A Unique and Rare Presentation of Obstructed Choledochal Cyst in an Adult: A Case Report

Choledochal cysts in adults are rare congenital abnormalities. Approximately 80% are found in childhood. Thus, their presentation in adults is always associated with complications, such as stone formation, inflammation and malignancies. The pathophysiology of this disease is yet uncertain. There are different types of choledochal cysts. Diagnosis can be challenging clinically; however, imaging techniques, such as ultrasound, magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT), can be helpful. We found several procedures performed in the extant literature, such as choledochoduodenostomy and choledochojejunostomy submucosal excision of the cyst; however, the best surgical option is excision with hepaticojejunostomy. We discuss the unusual presentation of a 33-year-old female patient with an obstructed choledochal cyst, despite having undergone a drainage procedure in childhood.

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Rare Presentation of the Type I Choledochal Cyst in a Young Adult

HPB ◽

10.1016/j.hpb.2020.11.897 ◽

2021 ◽

Vol 23 ◽

pp. S352

Author(s):

N.Y. Muppalla ◽

S. Sankar

Keyword(s):

Young Adult ◽

Choledochal Cyst ◽

Type I ◽

Rare Presentation

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Selected In Situ Hybridization Methods: Principles and Application

Molecules ◽

10.3390/molecules26133874 ◽

2021 ◽

Vol 26 (13) ◽

pp. 3874

Author(s):

Dominika Veselinyová ◽

Jana Mašlanková ◽

Katarina Kalinová ◽

Helena Mičková ◽

Mária Mareková ◽

...

Keyword(s):

In Situ Hybridization ◽

Imaging Techniques ◽

Cell Communication ◽

Probe Design ◽

Rapid Progress ◽

In Situ Techniques ◽

Different Types ◽

Laboratory Procedures ◽

The Individual

We are experiencing rapid progress in all types of imaging techniques used in the detection of various numbers and types of mutation. In situ hybridization (ISH) is the primary technique for the discovery of mutation agents, which are presented in a variety of cells. The ability of DNA to complementary bind is one of the main principles in every method used in ISH. From the first use of in situ techniques, scientists paid attention to the improvement of the probe design and detection, to enhance the fluorescent signal intensity and inhibition of cross-hybrid presence. This article discusses the individual types and modifications, and is focused on explaining the principles and limitations of ISH division on different types of probes. The article describes a design of probes for individual types of in situ hybridization (ISH), as well as the gradual combination of several laboratory procedures to achieve the highest possible sensitivity and to prevent undesirable events accompanying hybridization. The article also informs about applications of the methodology, in practice and in research, to detect cell to cell communication and principles of gene silencing, process of oncogenesis, and many other unknown processes taking place in organisms at the DNA/RNA level.

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Intracholecystic papillary-tubular neoplasm in a patient with choledochal cyst and anomalous pancreaticobiliary junction: case report

BJR|case reports ◽

10.1259/bjrcr.20180079 ◽

2019 ◽

Vol 5 (2) ◽

pp. 20180079

Author(s):

Marta Reis de Sousa ◽

Inês Santiago ◽

Maria J Barata ◽

Mireia Castillo ◽

Celso Matos

Keyword(s):

Case Report ◽

Bile Duct ◽

Gastric Adenocarcinoma ◽

Choledochal Cyst ◽

Histopathological Analysis ◽

Gallbladder Neoplasms ◽

Choledochal Cysts ◽

Bile Duct Dilatation ◽

Duct Dilatation ◽

Anomalous Pancreaticobiliary Junction

A 75-year-old female incidentally presented with an enhancing intraluminal gallbladder mass, main bile duct dilatation and anomalous pancreaticobiliary junction (APBJ) during the staging of gastric adenocarcinoma. Histopathological analysis confirmed the diagnosis of intracholecystic papillary-tubular neoplasm. Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder are rare gallbladder neoplasms, defined as intramucosal, preinvasive, exophytic, mass forming lesions. An association between choledochal cysts and anomalous pancreaticobiliary junction with gallbladder neoplasms is well known, and this case potentially illustrates gallbladder carcinogenesis related to these biliary anomalies.

