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Related Concept Videos

Cholecystitis01:20

Cholecystitis

Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...
Chronic Pancreatitis I: Introduction01:24

Chronic Pancreatitis I: Introduction

The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Chronic Pancreatitis I: Introduction01:25

Chronic Pancreatitis I: Introduction

Chronic pancreatitis is a long-standing, relapsing inflammation of the pancreas, characterized by irreversible damage to the gland. It results in progressive destruction of the pancreatic parenchyma, fibrosis, and eventual loss of both exocrine and endocrine function. The disease may evolve gradually after multiple episodes of acute pancreatitis or develop independently.EtiologyChronic pancreatitis can arise from a variety of causes:Alcohol use is the leading cause, accounting for 70–80% of...
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Appendicitis01:19

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
Acute Pancreatitis II: Clinical Manifestations and Management01:30

Acute Pancreatitis II: Clinical Manifestations and Management

Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...

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Updated: Jun 30, 2026

Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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T-cell PTLD presenting as acalculous cholecystitis.

Tamir Miloh1, Margret Magid, Alyssa Yurovitsky

  • 1Departments of Pediatric Hepatology, Mount SinaiHospital, New York, NY 10029, USA. tamir.miloh@mountsinai.org

Pediatric Transplantation
|September 18, 2008
PubMed
Summary

A child developed acalculous cholecystitis post-heart transplant, diagnosed with Epstein-Barr virus negative T-cell post-transplant lymphoproliferative disorder (PTLD). Despite chemotherapy, the PTLD relapsed, leading to a fatal outcome.

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Area of Science:

  • Pediatric Oncology
  • Transplant Immunology
  • Gastroenterology

Background:

  • Post-transplant lymphoproliferative disorder (PTLD) is a serious complication following solid organ transplantation.
  • Epstein-Barr virus (EBV) is commonly associated with PTLD, but EBV-negative cases occur.
  • Acalculous cholecystitis can be a rare manifestation of PTLD in pediatric transplant recipients.

Observation:

  • A five-year-old heart transplant recipient presented with acalculous cholecystitis three years post-transplant.
  • Histological examination revealed Epstein-Barr virus (EBV)-negative T-cell PTLD.
  • The PTLD involved multiple organs, including the gallbladder, liver, lungs, and mesenteric lymph nodes.

Findings:

  • The patient received chemotherapy and achieved initial remission.
  • The PTLD relapsed after 11 months of initial remission.
  • The patient ultimately succumbed to the disease.

Implications:

  • This case highlights the potential for EBV-negative T-cell PTLD to manifest as acalculous cholecystitis in pediatric heart transplant patients.
  • It underscores the aggressive nature and potential for relapse of PTLD, even with treatment.
  • Further research into the pathogenesis and treatment of EBV-negative PTLD is warranted.