scholarly journals A Rare Anomaly of Biliary System: MRCP Evidence of a Cystic Duct Cyst

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Cemil Goya ◽  
Mehmet Serif Arslan ◽  
Alpaslan Yavuz ◽  
Cihad Hamidi ◽  
Suzan Kuday ◽  
...  
Keyword(s):  
Cystic Duct ◽  
Clinical Symptoms ◽  
Rare Condition ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Colic ◽  
Cystic Dilatation ◽  
Duct Cyst ◽  
Abdominal Ultrasonography ◽  
Number Of Patients ◽  
The Right

Cystic duct cysts are a rare congenital anomaly. While the other bile duct cysts (choledochus and the intrahepatic bile ducts) are classified according to the classification described by Tadoni, there is no classification method described by the cystic duct cysts, although it is claimed that the cystic duct cysts may constitute a new “Type 6” category. Only a limited number of patients with cystic duct cysts have been reported in the literature. The diagnosis is usually made in the neonatal period or during childhood. The clinical symptoms are nonspecific and usually include pain in the right upper quadrant and jaundice. The condition may also present with biliary colic, cholangitis, cholelithiasis, or pancreatitis. In our case, the abdominal ultrasonography (US) performed on a 6-year-old female patient who presented with pain in the right upper quadrant pointed out an anechoic cyst at the neck of the gall bladder. Based on the magnetic resonance cholangiopancreatography (MRCP) results, a cystic dilatation was diagnosed in the cystic duct. The aim of this case-report presentation was to discuss the US and MRCP findings of the cystic dilatation of cystic duct, which is an extremely rare condition, in the light of the literature information.

scholarly journals Surgical approach to a left-sided gallbladder

2019 ◽  
Vol 12 (8) ◽  
pp. e230681
Author(s):  
Ryan Pereira ◽  
Marlon Perera ◽  
Matthew Roberts ◽  
John Avramovic
Keyword(s):  
Cystic Duct ◽  
Imaging Modality ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Falciform Ligament ◽  
Biliary Colic ◽  
Common Hepatic Duct ◽  
Critical View Of Safety ◽  
Symptomatic Gallstones ◽  
The Right

Biliary colic is a pain in the right upper quadrant or epigastrium thought to be caused by functional gallbladder spasm from a temporary obstructing stone in the gallbladder neck, cystic duct or common bile duct. A 56-year-old man presented with frequent episodes of typical biliary colic. At initial laparoscopy, the gallbladder was absent from its anatomic location. Further inspection revealed a left-sided gallbladder (LSGB), suspended from liver segment 3. Preoperative ultrasound, the most common imaging modality for symptomatic gallstones, has a low positive predictive value for detecting LSGB (2.7%). Laparoscopic cholecystectomy (LC) was delayed to attain additional imaging. A magnetic resonance cholangiopancreatography demonstrated the gallbladder left of the falciform ligament with the cystic duct entering the common hepatic duct from the left. The patient underwent an elective LC 8 weeks later. The critical view of safety is paramount to safe surgical dissection and could be safely achieved for LSGB.

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.

Biliary pain in the structure of episodes of right upper abdominal pain

2020 ◽  
Vol 18 (6) ◽  
pp. 42-52
Author(s):  
Yu.O. Shulpekova ◽  
◽  
V.M. Nechaev ◽  
V.T. Ivashkin ◽  
◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Cholecystitis ◽  
Heart Diseases ◽  
Biliary Colic ◽  
Recurrent Pain ◽  
Biliary Pain ◽  
Abdominal Ultrasonography ◽  
Locomotor System ◽  
Upper Abdominal ◽  
The Right