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Anomalous choledocho-pancretic ductal junction in a choledochal cyst: A case report

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0406179j ◽

2004 ◽

Vol 132 (5-6) ◽

pp. 179-181

Author(s):

Miodrag Jovanovic ◽

Dragoljub Bilanovic ◽

Radoje Colovic ◽

Nikica Grubor ◽

Milenko Ugljesic

Keyword(s):

Bile Duct ◽

Choledochal Cyst ◽

Bile Ducts ◽

Postoperative Recovery ◽

Biliary Colic ◽

Duodenal Wall ◽

Choledochal Cysts ◽

Bile Duct Wall ◽

Intrahepatic Bile Ducts ◽

Inflammatory Changes

Choledochal cysts are rare congenital anomalies, mostly detected in adults. Pathogenesis of these cysts seems to be in anomalous junction between pancreatic and common bile duct, above the papillary sphincterand outside of the duodenal wall. The absence of the sphincter above the junction is followed by reflux of the pancreatic juice into the bile duct leading to dilatation and fibrous changes of bile duct wall. A 38-year-old female is presented in whom a choledochal cyst was found 11 years earlier, during the operation performed for obstructive jaundice, when cystojejunostomy with Roux-en Y jejunal limb was carried out. In February 1990, she was admitted to our Institution for jaundice and biliary colic. The patient was reoperated. Operative cholangiography showed an anomalous pancreatobiliary junction, choledochal cyst, dilated cystic duct and moderate dilatation of intrahepatic bile ducts. Cholecystectomy, desanastomosis with partial excision of choledochal cyst, and retrocolic choledochojejunostomy with the same Roux-en-Y jejunal limb were performed. Total excision of choledochal cyst was too risky due to chronic inflammatory changes in the hepatoduodenal ligament. Postoperative recovery was uneventful and the patient remained symptom-free so far.

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Truncated Inception Net: COVID-19 Outbreak Screening using Chest X-rays

10.21203/rs.3.rs-20795/v1 ◽

2020 ◽

Cited By ~ 4

Author(s):

Dipayan Das ◽

KC Santosh ◽

Umapada Pal

Keyword(s):

Neural Network ◽

World Wide ◽

Imaging Techniques ◽

Imaging Systems ◽

Ct Scans ◽

X Rays ◽

X Ray ◽

X Ray Imaging ◽

Proposed Model ◽

Different Types

Abstract Since December 2019, the Coronavirus Disease (COVID-19) pandemic has caused world-wide turmoil in less than a couple of months, and the infection, caused by SARS-CoV-2, is spreading at an unprecedented rate. AI-driven tools are used to identify Coronavirus outbreaks as well as forecast their nature of spread, where imaging techniques are widely used, such as CT scans and chest X-rays (CXRs). In this paper, motivated by the fact that X-ray imaging systems are more prevalent and cheaper than CT scan systems, a deep learning-based Convolutional Neural Network (CNN) model, which we call Truncated Inception Net, is proposed to screen COVID-19 positive CXRs from other non-COVID and/or healthy cases. To validate our proposal, six different types of datasets were employed by taking the following CXRs: COVID-19 positive, Pneumonia positive, Tuberculosis positive, and healthy cases into account. The proposed model achieved an accuracy of 99.96% (AUC of 1.0) in classifying COVID- 19 positive cases from combined Pneumonia and healthy cases. Similarly, it achieved an accuracy of 99.92% (AUC of 0.99) in classifying COVID-19 positive cases from combined Pneumonia, Tuberculosis and healthy CXRs. To the best of our knowledge, as of now, the achieved results outperform the existing AI-driven tools for screening COVID-19 using CXRs.

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Large choledochal cyst initially interpreted as Mirizzi syndrome - case report and literature review

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh191112133m ◽

2020 ◽

Vol 148 (3-4) ◽

pp. 216-219

Author(s):

Vladimir Milosavljevic ◽

Boris Tadic ◽

Nikola Grubor ◽

Djordje Knezevic ◽

Slavko Matic

Keyword(s):

Surgical Treatment ◽

Choledochal Cyst ◽

Surgical Techniques ◽

Mirizzi Syndrome ◽

Operative Techniques ◽

Choledochal Cysts ◽

Cystic Dilatation ◽

Additional Imaging ◽

Histological Confirmation ◽

Extent Of Surgical Resection

Introduction. Choledochal cysts are congenital anomalies manifested as focal or diffuse cystic dilatation of the bile ducts. They are mostly diagnosed in childhood. The magnetic resonance and surgical management are the gold standard diagnostic and treatment modality. Case outline. We present a male patient who was presumed to have Mirizzi syndrome. This presumption was discarded by additional imaging procedures and by later surgical treatment. It was confirmed that it was a large choledochal cyst filled with stones. Considering the diagnosis and good patient?s general condition, we opted for surgical treatment. Conclusion. There are several surgical techniques that can be used in the treatment of choledochal cysts, wherein each is intended as a complete resection of the cyst with histological confirmation. Operative techniques do not affect the outcome of the treatment, but the time and extent of surgical resection, as well as any metaplasia of the epithelium, do.

