1/37. 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 = cardiac (Clic here for more details about this article) |
2/37. Aberrant pancreatic tissue accompanied by heterotopic gastric mucosa in the gall-bladder.A 5 mm pancreatic heterotopia was incidentally identified in the gall-bladder with small cholesterol polyps following cholecystectomy in an asymptomatic 49-year-old female. Microscopically, inflammatory changes in the wall were minimal. The aberrant tissue consisted of acini and ducts but did not have islet formation. Heterotopic gastric mucosal tissue with a mixture of foveolar cells and pyloric glands was seen at the orifice of the pancreatic heterotopia. Islet peptide-immunoreactive endocrine cells were scattered among the pancreatic parenchyma, and the gastric-type gland contained cells positive for gastrin, somatostatin and glucagon. A noteworthy finding was the immunohistochemical detection of a single insulin-containing cell in the pyloric gland.- - - - - - - - - - ranking = 178886.66332305keywords = gastric mucosa, pyloric, mucosa, gland (Clic here for more details about this article) |
3/37. Heterotopic gastric mucosa in the gallbladder: sonographic and CT findings.We present computed tomographic (CT) and sonographic findings of heterotopic gastric mucosa incidentally found in a 63-year-old male. CT showed a slightly high density area in the gallbladder, which was intermediately enhanced early after bolus injection of contrast medium. ultrasonography showed an echogenic sessile polyp. Histologically, the tumor consisted of gastric fundic glands containing parietal cells and chief cells.- - - - - - - - - - ranking = 178176.82450274keywords = gastric mucosa, mucosa, gland (Clic here for more details about this article) |
4/37. Heterotopic gastric mucosa in the gallbladder.We report on a case of heterotopic gastric mucosa in the body of the gallbladder. A 39-year-old man, who was asymptomatic, visited our hospital because of a polypoid lesion in the gallbladder, discovered during a routine health screening. ultrasonography (US) revealed a broad-based polypoid lesion 1.7 cm in diameter in the body of the gallbladder, which was free of gallstones. The gallbladder mass was faintly enhanced by helical computed tomography. Laparoscopic cholecystectomy was performed because of the possibility of malignancy. The specimen revealed a 1.7 x 1.3 cm polypoid lesion with deep delle in the body, with no gallstones in the gallbladder. Intraoperative frozen examination yielded a diagnosis of hyperplastic polyp of the gallbladder. Histologically, the polypoid lesion consisted of gastric fundic glands located in the whole wall of the gallbladder. The surrounding mucosa consisted of almost normal epithelium without any metaplastic changes. Postoperative technetium 99m-pertechnetate scintigraphy demonstrated no evidence of gastric heterotopia elsewhere in the body. We also review 18 other reports of heterotopic gastric mucosa in the gallbladder in the Japanese medical literature.- - - - - - - - - - ranking = 213903.30724966keywords = gastric mucosa, mucosa, gland (Clic here for more details about this article) |
5/37. Heterotopic gastric mucosa together with intestinal metaplasia and moderate dysplasia in the gall bladder: report of two clinically unusual cases with literature review.We report the clinicopathological findings of two patients with ectopic gastric mucosa within the gall ladder. The first patient, a 78 year old man, was asymptomatic. He was admitted to hospital for a colon adenocarcinoma. Intraoperatively, a firm nodule was palpable in the gall bladder. Histological examination of the resected specimen revealed a body type gastric mucosa in the submucosa, adjacent to which were extensive pyloric gland and intestinal metaplasia with mild to moderate dysplasia. The remaining gall bladder mucosa demonstrated changes of chronic cholecystitis. The second patient was a 62 year old woman with symptoms of chronic cholecystitis. The preoperative diagnosis was consistent with this diagnosis with a "polyp" at the junction of the neck and cystic duct. cholecystectomy was performed and the histological examination of the resected specimen showed that the "polyp" consisted of heterotopic gastric mucosa with glands of body and fundus type. In the remaining mucosa, chronic cholecystitis was evident. To the best of our knowledge, this is the first report of a clinicopathological presentation of heterotopic gastric mucosa, pyloric gland type, and intestinal metaplasia with dysplastic changes in the gall bladder. As heterotopic tissue may promote carcinogenesis of the gall bladder, close attention should be paid to any occurrence of such lesions in this anatomical region.- - - - - - - - - - ranking = 286066.11156379keywords = gastric mucosa, pyloric, mucosa, gland (Clic here for more details about this article) |