Acute or recurrent pain in the right upper part of the abdomen is a common cause for visits to physicians. Not less than two thirds of episodes of pain in this area are conditioned by biliary colic and acute cholecystitis. Other most common causes include diseases of the liver, pancreas, prepyloric and pyloric parts of the stomach and the beginning portion of the small intestine, the right kidney, and also subhepatic appendicitis. Some cases of developing pain are associated with the right lung affection and involvement of the diaphragmatic pleura, with heart diseases, involvement of the locomotor system and nerves. Taking into account a high prevalence of cholelithiasis in Russia – around 10–12% – we can conclude that episodes of biliary colic develop every year in 1 of 500–1000 individuals. In Russia, approximately half a million cholecystectomies are performed annually. The prevalence of gall stones among the paediatric population amounts to 2%. As distinct from adults, who in 80% of cases have an asymptomatic course of disease, pain episodes in children manifest themselves in 60–67% of cases. The diiagnosis of acute cholecystitis might meet with considerable difficulties; a scale for assessment of the likelihood of acute cholecystitis has been developed. Unlike in adults, in children a significantly large proportion of cases occur due to acalculous cholecystitis. Differentiating the causes of pain might be difficult, therefore, its character and concomitant symptoms should be thoroughly analysed, and the findings of additional examinations should also be taken into consideration (at the first step – assessment of haematological and biochemical parameters, urinalysis, electrocardiogram and abdominal ultrasonography). Key words: right upper abdominal pain, biliary colic, biliary dyskinesia, cholelithiasis

scholarly journals Portal Hypertensive Cholangiopathy, Which Masquerades as an Acute Portal Vein Thrombosis

2019 ◽  
Vol 36 (2) ◽  
pp. 182-185
Author(s):  
Kamila I. Cisak ◽  
Thanila A. Macedo ◽  
Shannon P. Sheedy ◽  
Patrick S. Kamath ◽  
Aneel A. Ashrani
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Colic ◽  
Abdominal Sonography ◽  
Vein Thrombosis ◽  
Abdomen Ct ◽  
Diagnostic Modalities

Portal hypertensive cholangiopathy is a rare complication of extrahepatic portal vein obstruction and portal cavernoma. It is usually asymptomatic but may be associated with jaundice, biliary colic, and fever. Abdominal sonography and Doppler are ideal initial diagnostic modalities, followed by magnetic resonance cholangiopancreatography or endoscopic retrograde cholangiopancreatography. These imaging modalities are important if an intervention is planned for the management of portal hypertension and for relieving biliary obstruction. If computed tomography (CT) is performed in isolation, it may be challenging to distinguish this entity from acute on chronic portal vein thrombosis. The diagnostic results should be interpreted cautiously. This case report of an abdomen CT performed on a patient with a history of portal vein thrombosis masqueraded as an acute on chronic portal vein thrombosis with cavernous collaterals. Doppler confirmed the diagnosis of portal hypertensive cholangiopathy. Correlation with clinical symptoms and Doppler may be necessary to distinguish portal hypertensive cholangiopathy from acute portal vein thrombus.

EP.TH.665Where’s the gallbladder? A rare case of gallbladder agenesis with cystic duct stone

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Tiffany Cheung ◽  
Roberto Presa ◽  
Antonio Manzelli
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Cystic Duct ◽  
De Novo ◽  
Stone Formation ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Filling Defect ◽  
Biliary Colic ◽  
Biliary Duct ◽  
Increased Risk ◽  
Gallbladder Agenesis

Abstract Aims Gallbladder agenesis is a rare congenital anatomical malformation with an incidence of 0.007-0.0027%. Although usually asymptomatic, clinically it may present similarly to biliary colic. There may be increased risk of de novo biliary duct stone formation due to biliary dyskinesia, subsequent duct dilatation and biliary stasis. We present a case of incidental gallbladder agenesis identified during intended laparoscopic cholecystectomy. Methods A 68 year-old female with no significant comorbidities presented with a 16 hour history of colicky right upper quadrant pain and vomiting. She had been awaiting cholecystectomy for increasingly symptomatic gallstones, most recently visualised within a contracted gallbladder on ultrasound two months prior. Recurrently obstructive LFT’s warranted urgent magnetic resonance cholangiopancreatography (MRCP), which identified a poorly-visualised contracted gallbladder and a 10mm common bile duct without filling defect. At index laparoscopic cholecystectomy, a very small thick-walled structure resembling the gallbladder was identified and safely excised in retrograde; a stone was seen within. Results Macroscopic examination revealed a 27 x 9 x 11mm piece of dark brown tissue containing soft orange material. Microscopic histological examination confirmed this to be cystic duct focally lined by mucinous epithelium with chronic inflammation. Findings were consistent with gallbladder agenesis. Conclusions Although rare, it is important for surgeons to maintain an index of suspicion for gallbladder agenesis, particularly if repeated imaging demonstrates a poorly-visualised or ‘contracted’ gallbladder despite adequate fasting. Furthermore, as in this case, the presence of ‘gallbladder’ stones radiologically does not preclude gallbladder agenesis. Anticipation of this malformation may aid interpretation of biliary anatomy, if incidentally found intra-operatively.

