31/429. Gallstone ileus: CT findings. Gallstone ileus is a rare complication of recurrent gallstone cholecystitis. The classic radiographic triad of small bowel obstruction, pneumobilia and ectopic gallstone on abdominal plain radiograph is described with CT imaging. Because of the better resolution of CT compared with abdominal radiography and its recent accession to emergency use, radiologists should be aware of CT findings of gallstone ileus. We report a case in which gallstone ileus was initially diagnosed by CT. ( info) |
| Analysis of 5 patients with gallbladder tuberculosis who had open cholecystectomy and review of literature have shown that, although still rare it presents as a part of systemic miliary tuberculosis, abdominal tuberculosis, isolated gallbladder tuberculosis and as a calculus cholecystitis in anergic patients. There are no pathognomonic signs, the diagnosis depends on suspicion of tuberculosis, peroperative findings and histological examination. ( info) |
| The authors report the case of a 49-year-old man, hematoma of the gallbladder associated with hemophilia b. The patient was diagnosed incidentally by abdominal computed tomography with a gallbladder tumor. Endoscopic retrograde cholangiopancreatography revealed negative gallbladder and angiography showed no obvious abnormality in the cystic artery. magnetic resonance imaging showed a mass of mixed intensity on T2-weighted image and a mass of mixed intensity on the lining of the gallbladder wall. hemorrhage in the gallbladder was thought to be most likely, however, the gallbladder tumor could not to be neglected. cholecystectomy was performed on the patient and the pathological diagnosis was of a hemorrhage in the gallbladder. hematoma of the gallbladder is a rare complication in patients with hemophilia b, however, it leads sometimes to a fatal course and magnetic resonance imaging is very useful to diagnose hemorrhage in the gallbladder. ( info) |
34/429. Acute torsion of the gallbladder: review of the literature and report of a case. A case report is presented, and the literature reviewed, of acute torsion of the gallbladder. Originally described as a rare pathological entity, it is being witnessed more frequently as a probable concomitant of increasing life expectancy. Because it is a benign condition if diagnosed rapidly and treated surgically, it should be considered in differential diagnostic possibilities. When encountered intraoperatively, prompt recognition of the process should lead to detorsion of the organ and cholecystectomy as the procedure of choice. ( info) |
35/429. gallbladder volvulus: experience of six consecutive cases at an institute. Recently we treated three patients with gallbladder volvulus within a short period. All three patients were examined preoperatively using computed tomography (CT). The first two cases were not diagnosed accurately before laparotomy. A precise diagnosis was made for the third one prior to surgery, based on our former experiences. Typical images, with marked edema and thickened wall of the gallbladder volvulus were shown on CT. We discuss six consecutive cases of the disease experienced at Hamamatsu Medical Center (i.e., the three patients rofed above, and three who did not have preoperative CT). ( info) |
36/429. Spontaneous neonatal gall bladder perforation. A full term neonate was operated for diaphragmatic eventration through the chest. Postoperatively the baby developed gastric outlet obstruction. ultrasonography and barium meal examination were suggestive of extrinsic compression in the region of the pylorus. At laparotomy a gall bladder perforation was found producing a biloma just abve the pylorus. drainage of the bilioma and temporary cholecystostomy cured the gastric outlet obstruction. ( info) |
| Two cases of massive haemorrhage from the gallbladder in patients suffering from common bile duct obstruction are described. Sudden operative decompression of the massively distended gallbladder was the probable cause of the bleeding. ( info) |
| A patient with type I cryoglobulinemia and monoclonal gammopathy of uncertain significance was found to have acute gallbladder vasculitis. The most prominent manifestation was upper abdominal pain in the setting of normal liver tests. An abdominal ultrasound demonstrated a thickened gallbladder wall, along with gallstones. HIDA scanning showed a nonfunctioning gallbladder with an edematous and thickened wall. There was characteristic leukocytoclastic vasculitis affecting the gallbladder. The patient recovered uneventfully subsequent to cholecystectomy. gallbladder vasculitis should be considered in patients with unexplained upper abdominal pain and systemic vasculitis. ( info) |
39/429. 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. ( info) |
| Torsion of the gallbladder is a surgical emergency, occurring mainly in the elderly. female is predominant to male with ratio 3 to 1. Despite its unknown etiology, the anatomical variations in the attachment of gallbladder which occur on the mobile mesentery to the inferior margin of the liver are usually found. When the gallbladder twists around the cystic duct and artery, torsion takes place with ensuing occlusion of the flow of bile and blood. Preoperative diagnosis is difficult to make; however, patients who receive prompt surgical treatment with cholecystectomy always get excellent outcomes. mortality rate is low with 3% to 5%. Here, we report on elderly male patient with gallbladder torsion at our hospital and review the existing literature. ( info) |