1/24. Small cell carcinoma of the gallbladder: report of two cases.Two Taiwanese patients with gallbladder small cell carcinoma are reported. One is a 79 year-old male, the other, a 86 year-old female. They both presented with the symptom/signs of acute cholecystitis and underwent cholecystectomy. An intramural mass in the gallbladder neck region was found in the first patient, while the second patient had a transmural indurated tumor in the gallbladder body with extension to the neck region. Characteristic histological and immunohistochemical features of small cell carcinoma were present in both, and electron dense neurosecretory granules were identified in the second. To our knowledge, the second patient is the oldest ever reported. The first patient received chemotherapy directed toward the initial erroneous diagnosis of non-Hodgkin s lymphoma and developed liver metastasis in two months. The second patient did not receive chemotherapy due to her poor general condition and local recurrence occurred in six weeks. Both passed away three and five months after surgery, respectively.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/24. Spontaneous necrosis of gallbladder carcinoma in patient with pancreaticobiliary maljunction.While gallbladder carcinoma is occasionally associated with pancreaticobiliary maljunction, spontaneous necrosis of carcinoma is extremely rare. We herein present a case of spontaneous necrosis of gallbladder carcinoma associated with direct invasion of viable cancer cell nests to the muscularis propria and subserosal layer located beneath the primary nodules. A 65-year-old Japanese man was admitted to a local hospital, complaining of repeated discomfort in the right hypochondrium. ultrasonography and computed tomography scanning revealed cholecystitis associated with gallstones. cholecystectomy was performed, and operative cholangiography demonstrated pancreaticobiliary maljunction. The resected gallbladder showed multiple mixed stones filled with necrotic debris and bile sludge. Scrutiny of the mucosal surface revealed multiple small necrotic nodules in the fundus, which were histologically confirmed to be necrotic remnants of a cancerous glandular structure. Small nests of papillary adenocarcinoma were found beneath the nodules in the muscularis propria and in the venous structure located in the connective tissues next to the divided margin of the gallbladder bed. Resection of S4a and S5 of the liver and resection of the extrahepatic bile duct was then performed to remove the remaining cancerous tissues and/or micrometastasis in the liver and bile duct. The biliary tree was reconstructed with a hepaticoduodenostomy. No cancer nests or any precancerous lesions were found in the additionally resected specimens. This case indicates a unique morphological feature of gallbladder carcinoma associated with pancreaticobiliary maljunction, which provides some insight into the pathogenesis of spontaneous necrosis of gallbladder carcinoma.- - - - - - - - - - ranking = 1.4285714285714keywords = gallbladder (Clic here for more details about this article) |
3/24. The pathology of acute hepatic disintegration in hereditary haemorrhagic telangiectasia.AIMS: Hereditary haemorrhagic telangiectasia is a rare inherited disease in which telangiectases affect skin, mucous membranes and the gastrointestinal tract. Hepatic involvement is common but usually asymptomatic. We report a case of acute hepatic disintegration in hereditary haemorrhagic telangiectasia, document the histopathological findings and present a hypothesis to explain them. methods AND RESULTS: The patient presented at the age of 34 years with abdominal pain, leading to the surgical removal of a severely inflamed gallbladder. Signs of liver damage became increasingly apparent over the next few weeks, with disruption of the intrahepatic biliary tree and marked vascular shunting, necessitating liver transplantation. Six months after the transplant a diagnosis of hepatic hereditary haemorrhagic telangiectasia was made. The principal features of hepatic hereditary haemorrhagic telangiectasia are periportal telangiectases and sinusoidal congestion and dilatation. Acute hepatic disintegration is characterized by disruption of liver structure, hepatocyte necrosis, haemorrhage and extravasation of bile. CONCLUSIONS: Periportal telangiectases in a liver biopsy are highly suggestive of hereditary haemorrhagic telangiectasia. Acute hepatic disintegration is likely to be a consequence of rupture of telangiectases and ischaemic necrosis of intrahepatic bile ducts. patients with hereditary haemorrhagic telangiectasia are at risk of acute hepatic disintegration following intra-abdominal sepsis.- - - - - - - - - - ranking = 0.14285714285714keywords = gallbladder (Clic here for more details about this article) |
4/24. Acute cholecystitis and duodenitis associated with churg-strauss syndrome.We describe a patient with acute cholecystitis and duodenitis associated with churg-strauss syndrome. A 36-year-old male, who had been healthy, had abdominal pain following high fever. He had marked hypereosinophilia of 17,000/mm3. Radiographs of the chest disclosed a transient infiltrated lesion in the left lower lung. Ultrasonographic and gastroendoscopic examinations revealed acute cholecystitis and duodenitis, respectively. Endoscopic retrograde cholangiopancreatography demonstrated a filling defect suspecting aberrant ascariasis in the common bile duct. The patient suddenly developed distally dominant mononeuritis multiplex, especially in the upper limbs. Muscle biopsy revealed vasculitis of intramuscular arteries with infiltration of eosinophils. These findings fulfilled the diagnostic criteria of churg-strauss syndrome. Corticosteroid dramatically resolved the abdominal symptoms. cholecystectomy and removal of the foreign body were performed. Histological examinations revealed that necrosis of the gallbladder was caused by occlusion due to thrombosed arteries and that the foreign body in the common bile duct was an aggregate of necrotic epithelium of the bile duct wall surrounded by inflammatory cells. Although abdominal complaints rarely appeared as an initial symptom in the patients with churg-strauss syndrome, this syndrome should be taken into consideration for an accurate diagnosis when the patients with abdominal pain of unknown origin had eosinophilia, asthma, or allergic rhinitis.- - - - - - - - - - ranking = 0.14285714285714keywords = gallbladder (Clic here for more details about this article) |