scholarly journals Đặc điểm bệnh u nguyên bào gan và kết quả điều trị ở trẻ em tại bệnh viện Nhi Đồng 2

2020 ◽  
Author(s):  
Ngọc Phú Đặng
Keyword(s):  
Survival Rate ◽  
Liver Transplant ◽  
Clinical Symptoms ◽  
Treatment Protocol ◽  
Female Ratio ◽  
Number Of Patients ◽  
Response To Chemotherapy ◽  
Right Lobe ◽  
The Right ◽  
Male To Female

CHARACTERISTICS AND TREATMENT OF HEPATOBLASTOMA IN CHILDREN AT PEDIATRIC HOSPITAL 2 Objective: To determine the epidemiological, clinical, paraclinical characteristics and evaluate the result in treatment of hepatoblastoma (HB) at Department of Hematology-Oncology, Children’s Hospital 2 from January 2011 to end of May 2019. Method: Cases series study in combination of retrospective and prospective. Results: From January 2011 to end of May 2019, there were 67 patients diagnosed with HB. The mean age at diagnosis was 22.7 ± 22.9 months with the most prevalent age group ranging from 6 months to 3 years. The male to female ratio was 1.8/1. The most common clinical symptoms were abdominal distention and hepatomegaly, approximately 7.5% HB cases were detected accidentally by ultrasound. Nearly 60% and 80% patients presented with anemia and thrombocytosis at admission, respectively.Almost tumors were unifocal locating in the right lobe of the liver and 58.2% cases belonged to standard risk group. Assessing treatment protocol in 54 HB patients demonstrate that number of patients undergoing hepatectomy after preoperative chemotherapy accounted for 82%. The most frequent acuteside effects after chemotherapy were myelotoxicity and infection. The proportion of fatal and relapsed cases was 31.5% and 12.9% respectively. Overall and event-free survival rate of the study after 3 years was 65.7% and 68.1% individually. Conclusion: Hepatoblastoma is a rare malignant childhood disease, pretty good response to chemotherapy followed by surgery. However mortality rate is rather high compared to worldwide reasearchs. Thus development of liver transplant is necessary to improve survival rate. Keywords: Hepatoblastoma, chemothearapy, surgery, liver transplant.

scholarly journals Epehólyag-agenesia. Epekövességet utánzó ritka rendellenesség egy felnőtt nőben

2019 ◽  
Vol 160 (38) ◽  
pp. 1510-1513
Author(s):  
Călin Molnar ◽  
Tibor Sárközi ◽  
Cedric Kwizera ◽  
Marian Botoncea ◽  
Opriș Zeno ◽  
...  
Keyword(s):  
Rare Case ◽  
Medical Literature ◽  
Rare Condition ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Final Diagnosis ◽  
Biliary Colic ◽  
Caucasian Woman ◽  
Imaging Studies ◽  
History Of ◽  
Gallbladder Agenesis

