Anatomical variant of cystic duct drainage

2021 ◽  
Author(s):  
Bhavik Patel
Keyword(s):  
Cystic Duct ◽  
Anatomical Variant

CHOLANGIOSCOPY-GUIDED LITHOTRIPSY OF CYSTIC DUCT REMNANT STONES

2020 ◽  
Author(s):  
MR Pineda-De Paz ◽  
FJ Flores-Renteria ◽  
LA Waller-Gonzalez ◽  
R Soto-Solis ◽  
Keyword(s):  
Cystic Duct

Duodenal Ulcer Induced by Hem-o-Lok clip after Reduced Port Laparoscopic Cholecystectomy

2016 ◽  
Vol 25 (1) ◽  
pp. 95-98 ◽  
Author(s):  
Koichi Soga ◽  
Kyoichi Kassai ◽  
Kenji Itani
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Cystic Duct ◽  
Duodenal Bulb ◽  
Mucosal Injury ◽  
Normal Mucosa ◽  
Surrounding Tissue ◽  
Inferior Wall ◽  
Endoscopic Clip

The patient was a 66-year-old woman who had undergone laparoscopic cholecystectomy (Lap-C) secondary to chronic cholecystitis status post endoscopic choledocholithotomy 13 months previously. During surgery, Hem-o-Lok clips were used to control the cystic duct and the cystic artery. Due to the presence of extensive adhesions of the cystic duct and surrounding tissue, the surgeons had difficulty in debriding the area. Thirteen months after Lap-C, the patient underwent a screening esophagogastroduodenoscopy (EGD), which demonstrated clip appearance at the inferior wall of the first part of the duodenum. In the EGD, duodenal erosions and edema were observed around the clip. We appreciated that endoscopic clip removal would be difficult because of the presence of severe adhesions and inflammation of the duodenal bulb. On clinical examination of the patient, no major abnormalities or physical findings were noted. Therefore, we decided not to attempt to remove the clip. The patient was treated with an oral proton pump inhibitor to prevent extensive duodenal mucosal injury. Two months later, we repeated the EGD, which revealed that the clip was no longer present, and the duodenum was covered with normal mucosa surrounding the scar. Abbreviations: EGD: esophagogastroduodenoscopy; Lap-C: laparoscopic cholecystectomy; PPI: proton pump inhibitor.

Absence of Cystic Duct: a case report

2021 ◽  
pp. 1
Author(s):  
Talal Al-Shahri ◽  
Wassem Al-Qalqali
Keyword(s):  
Case Report ◽  
Cystic Duct

Pseudo-endocarditis secondary to ruptured posteromedial papillary muscle with anatomical variation: A Case Report

2020 ◽  
pp. 179
Author(s):  
Keyword(s):  
Myocardial Infarction ◽  
Mitral Valve ◽  
Papillary Muscle ◽  
Anatomical Variation ◽  
Low Grade ◽  
Papillary Muscle Rupture ◽  
Atypical Chest Pain ◽  
Anatomical Variant ◽  
Muscle Rupture ◽  
Mitral Valve Vegetation

Myocardial infarction is the leading cause of papillary muscle rupture. This complication occurs in up to 5% of cases post MI and although rare, it constitutes a cardiac emergency if left untreated. On this basis, a 59-year-old male presented with low-grade fever and atypical chest pain with raised inflammatory markers and troponin levels. He was treated for infective endocarditis after echocardiography revealed a mass on the mitral valve, which was presumed to be a mitral valve vegetation and so he completed a 6-weeks course of antibiotics followed by elective mitral valve replacement surgery. During surgery, it was discovered that there was no endocarditis. Instead an unusually small muscle head of one of the posteromedial papillary muscle groups had ruptured secondary to an inferior myocardial infarction. This ruptured muscle head was highly mobile and mimicked a mitral valve vegetation. The mitral valve was successfully repaired, and the right coronary artery grafted. He made a full recovery but developed new-onset atrial fibrillation for which he is awaiting elective cardioversion. One should have a high index of suspicion for diagnosing papillary muscle rupture as it may mimic valvular vegetation on echocardiography, especially if the papillary muscle involved is an anatomical variant.

Clinical aspects and surgical technique in Mirizzi syndrome: A systematic review

2020 ◽  
pp. 35871-35873
Keyword(s):  
Surgical Technique ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Signs And Symptoms ◽  
Mirizzi Syndrome ◽  
Common Hepatic Duct ◽  
Clinical Aspects ◽  
Main Diagnosis ◽  
Biliary Surgery ◽  
Electronic Library

Mirizzi syndrome is described in the 1940s as follows: partial obstruction of the secondary common hepatic duct by gallstones, impacted on the cystic duct or gallbladder infundibulum, associated with the inflammatory response that involved the cystic duct and the common hepatic duct. As it is a rare and delicate condition, differential diagnosis is extremely important, in which the patient's clinical condition is verified through anamnesis and complementary exams, where immediately after the surgical intervention can be performed. This work aims to describe, through a literature review, the clinical aspects and the surgical technique in Mirizzi Syndrome. Were used as a database for research sites containing scientific articles available online such as Virtual Health Library (VHL), Scientific Electronic Library Online (Scielo) and PubMed. 154 articles were found through the descriptors, where after applying the inclusion and exclusion criteria 11 articles remained to write the work. According to the articles surveyed, it is clear that most of them do not report the syndrome as the main diagnosis, possibly because it is a pathology with signs and symptoms very close to other diseases of the bile duct, therefore leaving the syndrome sometimes described in the context of these other diseases. Finally, it concludes that even though the preoperative diagnosis is rare, it should be suspected in individuals undergoing biliary surgery.

