1/311. Perforation of the gallbladder: analysis of 19 cases.Perforation of the gallbladder occurred in 19 (3.8%) of 496 patients with acute cholecystitis treated at one hospital in an 8-year period. The average age of the 19 patients was 69 years and the female:male ratio was 3:2. Most had a history suggestive of gallbladder disease and most had coexisting cardiac, pulmonary, renal, nutritional or metabolic disease. The duration of the present illness was short, perforation occurring within 72 hours of the onset of symptoms in half the patients; the diagnosis was not suspected preoperatively in any. In the elderly patient with acute cholecystitis who has a long history of gallbladder disease, cholecystectomy should be performed early, before gangrene and perforation of the gallbladder can occur.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/311. Choledochoduodenal fistula at the anterior wall of the duodenal bulb: a rare complication of duodenal ulcer.A 38 year-old man was admitted to our hospital with the chief complaint of epigastralgia. His laboratory data revealed leukocytosis and increased serum amylase, and abdominal ultrasonography revealed diffuse swelling of the pancreas. Thus, he was diagnosed as having acute pancreatitis. Moreover, abdominal computed tomography showed pneumobilia in the gallbladder and the common bile duct. Gastroduodenal fiberscopy demonstrated peptic ulcer scars around a foramen with smooth margins at the anterior wall of the duodenal bulb. The bile juice flowed from the bottom of the foramen. Endoscopic retrograde cholangiopancreatography revealed the fistula between the common bile duct and the anterior wall of the duodenal bulb, but not the posterior wall. However, there was no pancreatico-biliary maljunction and no stones in the gallbladder or bile duct. This is a rare case of choledochoduodenal fistula at the anterior wall of the duodenal bulb caused by duodenal peptic ulcer disease.- - - - - - - - - - ranking = 0.25keywords = gallbladder (Clic here for more details about this article) |
3/311. gallbladder adenomyomatosis: findings on MRI.BACKGROUND: To describe the characteristic magnetic resonance imaging (MRI) findings of gallbladder adenomyomatosis in two cases. methods: Two patients had abdominal MRI findings of gallbladder adenomyomatosis confirmed at cholecystectomy. RESULTS: The surgical specimen showed findings typical of adenomyomatosis, including marked thickening of both epithelial and muscular elements with multiple Rokitansky-Aschoff sinuses. On gadolinium-enhanced spoiled gradient-echo images and single-shot fast spin-echo images, mild gallbladder wall thickening with multiple intramural cystic components from Rokitansky-Aschoff sinuses were readily visualized. CONCLUSION: Adenomyomatosis of the gallbladder can be detected and diagnosed from MRI findings.- - - - - - - - - - ranking = 0.5keywords = gallbladder (Clic here for more details about this article) |
4/311. Advanced adenosquamous carcinoma of the gallbladder with bilio-biliary fistula: an uncommon case treated by hepatopancreatoduodenectomy.A 70 year-old female, who presented with jaundice and abdominal pain, was found to have an advanced gallbladder cancer involving the liver parenchyma, duodenum, and transverse colon. This was complicated by a bilio-biliary fistula between the gallbladder and both the right and left hepatic ducts. After obtaining an accurate pre-operative diagnosis, the patient underwent hepatopancreatoduodenectomy (HPD) with lymph node dissection around the hepatic pedicle, celiac trunk, aorta, and inferior vena cava. Histologic examination revealed adenosquamous carcinoma. This rare variant accounts for 3.5% of gallbladder cancers, and is associated with a worse prognosis than adenocarcinoma. The patient is in good condition without any signs of recurrence 42 months after the HPD. In this case report, we discuss the histological type and internal biliary fistula with regard to the literature, and the usefulness of an aggressive surgical procedure such as HPD with extended lymph node dissection which can improve survival and quality of life in selected patients.- - - - - - - - - - ranking = 0.875keywords = gallbladder (Clic here for more details about this article) |
5/311. Pre-operative imaging can diagnose torsion of the gallbladder: report of a case.Torsion of the gallbladder is a rare disease and pre-operative diagnosis of the disease is uncommon. About 400 cases have been reported, but only 4 were diagnosed by pre-operative imaging. We report on a case of gallbladder volvulus diagnosed pre-operatively using pre-operative imaging with ultrasound and computed tomography.- - - - - - - - - - ranking = 0.75keywords = gallbladder (Clic here for more details about this article) |
