled from subject attending routine medical check-up. The presence of Hp in stomach was confirmed by ?4C-breath test. The polymerase chain reaction (PCR) assay was used to detect the Hp in bile.
The Hp-positive rate in stomach was much higher in control (26/38,68.4%) than the patients with pancreatico-biliary disease(l1/38, 28.9%) (p<0.01). The Hp-positive rate in bile of pancreatico-biliary disease was 18.4% but, there is no relation between of the presence of Hp in the stomach and in the bile (p=0.33). Also there was no significant difference of the presence of Hp in bile (p>0.05) and stomach (p=0.28) between benign and malignant disease.
The Hp-positive rate in bile was similar in benign and malignant pancreatico-biliary disease. But Hp may not be important risk factor in pancreatico-biliary disease in Hp-prevatent country like south Korea.
, Doe-Young Kim, Hye-Kyung Jung, Il-Hwan Moon, Sue-Yeun Shin, Jae-Jin Kwak Milk of calcium bile or limy bile is a rare disorder in which the gallbladder lumen is filled with a thick, paste-like, radio-opaque material. Churchman first reported a case of curious deposition of calcium salts within the gallbladder in 1911. Volkmann first used the term Kalkmilchgalle or milk of calcium bile in 1926. The radio-opaque material is almost entirely composed of calcium carbonate by weight. The mechanisms by which bile turns limy and radio-opaque or the time required for this biochemical alteration to occur are not well understood. The limy bile is found mostly in a gallbladder complicated by cholecystitis. Recently, we experienced a 33 year old woman who had a milk of calcium bile in the gallbladder lumen. We report this case with a review of literature.
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