5/24. The interrupted rim sign in acute cholecystitis: a method to identify the gangrenous form with MRI.We present the imaging findings on MR of a patient with acute gangrenous cholecystitis that demonstrated patchy enhancement of the gallbladder mucosa on gadolinium-enhanced fat-saturated T1-weighted gradient echo images. This interrupted rim of mucosal enhancement correlated with patchy areas of necrosis and inflammation of the gallbladder mucosa on the histopathological examination.- - - - - - - - - - ranking = 0.28571428571429keywords = gallbladder (Clic here for more details about this article) |
6/24. Videolaparoscopic treatment for isolated necrosis and abscess of the round ligament of the liver.A case involving abcess and necrosis of the round ligament of the liver is described. This type of case is seldom reported in medical literature. Laparaoscopy is a very useful and feasible tool for the diagnosis and treatment of such cases. The video shows an oversized round ligament with necrotic appearance partially blocked by the epiplon, gallbladder, and stomach. (This online case report contains a video.).- - - - - - - - - - ranking = 0.14285714285714keywords = gallbladder (Clic here for more details about this article) |
7/24. A case of emphysematous cholecystitis managed by laparoscopic surgery.BACKGROUND: emphysematous cholecystitis is a rare condition caused by ischemia of the gallbladder wall with secondary gas-producing bacterial proliferation. The pathophysiology and epidemiology of this condition differ from that in gallstone-related acute cholecystitis. This report illustrates a case of emphysematous cholecystitis successfully treated by laparoscopic surgery. methods: An 83-year-old female patient was admitted to the hospital with acute abdominal syndrome. Clinical examination and blood tests suggested acute cholecystitis. Plain radiography revealed a circular gas pattern in the right upper quadrant suggestive of emphysematous cholecystitis. Subsequent computed tomography confirmed the presence of gas in the gallbladder wall and a gas-fluid level within the organ. RESULTS: Emergency laparoscopic cholecystectomy was successfully performed during which bubbling of the gallbladder wall was observed. Intraoperative cholangiography revealed no bile duct stones or biliary obstruction. The patient made an unremarkable recovery from surgery with no postoperative complications or admission to the intensive care unit. Pathological analysis revealed full-thickness infarctive necrosis of the gallbladder. Bacterial cultures grew clostridium perfringens. CONCLUSIONS: This case illustrates a typical case of emphysematous cholecystitis successfully treated by laparoscopic surgery. It contributes to suggestions from other reports that this condition can be safely treated by the laparoscopic approach.- - - - - - - - - - ranking = 0.57142857142857keywords = gallbladder (Clic here for more details about this article) |
8/24. Two reports of acute neonatal acalculous cholecystitis (necrotizing cholecystitis) in a 2-week-old premature infant and a term neonate.We present 2 cases of acute acalculous cholecystitis, an extremely rare entity in newborns. A number of risk factors have been identified, such as inspissated bile, prematurity, sepsis, dehydration, total parenteral nutrition, medications, and escherichia coli lipopolysaccharide endotoxin. In our cases, gallbladder bile had positive bacterial cultures for E coli. We present the cases of a premature infant and a term neonate who developed acute acalculous cholecystitis: one with several risk factors and the second with a very atypical presentation.- - - - - - - - - - ranking = 0.14285714285714keywords = gallbladder (Clic here for more details about this article) |
9/24. Isolated necrotizing panarteritis of the gallbladder. Case report.Two cases of isolated gallbladder involvement by necrotizing panarteritis histologically resembling classic polyarteritis nodosa are reported and the literature is reviewed. No reports suggest that isolated gallbladder involvement may evolve to systemic ('classic') polyarteritis nodosa. Finding of necrotizing panarteritis in the gallbladder without clinical evidence of systemic/multiorgan disease does not warrant extensive investigations.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
10/24. Hepatic infarction and gallbladder necrosis complicating arterial embolization for bleeding duodenal ulcer.A case of severe duodenal hemorrhage in a septic renal allograft recipient is presented in which successful occlusion of the gastroduodenal artery by Gelfoam emboli also resulted in severe hepatic infarction and gallbladder necrosis. These complications were caused by reflux of emboli from the gastroduodenal artery into the distal branches of the hepatic artery.- - - - - - - - - - ranking = 0.71428571428571keywords = gallbladder (Clic here for more details about this article) |
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