6/37. Ectopic liver (choristoma) associated with the gallbladder encountered during laparoscopic cholecystectomy: a case report.Ectopic liver has been but rarely described usually in the vicinity of liver such as on the gallbladder, hepatic ligaments, diaphragm, thoracic cavity, adrenal glands, pancreas, omentum, spleen, esophagus and umbilical cord. A simple classification for anomalous liver tissues found on the wall of gallbladder is 1. Accessory liver lobe 2. Ectopic nodule 3. Aberrant microscopic tissue. Ectopic nodules of liver tissue attached to the gallbladder are completely detached from the liver and has been described by various names such as accessory lobe, ectopic liver, accessory liver and heterotopic liver but the specific pathological term for this entity is choristoma introduced by Albert in 1904 meaning displacement. Several possible mechanisms may explain ectopic liver at various sites such as the development of an accessory lobe of the liver with atrophy or regression of the original connection to the main liver or migration of pars hepatica to the rudiment of various organs. In this paper we present a case of ectopic liver or choristoma attached to the gallbladder encountered during an elective laparoscopic cholecystectomy which was successfully removed with the gallbladder.- - - - - - - - - - ranking = 28.247256515775keywords = gland (Clic here for more details about this article) |
7/37. Hemorrhagic cholecystitis as a likely cause of nontraumatic hemobilia in metachromatic leukodystrophy: report of a case.A 17-years-old man with the juvenile form of MLD developed massive hemobilia. CT and US scans showed blood and clots filling the gallbladder and the biliary ways, with no bleeding source seen at selective angiography. Explorative laparotomy evidenced bleeding from a papillomatous gallbladder mucosa, resolved with cholecystectomy. Histologic examination with specific colorations diagnosed hemorrhagic cholecystitis from metachromatic leukodystrophy of the gallbladder. This is, to our knowing, the third case reported in literature, and thus hemorrhagic cholecystitis may be considered a life-threatening complication of MLD to be prevented with cholecystectomy as soon as signs of gallbladder pathology (papillomatosis/polyposis, jaundice, abdominal pain) are suspected.- - - - - - - - - - ranking = 96.767297668038keywords = mucosa (Clic here for more details about this article) |
8/37. Ciliated foregut cyst of the gallbladder: report of a case.We report the rare case of a gallbladder cyst arising from the foregut remnants. A 36-year-old woman was referred to our hospital after screening ultrasonography (US) detected a tumor in the gallbladder. On admission, she was well and her blood analyses were all normal. US showed a cystic mass with internal high-echoic lesions, and computed tomography (CT) demonstrated a protruding tumor with slight enhancement in the gallbladder. Angiography provided no additional information; however, sequential CT-arteriography (CTA) clearly demonstrated that this tumor was a cystic lesion. Surgical exploration was performed, first because of the difficulty in establishing a definite diagnosis, and also because the patient wanted the tumor removed. The resected specimen contained a unilocular cystic tumor that looked like a submucosal tumor. Histologically, the wall of the cyst was lined by ciliated stratified columnar epithelium with interspersed goblet cells and underlying smooth muscle fibers. The mass was finally diagnosed as a congenital ciliated foregut cyst of the gallbladder. cysts of the gallbladder are uncommon and the majority are acquired. To our knowledge, this represents only the fourth report of a ciliated foregut cyst of the gallbladder in the literature. Although rare, an awareness of this entity could allow a preoperative diagnosis to be made, whereby surgical exploration may be avoided. CT-A is a very useful diagnostic tool, especially when the nature of the tumor presents a difficult differential diagnosis.- - - - - - - - - - ranking = 96.767297668038keywords = mucosa (Clic here for more details about this article) |
9/37. Computed tomographic finding in adenomyomatosis of the gallbladder.We report on an uncommon case of symptomatic generalized adenomyomatosis of the gallbladder. It was initially suspected by ultrasonography and further confirmed by computed tomography (CT). A postcontrast CT scan at the level of the gallbladder body demonstrated the characteristic rosary sign. The rosary sign is formed by the enhanced proliferative mucosal epithelium with the intramural diverticula surrounded by the unenhanced hypertrophied muscle coat of the gallbladder. Similar CT scans were obtained sequentially in the caudal direction. These CT scan findings indicated generalized adenomyomatosis of the gallbladder. The patient received a cholecystectomy. The pathologic report showed specific changes of adenomyomatosis corresponding to the findings on the CT scan. Generalized adenomyomatosis of the gallbladder, therefore, can be accurately diagnosed by CT.- - - - - - - - - - ranking = 96.767297668038keywords = mucosa (Clic here for more details about this article) |
10/37. Heterotopic gastric mucosa in a duplicate gallbladder.A 7-year-old girl presented with recurrent acute pancreatitis. Detailed investigations, including endoscopic retrograde cholangiography, suggested a poorly defined biliary tract abnormality. At laparotomy, this was discovered to be a duplicate gallbladder each with a separate cystic duct but contained within a single serosal envelope. Both gallbladders were removed, and histologic examination found the inferior organ to be lined by heterotopic fundic-type gastric mucosa. Despite the absence of any remaining structural biliary abnormality and no evidence of residual ectopic gastric mucosa, the patient experienced a few further episodes of self-limiting mild acute pancreatitis during the following 3 years. The presence of heterotopic gastric mucosa in a duplicate gallbladder has not been described previously.- - - - - - - - - - ranking = 249408.00814472keywords = gastric mucosa, mucosa (Clic here for more details about this article) |
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