Computed tomography findings of ceftriaxone-associated biliary pseudocholelithiasis in adults

Yoshida, Rika; Yoshizako, Takeshi; Katsube, Tomoko; Kitagaki, Hajime

doi:10.1007/s11604-019-00893-5

Cited by 10 publications

(9 citation statements)

References 23 publications

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“…In the present study, we found 1 case of cholangitis requiring biliary drainage via ERCP (4%, 1/24). Pseudolithiasis mainly showed a high-density sludge pattern on CT ( 17 ). Most of the pseudolithiasis cases found in this study showed a sludge pattern, and the stone extracted by ERCP also showed a sludge-like appearance.…”

Section: Discussionmentioning

confidence: 99%

Ceftriaxone-associated Pseudolithiasis in Elderly People: Frequency and Risk Factors

et al. 2021

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Objective Ceftriaxone (CTRX) is a widely used antibiotic because of its long plasma half-life and good tissue transmission. Many of the reported studies on CTRX-associated pseudolithiasis were performed in children. Although some studies have been published in adults, there are no studies limited to elderly people. The present study investigated CTRX-associated pseudolithiasis and explored its risk factors in the elderly. Methods We retrospectively reviewed 133 elderly patients (" 65 years old) treated with CTRX. Pseudolithiasis was defined as stones or sludge newly appearing in the gallbladder, as detected by computed tomography after the administration of CTRX. We evaluated the risk factors for pseudolithiasis using multivariate regression and inverse probability of treatment weighting analyses. Results Among the 133 patients, 24 (18%) developed CTRX-associated pseudolithiasis. In a multivariate analysis, the CTRX dose [odds ratio (OR) 4.54, 95% confidence interval (CI) 1.36-15.07, p=0.012] and CTRX treatment duration (OR 2.80, 95% CI 1.06-8.04, p=0.043) were significantly associated with pseudolithiasis formation. The cut-off value of the total CTRX dose associated with pseudolithiasis formation was 19 g. A propensity analysis determined that the frequency of pseudolithiasis was increased in patients treated with >19 g total CTRX compared with those who received ! 19 g in total (OR 4.06, p= 0.008). ConclusionThe incidence rate of CTRX-induced pseudolithiasis is high in elderly people, and the CTRX dose and CTRX treatment duration are significant risk factors for pseudolithiasis. A total dose of >19 g increases the likelihood of pseudolithiasis formation in elderly people treated with CTRX.

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Section: Discussionmentioning

confidence: 99%

Ceftriaxone-associated Pseudolithiasis in Elderly People: Frequency and Risk Factors

et al. 2021

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“…The patient in this case was also found to have pseudolithiasis in the extrahepatic bile duct. Yoshida et al (14) reported that 7 patients (41.2%) showed gallbladder enlargement along with a common bile duct stone and reported the high-density sludge pattern as the most common CT finding of CTRX-associated pseudolithiasis in adults. In our patient, EUS showed a hyperechoic structure adhering to the long axis of the bile duct wall.…”

Section: Discussionmentioning

confidence: 99%

Ceftriaxone-associated Pseudolithiasis in the Gallbladder and Bile Duct of an Elderly Patient

et al. 2020

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A 78-year-old man had been undergoing treatment with Cefamezin for pyogenic spondylitis. Because of complication of a urinary tract infection, the medication was switched to ceftriaxone (CTRX) 2 g/day. On day 18 after starting CTRX, the patient began experiencing abdominal pain. Computed tomography (CT) and endoscopic ultrasound led to the identification of calculi in the gallbladder and extrahepatic bile duct with a peculiar formation. We suspected CTRX-associated pseudo-cholecystolithiasis and pseudo-choledocholithiasis, although CT performed at admission had shown no such findings. Therefore, CTRX was discontinued. By day 17 after CTRX cessation, both the pseudo-cholecystolithiasis and pseudo-choledocholithiasis had disappeared.

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“…Even with the aid of cutting edge technique of dual-energy CT, the sensitivity for the CS is around 75% −85% 13 and sometimes suffers from false positive finding of the gallstones. 14 Although MRCP is comparable to ERCP in detecting CBD pathologies and even more accurate than CT or US, 15 its detection is dependent on heavily T2-weighted image (T2WI) that depict pathologies only as filling defects in the bright bile. The strategy of this contrast creation functions most of the occasions; however, there are several exceptional situations.…”

Section: Introductionmentioning

confidence: 99%

“…Even with the aid of cutting edge technique of dual-energy CT, the sensitivity for the CS is around 75%−85% 13 and sometimes suffers from false positive finding of the gallstones. 14 …”

Section: Introductionmentioning

confidence: 99%

Three Dimensional Ultra-short Echo Time MRI Can Depict Cholesterol Components of Gallstones Bright

Takahashi

Takehara

Fujisaki³

et al. 2021

magn reson med sci

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Purpose Non-calcified cholesterol stones that are small in size are hard to be depicted on CT or magnetic resonance cholangiopancreatography. This institutional review board (IRB)-approved retrospective in vitro study aims to characterize contrast behaviors of 3 main components of the gallstones, i.e., cholesterol component (CC), bilirubin calcium component (BC) and CaCO 3 (CO) on 3D radial scan with ultrashort TE (UTE) MRI, and to test the capability of depicting CC of gallstones as bright signals as compared to background saline. Methods Fourteen representative gallstones from 14 patients, including 15 CC, 6 BC and 4 CO, were enrolled. The gallstones underwent MRI including fat-saturated T1-weighted image (fs-T1WI) and UTE MRI with dual echoes. The contrast-to-noise ratio (CNR) and the chemical analysis for the 25 portions of the stones were compared. Results BC was bright on fs-T1WI, which did not change dramatically on UTE MRI and the signal did not remain on UTE subtraction image between dual echoes. Whereas the CC was negative or faintly positive signal on fs-T1WI, bright signal on UTE MRI and the contrast remained even higher on the UTE subtraction, which reflected their short T2 values. Median CNRs and standard errors of the segments on each imaging were as follows: on fs-T1WI, −10.2 ± 4.2 for CC, 149.7 ± 27.6 for BC and 37.9 ± 14.3 for CO; on UTE MRI first echo, 16.7 ± 3.3 for CC, 74.9 ± 21.3 for BC and 17.7 ± 8.4 for CO; on UTE subtraction image, 30.2 ±2.0 for CC, −11.2 ± 5.4 for BC and 17.8 ± 10.7 for CO. Linear correlations between CNRs and cholesterol concentrations were observed on fs-T1WI with r = −0.885, ( P < 0.0001), UTE MRI first echo r = −0.524 ( P = 0.0072) and UTE subtraction with r = 0.598 ( P = 0.0016). Conclusion UTE MRI and UTE subtraction can depict CC bright.

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Computed tomography findings of ceftriaxone-associated biliary pseudocholelithiasis in adults

Cited by 10 publications

References 23 publications

Ceftriaxone-associated Pseudolithiasis in Elderly People: Frequency and Risk Factors

Ceftriaxone-associated Pseudolithiasis in Elderly People: Frequency and Risk Factors

Ceftriaxone-associated Pseudolithiasis in the Gallbladder and Bile Duct of an Elderly Patient

Three Dimensional Ultra-short Echo Time MRI Can Depict Cholesterol Components of Gallstones Bright

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