Xanthogranulomatous cholecystitis: the use of preoperative CT findings to differentiate it from gallbladder carcinoma

Abstract The relationship between the results of early operation for ruptured intracranial aneurysms (72 cases) and the preoperative computed tomographic (CT) findings was studied. There was a correlation among the surgical results, the development of symptomatic vasospasm, and high density on the preoperative CT scan, particularly the presence of a localized, thick layer in the subarachnoid space. However, no relationship was found between the occurrence of ventricular enlargement and the preoperative CT findings. Cisternal or ventricular drainage might contribute to an uncomplicated postoperative course for patients with severe subarachnoid clot shown on the preoperative CT scan.

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Are Preoperative CT Findings Useful for Predicting Postoperative Intraabdominal Abscess in the Patients with Acute Appendicitis?

Medicina ◽

10.3390/medicina55010006 ◽

2019 ◽

Vol 55 (1) ◽

pp. 6 ◽

Cited By ~ 3

Author(s):

Kohga Kohga ◽

Kiyoshige Yajima ◽

Takuya Okumura ◽

Kimihiro Yamashita ◽

Jun Isogaki ◽

...

Keyword(s):

Acute Appendicitis ◽

Medical Records ◽

Independent Predictor ◽

Univariate Analysis ◽

Operation Time ◽

Intraabdominal Abscess ◽

Ct Findings ◽

Free Air ◽

Preoperative Ct ◽

Ct Finding

Background and objective: In patients with acute appendicitis (AA), preoperative computed tomography (CT) findings suggesting development of intraabdominal abscess (IAA) had not been widely used. The aim of this study was to investigate the preoperative clinical and radiological factors that predict the development of a postoperative IAA in patients with AA who were treated by laparoscopic appendectomy (LA). Methods: Two hundred and sixteen patients with pathologically proven AA underwent LA between January 2013 and March 2018 in our department. Medical records and preoperative CT images of these 216 patients were retrospectively reviewed and the predictive factors of postoperative IAA were investigated. In addition, patients were divided into complicated appendicitis (CA) and simple appendicitis (SA) and perioperative factors of two groups were compared. Results: One hundred and forty-seven patients were diagnosed with CA, while the other 69 patients were diagnosed with SA. Sixteen patients developed postoperative IAA in the CA group, while no patients in the SA group did. The univariate analysis revealed that time from onset to surgery more than 3 days (p = 0.011), the preoperative CT finding of periappendiceal fluid (p = 0.003), abscess (p < 0.001), and free air (p < 0.001), operation time more than 120 min (p = 0.023) and placement of a drainage tube (p < 0.001) were significantly associated with the development of IAA. Multivariate analysis revealed that the preoperative CT finding of free air was independently associated with the development of IAA (p = 0.007, odds ratio = 5.427, 95% CI: 1.586–18.57). Conclusions: IAA developed predominantly in patients with CA. Preoperative CT findings of free air was found to be an independent predictor for the development of IAA. Surgeons should be meticulous in managing the postoperative course of patients with this finding.

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A scoring system based on computed tomography for the correct diagnosis of xanthogranulomatous cholecystitis

Acta Radiologica Open ◽

10.1177/2058460120918237 ◽

2020 ◽

Vol 9 (4) ◽

pp. 205846012091823 ◽

Cited By ~ 1

Author(s):

Ryota Ito ◽

Takashi Kobayashi ◽

Gou Ogasawara ◽

Yoshiharu Kono ◽

Kazuhiko Mori ◽

...

Keyword(s):

Computed Tomography ◽

Confidence Interval ◽

Gallbladder Cancer ◽

Scoring System ◽

Correct Diagnosis ◽

Chronic Cholecystitis ◽

Wall Thickening ◽

Xanthogranulomatous Cholecystitis ◽

Ct Findings ◽

Pericholecystic Abscess

Background Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis. The differential diagnoses of XGC include gallbladder cancer (GBC), adenomyomatosis, and actinomycosis of the gallbladder. Purpose To assess the usefulness of computed tomography (CT) findings in the diagnosis of XGC and differentiation from GBC. Material and Methods We retrospectively assessed the pathological and radiological records of 13 patients with pathologically proven XGC and 33 patients with GBC. Results Significant differences were observed for the following five CT findings: diffuse wall thickening (XGC = 85%, GBC = 15%, P < 0.01); absence of polypoid lesions (XGC = 100%, GBC = 48%, P < 0.01); intramural nodules or bands (XGC = 54%, GBC = 9%, P < 0.01); pericholecystic infiltration (XGC = 69%, GBC = 9%, P < 0.01); and pericholecystic abscess (XGC = 23%, GBC = 0%, P = 0.018). We defined the scoring system based on how many of the five CT findings were observed. Our scoring system, which included these findings, revealed that patients with three or more findings had sensitivity of 77% (95% confidence interval [CI] = 57–87) and specificity of 94% (95% CI = 86–98). Conclusion Our scoring system can assist in the differentiation of XGC from GBC.

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