Postcholecystectomy syndrome

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Postcholecystectomy syndrome
Classification and external resources
ICD-10	K 91.5
ICD-9	576.0

Postcholecystectomy syndrome (PCS) describes the presence of abdominal symptoms after surgical removal of the gallbladder (Cholecystectomy).

Symptoms of postcholecystectomy syndrome may include:

Upset stomach, nausea, and vomiting.

Gas, bloating, and diarrhea.

Persistent pain in the upper right abdomen.^[1]

Symptoms occur in about 5 to 40 percent of patients who undergo cholecystectomy. ^[2]

The pain associated with post-cholecystectomy syndrome is usually ascribed to either sphincter of Oddi dysfunction or to post-surgical adhesions. ^[3]

Approximately 50% of cases are due to biliary causes such as remaining stone, biliary injury, dysmotility and choledococyst. The remaining 50% are due to non-biliary causes. This is because upper abdominal pain and gallstones are both common but are not always related.

References

^ Womack NA, Crider RL (1947). "The Persistence of Symptoms Following Cholecystectomy". Ann. Surg. 126 (1): 31–55. doi:10.1097/00000658-194707000-00004. PMC 1803303. PMID 17858976. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1803303.
^ "Postcholecystectomy syndrome". WebMD. http://www.webmd.com/hw-popup/Postcholecystectomy-syndrome. Retrieved 2009-03-07.
^ Hyvärinen H, Sipponen P, Silvennoinen E (December 1990). "Intestinal adhesions: an overlooked cause of the postcholecystectomy syndrome". Hepatogastroenterology 37 (Suppl 2): 58–61. PMID 2083937.

Digestive system · Digestive disease · Gastroenterology (primarily K20–K93, 530–579)

Upper GI tract

Esophagus	Esophagitis (Candidal, Herpetiform) · Rupture (Boerhaave syndrome, Mallory-Weiss syndrome) · UES (Zenker's diverticulum) · LES (Barrett's esophagus) · Esophageal motility disorder (Nutcracker esophagus, Achalasia, Diffuse esophageal spasm, Gastroesophageal reflux disease (GERD)) · Laryngopharyngeal reflux (LPR) · Esophageal stricture · Megaesophagus

Stomach	Gastritis (Atrophic, Ménétrier's disease, Gastroenteritis) · Peptic (gastric) ulcer (Cushing ulcer, Dieulafoy's lesion) · Dyspepsia · Pyloric stenosis · Achlorhydria · Gastroparesis · Gastroptosis · Portal hypertensive gastropathy · Gastric antral vascular ectasia · Gastric dumping syndrome · Gastric volvulus

Lower GI tract:
Intestinal/
Enteropathy

Small intestine (Duodenum/Jejunum/Ileum)	Enteritis (Duodenitis, Jejunitis, Ileitis) — Peptic (duodenal) ulcer (Curling's ulcer) — Malabsorption: Coeliac · Tropical sprue · Blind loop syndrome · Small bowel bacterial overgrowth syndrome · Whipple's · Short bowel syndrome · Steatorrhea · Milroy disease · bile acid malabsorption

Large intestine (Appendix/Colon)	Appendicitis · Colitis (Pseudomembranous, Ulcerative, Ischemic, Microscopic, Collagenous, Lymphocytic) · Functional colonic disease (IBS, Intestinal pseudoobstruction / Ogilvie syndrome) — Megacolon / Toxic megacolon · Diverticulitis/Diverticulosis

Large and/or small	Enterocolitis (Necrotizing) · IBD (Crohn's disease) — Vascular: Abdominal angina · Mesenteric ischemia · Angiodysplasia — Bowel obstruction: Ileus · Intussusception · Volvulus · Fecal impaction — Constipation · Diarrhea (Infectious) · Intestinal adhesions

Rectum	Proctitis (Radiation proctitis) · Proctalgia fugax · Rectal prolapse · Anismus

Anal canal	Anal fissure/Anal fistula · Anal abscess · Anal dysplasia · Pruritus ani

GI bleeding/BIS

Upper (Hematemesis, Melena) · Lower (Hematochezia)

Accessory

Liver	Hepatitis (Viral hepatitis, Autoimmune hepatitis, Alcoholic hepatitis) · Cirrhosis (PBC) · Fatty liver (NASH) · Vascular (Budd-Chiari syndrome, Hepatic veno-occlusive disease, Portal hypertension, Nutmeg liver) · Alcoholic liver disease · Liver failure (Hepatic encephalopathy, Acute liver failure) · Liver abscess (Pyogenic, Amoebic) · Hepatorenal syndrome · Peliosis hepatis

Gallbladder	Cholecystitis · Gallstones/Cholecystolithiasis · Cholesterolosis · Rokitansky-Aschoff sinuses · Postcholecystectomy syndrome · Porcelain gallbladder

Bile duct/ Other biliary tree	Cholangitis (PSC, Secondary sclerosing cholangitis, Ascending) · Cholestasis/Mirizzi's syndrome · Biliary fistula · Haemobilia · Gallstones/Cholelithiasis Common bile duct (Choledocholithiasis, Biliary dyskinesia) · Sphincter of Oddi dysfunction

Pancreatic	Pancreatitis (Acute, Chronic, Hereditary, Pancreatic abscess) · Pancreatic pseudocyst · Exocrine pancreatic insufficiency · Pancreatic fistula

Abdominopelvic

Hernia	Diaphragmatic (Congenital) · Hiatus Inguinal (Indirect, Direct) · Umbilical · Femoral · Obturator · Spigelian Lumbar (Petit's, Grynfeltt-Lesshaft) Undefined location (Incisional · Internal hernia)

Peritoneal	Peritonitis (Spontaneous bacterial peritonitis) · Hemoperitoneum · Pneumoperitoneum

M: DIG

anat(t, g, p)/phys/devp/enzy

noco/cong/tumr, sysi/epon

proc, drug(A2A/2B/3/4/5/6/7/14/16), blte

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