Diagnosis of acute cholecystitis: value of contrast agent in the gallbladder and cystic duct on Gd-EOB-DTPA enhanced MR cholangiography

2014 ◽  
Vol 38 (2) ◽  
pp. 174-178 ◽  
Author(s):  
In Young Choi ◽  
Sang Hoon Cha ◽  
Suk Keu Yeom ◽  
Seung Wha Lee ◽  
Hwan Hoon Chung ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Acute Cholecystitis ◽  
Cystic Duct ◽  
Mr Cholangiography

scholarly journals Cor triatriatum dexter, a very rare congenital anomaly presented in a complex pathological context – case presentation

2014 ◽  
Vol 60 (4) ◽  
pp. 160-162
Author(s):  
Liliana Gozar ◽  
Cristina Blesneac ◽  
Rodica Toganel
Keyword(s):  
Congenital Anomaly ◽  
Cytomegalovirus Infection ◽  
Cor Triatriatum ◽  
Anatomical Feature ◽  
Renal Anomalies ◽  
Anatomical Variant ◽  
Case Presentation ◽  
Congenital Cytomegalovirus ◽  
Rare Congenital Anomaly ◽  
Cor Triatriatum Dexter

Abstract Background Cor triatriatum dexter is an extremely rare congenital anomaly, and in most cases, without hemodynamic significance. Congenital cytomegalovirus infection is the most common viral infection, the majority of infected infants being asymptomatic and only 5-15% being symptomatic in the neonatal period. Case report We present the case of a female infant, aged 3 months. Clinical examination reveals cranial and facial anomalies. The karyotype was normal. Laboratory tests revealed the presence of anti-CMV antibodies in urine. Imaging studies showed cerebral and renal anomalies. Echocardiographic exam revealed a congenital anatomical feature without hemodynamic significance - cor triatriatum dexter. Conclusions although cytomegalovirus infection is mostly asymptomatic, it can present as a complex pathological association, in which a congenital cardiac anatomical feature without hemodynamic significance, considered by some authors as an anatomical variant, can appear

scholarly journals The Influence of Pre-Procedural Imaging and Cystic Duct Cholangiography on Endoscopic Transpapillary Gallbladder Drainage in Acute Cholecystitis

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1286
Author(s):  
Junya Sato ◽  
Kazunari Nakahara ◽  
Yosuke Michikawa ◽  
Ryo Morita ◽  
Keigo Suetani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Cholecystitis ◽  
Cystic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Procedure Time ◽  
Technical Success ◽  
Factors Affecting ◽  
Gallbladder Drainage ◽  
Procedural Evaluation ◽  
The Relationship

Endoscopic transpapillary gallbladder drainage (ETGBD) for acute cholecystitis is challenging. We evaluated the influence of pre-procedural imaging and cystic duct cholangiography on ETGBD. Patients who underwent ETGBD for acute cholecystitis were retrospectively examined. The rate of gallbladder contrast on cholangiography, the accuracy of cystic duct direction and location by computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP), and the relationship between pre-procedural imaging and the technical success of ETGBD were investigated. A total of 145 patients were enrolled in this study. Gallbladder contrast on cholangiography was observed in 29 patients. The accuracy of cystic duct direction and location (proximal or distal, right or left, and cranial or caudal) by CT were, respectively, 79%, 60%, and 58% by CT and 68%, 55%, and 58% by MRCP. Patients showing gallbladder contrast on cholangiography underwent ETGBD with a significantly shorter procedure time and a lower rate of cystic duct injury. No other factors affecting procedure time, technical success, and cystic duct injury were identified. Pre-procedural evaluation of cystic duct direction and location by CT or MRCP was difficult in patients with acute cholecystitis. Patients who showed gallbladder contrast on cholangiography showed a shorter procedure time and a lower rate of cystic duct injury.

scholarly journals A case of right hepatic duct entering cystic duct successfully treated by laparoscopic subtotal cholecystectomy through preoperatively placed biliary stent

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Hirao ◽  
HiroHisa Okabe ◽  
Daisuke Ogawa ◽  
Daisuke Kuroda ◽  
Katsunobu Taki ◽  
...  
Keyword(s):  
Cystic Duct ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Endoscopic Retrograde ◽  
Case Presentation ◽  
Endoscopic Nasobiliary Drainage ◽  
Subtotal Cholecystectomy ◽  
Upper Abdominal ◽  
The Right ◽  
Nasobiliary Drainage

Abstract Background Laparoscopic cholecystectomy is a well-established surgical procedure and is one of the most commonly performed gastroenterological surgeries. Therefore, strategy for the management of rare anomalous cystic ducts should be determined. Case presentation A 56-year-old woman was admitted to our hospital owing to upper abdominal pain and diagnosed with acute cholecystitis. Magnetic resonance cholangiopancreatography suspected that several small stones in gallbladder and the right hepatic duct drained into the cystic duct. Endoscopic retrograde cholangiopancreatography confirmed the cystic duct anomaly, and an endoscopic nasobiliary drainage catheter (ENBD) was placed at the right hepatic duct preoperatively. Intraoperative cholangiography with ENBD confirmed the place of division in the gallbladder, and laparoscopic subtotal cholecystectomy was safely performed. Conclusions The present case exhibited rare right hepatic duct anomaly draining into the cystic duct, which might have caused biliary tract disorientation and bile duct injury (BDI) intraoperatively. Any surgical technique without awareness of this anomaly preoperatively might insufficiently prevent BDI, and preoperative ENBD would facilitate safe and successful surgery.

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