6/311. Posttraumatic torsion of accessory lobe of the liver and the gallbladder.Torsion of an accessory lobe of the liver and of the gallbladder is a rare etiology for acute abdominal pain in children and infants. We report a case of an 8-year-old girl who was admitted with acute epigastric pain and vomiting, after her brother had jumped on her back. physical examination revealed an afebrile child with a nontender right upper quadrant (RUQ) mass. color Doppler ultrasound and contrast-enhanced CT demonstrated a heterogeneous, avascular mass with displacement of a thickened-wall gallbladder. A contorted, congested accessory lobe of the liver and the gallbladder were resected at laparotomy. Imaging and operative findings are presented and a differential diagnosis is discussed in order to increase awareness of this rare condition.- - - - - - - - - - ranking = 0.875keywords = gallbladder (Clic here for more details about this article) |
7/311. Torsion of the gallbladder: laparoscopic identification and treatment.Torsion of the gallbladder is an unusual cause of necrosis of the gallbladder. Since its first description a century ago, its diagnosis prior to operative exploration has been extremely elusive. The diagnostic value of current radiological imaging is limited. In the present report, we describe a case of torsion of the gallbladder in which laparoscopy was used successfully to identify and treat this condition without the usual requirement of open exploration. Additionally, the etiology, incidence, clinical presentation, radiologic studies, and treatment of the condition are reviewed.- - - - - - - - - - ranking = 0.875keywords = gallbladder (Clic here for more details about this article) |
8/311. Ultrasonographic evaluation of pericholecystic abscesses.Pericholecystic abscess formation is a serious complication of cholecystitis that develops after gallbladder perforation and is usually associated with acute inflammatory signs and symptoms. Ultrasonographic findings in three surgically proven cases of pericholecystic abscess are reported. The findings ranged from a well defined band of low-level echoes around the gallbladder to multiple, poorly defined hypoechoic masses surrounding an irregular, indistinct gallbladder outline. The former situation correlated with a well encapsulated pericholecystic inflammatory process, while the latter was associated with extensive abscess formation resulting from gallbladder rupture. cholelithiasis was identified in two of the three cases. Ultrasound for preoperative detection of pericholecystic abscess is discussed.- - - - - - - - - - ranking = 0.5keywords = gallbladder (Clic here for more details about this article) |
9/311. gallbladder tuberculosis (case report and review of the literature).The incidence of abdominal tuberculosis is increasing and the familiarity with its clinical presentation shortens its diagnostic time and improves its management. gallbladder tuberculosis has unique considerations regarding its pathology, diagnosis and surgical management. The authors report a case of gallbladder tuberculosis in a 40 year-old female who presented with a clinical picture of acute cholecystitis. Abdominal ultrasound showed a dilated gallbladder with a large gall stone located in the neck region. Several lymph nodes were seen in the hilum of the liver compressing the portal vein which were associated with smaller retroperitoneal lymph nodes. The diagnosis of gallbladder tuberculosis was reached only during surgery and was proven by histopathology. The gallbladder was adherent to the surrounding tissues and covered with multiple tuberculous nodules. The patient had a retrograde open cholecystectomy and treated with anti-tuberculous drugs. The literature on this topic is reviewed.- - - - - - - - - - ranking = 0.5keywords = gallbladder (Clic here for more details about this article) |
10/311. Sonographic diagnosis of a ruptured primary hydatid cyst of the gallbladder.We report an unusual case of a ruptured primary hydatid cyst of the gallbladder. The sonographic appearance-a distended gallbladder containing an intraluminal mass with undulating membranes in the neck and body-led to the diagnosis of this extremely rare condition.- - - - - - - - - - ranking = 0.75keywords = gallbladder (Clic here for more details about this article) |
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