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Imaging techniques in diagnostics, differentiation and monitoring of different types of thyroiditis

Thyroid Research ◽

10.1186/1756-6614-6-s2-a50 ◽

2013 ◽

Vol 6 (S2) ◽

Author(s):

Marek Ruchała ◽

Ewelina Szczepanek-Parulska

Keyword(s):

Imaging Techniques ◽

Different Types

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The Efficacy of Polyunsaturated Fatty Acids as Protectors against Calcium Oxalate Renal Stone Formation: A Review

Nutrients ◽

10.3390/nu12041069 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1069

Author(s):

Allen L. Rodgers ◽

Roswitha Siener

Keyword(s):

Fatty Acids ◽

Polyunsaturated Fatty Acids ◽

Fish Oil ◽

Calcium Oxalate ◽

Renal Stone ◽

Stone Formation ◽

Membrane Phospholipids ◽

Dietary Pufa ◽

Evening Primrose ◽

Different Types

In the pathogenesis of hypercalciuria and hyperoxaluria, n-6 polyunsaturated fatty acids (PUFAs) have been implicated by virtue of their metabolic links with arachidonic acid (AA) and prostaglandin PGE2. Studies have also shown that n-3 PUFAs, particularly those in fish oil—eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—can serve as competitive substrates for AA in the n-6 series and can be incorporated into cell membrane phospholipids in the latter’s place, thereby reducing urinary excretions of calcium and oxalate. The present review interrogates several different types of study which address the question of the potential roles played by dietary PUFAs in modulating stone formation. Included among these are human trials that have investigated the effects of dietary PUFA interventions. We identified 16 such trials. Besides fish oil (EPA+DHA), other supplements such as evening primrose oil containing n-6 FAs linoleic acid (LA) and γ-linolenic acid (GLA) were tested. Urinary excretion of calcium or oxalate or both decreased in most trials. However, these decreases were most prominent in the fish oil trials. We recommend the administration of fish oil containing EPA and DHA in the management of calcium oxalate urolithiasis.

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Type VI Choledochal Cysts—Case Report and Review of Literature

The Surgery Journal ◽

10.1055/s-0039-1693652 ◽

2019 ◽

Vol 05 (03) ◽

pp. e82-e86 ◽

Cited By ~ 1

Author(s):

J. M. V. Amarjothi ◽

Villalan Ramasamy ◽

Jeyasudhahar Jesudasan ◽

O. L. NaganathBabu

Keyword(s):

Hepatic Duct ◽

Treatment Options ◽

Magnetic Resonance Cholangiopancreatography ◽

Interesting Case ◽

Common Hepatic Duct ◽

Choledochal Cysts ◽

Middle Aged ◽

Complete Excision ◽

Intrahepatic Bile Ducts ◽

Aged Woman

AbstractCholedochal cysts (CDC), are rare congenital dilations involving the extra hepatic biliary apparatus with or without dilation of the intrahepatic bile ducts. They are conventionally classified into five types. A new type, type VI, causing dilation of the cystic duct between the neck of the gall bladder and the common hepatic duct (CHD) has been described in medical literature which is the rarest of all these subtypes. They are commonly observed in middle aged females and are mostly symptomatic. Most of these cysts need magnetic resonance cholangiopancreatography (MRCP) for accurate diagnosis. Treatment options for these lesions are not well defined but range from simple cholecystectomy to complete excision of the entire bile duct and biliary reconstruction, as there is a concern of malignant transformation in these cysts. Hence, these rare cysts, though rare, must be borne in mind when dealing with suspicious cystic lesions in the biliary tract. Here, we present an interesting case of such a rare cyst and its management in a middle aged woman.

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Diagnostic dilemma in a large choledochal cyst

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v22i2.28744 ◽

2019 ◽

Vol 22 (2) ◽

pp. 38-40

Author(s):

Tul Maya Gurung ◽

Rabin Koirala ◽

Amit Shrestha

Keyword(s):

Differential Diagnosis ◽

Choledochal Cyst ◽

Congenital Anomalies ◽

Biliary Drainage ◽

Abdominal Mass ◽

Choledochal Cysts ◽

Diagnostic Dilemma ◽

Variable Presentation

Choledochal cysts are rare congenital anomalies that have a variable presentation with occasional diagnostic and therapeutic dilemmas. Our case is a 14-year female presented with recurrent abdomen pain with confusing diagnostic findings, suggestive of a large choledochal cyst (22x29x17cm) initially managed by percutaneous tube biliary drainage and later underwent excision and HPE revealing non-malignant findings. The choledochal cyst should always be a differential diagnosis for any patient presenting with an abdominal mass and should be managed accordingly.

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