Abstract: Gallbladder agenesis is a rare congenital malformation due to an embryological defect of the biliary system. In most cases it is asymptomatic, but it can also mimic biliary colic. We report the case of a 72-year-old Caucasian woman with a medical history of cardiovascular disease and hypercholesterolemia, under cholesterol-lowering and hypotensive treatment, who presented symptoms suggesting biliary colic. She underwent laparoscopic surgery that confirmed the final diagnosis. We present our approach in this rare case as well as a brief review of medical literature. The surgeon should decide intraoperatively whether to continue and search for a possible ectopic gallbladder or investigate further with imaging studies. Gallbladder agenesis is a rare condition that the surgeon must be aware of. In the cases of inconclusive or indirect signs of cholelithiasis, the best approach is complementary imaging investigations such as magnetic resonance cholangiopancreatography in order to avoid surgery. Orv Hetil. 2019; 160(38): 1510–1513.

Intraoperative Diagnosis of Gallbladder Agenesis

2021 ◽  
pp. 000313482110604
Author(s):  
Maryselle Winters ◽  
Derek T. Clar ◽  
Kelly Van Fossen
Keyword(s):  
Ultrasound Examination ◽  
Rare Condition ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Colic ◽  
Imaging Findings ◽  
Intraoperative Diagnosis ◽  
Increased Risk ◽  
History Of ◽  
Elective Laparoscopic Cholecystectomy ◽  
Gallbladder Agenesis

Gallbladder agenesis is a congenital anomaly that often presents with symptoms of biliary colic. Due to the rarity of this condition, it is often difficult to diagnose pre-operatively. Here we present a case of a 33-yo female with a 6-month history of right upper quadrant abdominal pain and associated nausea. With false-positive imaging findings of cholelithiasis on ultrasound examination, an incidental intraoperative diagnosis of gallbladder agenesis was made during a routine elective laparoscopic cholecystectomy. This finding was confirmed with postoperative magnetic resonance cholangiopancreatography. The primary aim in reporting this case is to further promote awareness of this rare condition out of concern for increased risk of iatrogenic operative injury in the setting of a condition where conservative management is recommended.

The characteristic clinical symptoms of C-4 radiculopathy caused by ossification of the posterior longitudinal ligament

2014 ◽  
Vol 20 (5) ◽  
pp. 480-484 ◽  
Author(s):  
Keiichi Katsumi ◽  
Akiyoshi Yamazaki ◽  
Kei Watanabe ◽  
Toru Hirano ◽  
Masayuki Ohashi ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Rare Condition ◽  
Posterior Longitudinal Ligament ◽  
Cervical Radiculopathy ◽  
Foraminal Stenosis ◽  
Spinal Nerves ◽  
Patient Screening ◽  
Intracranial Lesions ◽  
The Right

Cervical radiculopathy of the C2–4 spinal nerves is a rare condition and is poorly documented in terms of clinical symptoms, hindering its detection during initial patient screening based on imaging diagnostics. The authors describe in detail the clinical symptoms and successful surgical treatment of a patient diagnosed with isolated C-4 radiculopathy. This 41-year-old man suffered from sleep disturbance because of pain behind the right ear, along the right clavicle, and at the back of his neck on the right side. The Jackson and Spurling tests were positive, with pain radiating to the area behind the patient's ear. Unlike in cases of radiculopathy involving the C5–8 spinal nerves, no loss of upper-extremity motor function was seen. Magnetic resonance imaging showed foraminal stenosis at the C3–4 level on the right side, and multiplanar reconstruction CT revealed a beak-type ossification of the posterior longitudinal ligament in the foraminal region at the same level. In the absence of intracranial lesions or spinal cord compressive lesions, the positive Jackson and Spurling tests and the C3–4 foraminal stenosis were indicative of isolated C-4 radiculopathy. Microscopic foraminotomy was performed at the C3–4 vertebral level and the ossified lesion was resected. The patient's symptoms completely resolved immediately after surgery. To the authors' knowledge, this report is the first to describe the symptomatic features of isolated C-4 radiculopathy, in a case in which the diagnosis has been confirmed by both radiological findings and surgical outcome. Based on this case study, the authors conclude that the characteristic symptoms of C-4 radiculopathy are the presence of pain behind the ear and in the clavicular region in the absence of upper-limb involvement.

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