Cases reported "Gallbladder Diseases"

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1/11. Ciliated foregut cyst of the gallbladder: a case report and review of the literature.

    A case is presented of a ciliated cyst of the gallbladder in a 36-year-old Korean woman which was incidentally found on ultrasonographic study. A cystic mass measuring 1.5 x 1 x 1 cm was found in the fundus of the gallbladder. The cyst was unilocular and intramural without communication to the lumen. Microscopically, the cyst wall was lined by a single layer of pseudostratified, ciliated, columnar epithelium and goblet cells with underlying smooth muscle layers. This was considered to be the cyst arising from the embryonic foregut and showing differentiation toward respiratory structures. The term 'ciliated foregut cyst of the gallbladder' is suggested here.
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2/11. A fundal cyst of the gallbladder: An unusual abdominal mass.

    A female, aged 80 years, presenting with a large abdominal mass causing distension and right-sided hydronephrosis, is presented. The mass proved to be a unilocular cyst attached to the fundus of a thick-walled gallbladder. Histological examination demonstrated invasive adenocarcinoma in the gallbladder. The cyst was lined by gallbladder type epithelium which showed the appearances of carcinoma-in-situ. The aetiology of this cystic lesion is discussed. It seems most likely that it is an acquired lesion caused by occlusion of the communication into a fundal diverticulum. This lesion is unusual, but should be considered in the differential diagnosis of obscure intraabdominal masses.
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3/11. Caring for a limited-English proficient patient.

    Each day in the united states, health care workers try to communicate with patients who are deaf, hard of hearing, or limited-English proficient (LEP). According to government regulations, these patients are guaranteed access to language accommodations. The legal implications of these regulations will be discussed along with ways to facilitate communication with patients who are deaf, hard of hearing, or LEP and the requirements for those who act as interpreters for such patients.
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4/11. Cholecysto-hydatid cyst fistula.

    A 27-year-old woman developed recurrent hydatid of liver. CT scan showed unilocular cysts in segments IV and VII. Intraoperatively, there was a fistulous communication between the gall bladder and the cyst in segment IV. Partial pericystectomy along with cholecystectomy was done for the segment IV cyst; percutaneous aspiration, instillation and re-aspiration using hypertonic saline was done for the cyst in segment VII. This was followed by albendazole treatment.
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5/11. Cholecystocolonic fistula: serial CT imaging features.

    We report the CT imaging findings of an unusual case of cholecystocolonic fistula, which had presented in the emergency department with melena. It is rare for the fistulous communication to occur between gallbladder and the colon. We describe the serial imaging findings, which were diagnostic of this condition.
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6/11. A case of pericholecystic abscess diagnosed by ultrasonography.

    Pericholecystic abscess is a serious complication of cholecystitis. Though preoperative diagnosis is easy by gray-scale ultrasonography, there has been no case reported in which the communication between pericholecystic abscess and the gallbladder was demonstrated ultrasonically. We experienced a case in which the communication route between a pericholecystic abscess and the gallbladder was successfully demonstrated by a real-time electric linear scanner. Furthermore, the abscess was successfully treated by percutaneous drainage following ultrasonically guided puncture. This success demonstrates that ultrasonography by a real-time scanner can be effective for diagnosis and treatment of acute cholecystitis and pericholecystic abscess.
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7/11. Cholecystoduodenocolic fistula with recurrent gallstone ileus.

    The combination of cholecystoduodenocolic fistula with gallstone ileus is rarely seen. To our knowledge, there have only been six previous reports with these findings. A 66-year-old woman's condition was diagnosed preoperatively as small-bowel obstruction and communications between the gallbladder, duodenum, and colon. The small-bowel obstruction was successfully relieved by removing a large gallstone from the midileum, leaving the inflammatory mass in the right upper quadrant undisturbed. Three weeks later the small-bowel obstruction recurred. At reoperation two gallstones were found obstructing the midileum and were removed. The cholecystoduodenocolic fistula was dissected and the duodenum and colon were repaired. A cholecystostomy was done. The patient recovered and has been well four years later.
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8/11. Spontaneous biliothorax (thoracobilia) following cholecystopleural fistula presenting as an acute respiratory insufficiency. Successful removal of gallstones from the pleural space.

    A patient presented to the emergency department with tachypnea, fever, a right pleural effusion, and lung consolidation. The computed tomographic guided thoracentesis yielded a greenish fluid with bilirubin. The ultrasound examination demonstrated a distended gallbladder with stones, positioned on the ventral face of the liver and a free communication between the fundus and the pleural cavity. The cholecystopleural fistula was confirmed at operation.
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9/11. Epithelial cyst of the gallbladder demonstrated by ultrasonography: case report.

    We present a rare case of epithelial cyst of the gallbladder in a 71-year-old man. Abdominal ultrasonography revealed a small cystic structure adjacent to the gallbladder. The cyst wall was thin and smooth, and protruded into the lumen of the gallbladder. Histologically, the cyst had no communication with the lumen of the gallbladder. The cyst wall was composed of fibro-muscular fiber, and lined by a single layer of ciliated columnar epithelium. Epithelial cyst of the gallbladder should be included in the differential diagnosis when radiological studies show a cystic structure in or adjacent to the gallbladder.
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10/11. Bronchobiliary and bronchopleural fistulas.

    In the course of treating approximately 2,000 patients with postoperative stricture of the bile duct, 16 bronchopleural and bronchobiliary fistulas were encountered. Three patients have been seen in the past year. This has prompted a review of our experience since it was previously recorded in 1955. Fistulous complications of obstructive biliary tract disease take three forms: (1) massive fulminating biliary empyema; (2) acute necrotizing bile bronchiolitis and pneumonia when pleural symphysis exists; and (3) a more indolent, chronic, recurring form of bronchobiliary communication. We have learned that transdiaphragmatic perforation occurs at a certain characteristic location in the diaphragm. An understanding of the pathological anatomy and pathogenesis has provided a specific and sequential mode of surgical treatment. When this has been adhered to strictly, cure has resulted.
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