scholarly journals Gallbladder agenesis diagnosed intraoperatively complicated by common hepatic duct injury

2021 ◽  
Vol 8 (2) ◽  
pp. 710
Author(s):  
Basel Mohamed Alaradi ◽  
Ahmed E. Jawad ◽  
Devpal C. Patil
Keyword(s):  
Congenital Anomaly ◽  
Preoperative Diagnosis ◽  
Open Surgery ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Abdominal Ultrasound ◽  
Biliary Colic ◽  
Common Hepatic Duct ◽  
Rare Congenital Anomaly ◽  
Gallbladder Agenesis

Gallbladder agenesis is a rare congenital anomaly among biliary abnormalities, and its preoperative diagnosis has been considered very difficult. Gallbladder agenesis becomes symptomatic in almost 23% of cases mostly with symptoms mimicking biliary colic, which is poorly understood. Initial workup for suspected gallbladder diseases, such as abdominal ultrasound, can be misleading or inconclusive. Often it is misinterpreted as other diseases leading to unnecessary surgery. We reported a case of a 31-year-old Bahraini male presenting with recurrent symptoms, suggesting biliary colic. Abdominal ultrasound showed False-positive contracted gallbladder. The patient was then taken to the operative theater for laparoscopic cholecystectomy. Intraoperatively, the gallbladder could not be seen, and eventually the decision was made to converted to open surgery which was complicated by common hepatic duct injury. Gallbladder agenesis was confirmed postoperatively by magnetic resonance cholangiopancreatography (MRCP).  

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 Gallbladder Hypoplasia Treated by Laparoscopy: A Case Report and Literature Review

2019 ◽  
Vol 3 (1) ◽  
pp. 01-03
Author(s):  
Víctor Serrats
Keyword(s):  
Congenital Anomaly ◽  
Abdominal Pain ◽  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Magnetic Resonance ◽  
Histopathological Examination ◽  
Gallbladder Disease ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Colic ◽  
Rare Congenital Anomaly

The gallbladder hypoplasia is a rare congenital anomaly. We present a case of a 38-year-old man who was referred to us for surgical management of gallbladder disease. The patient presented abdominal pain compatible with repeating biliary colic as the first clinical manifestation. Preoperatively, the magnetic resonance cholangiopancreatography imaging was useful to study thoroughly the biliary tract in order to avoid any iatrogenic injury. Intraoperatively, laparoscopy revealed a rudimentary gallbladder and the histopathological examination confirmed the diagnosis of hypoplasic gallbladder. Laparoscopic cholecystectomy was successful and the patient did not present abdominal pain again.

scholarly journals Gallbladder Agenesis and Cystic Duct Absence in an Adult Patient Diagnosed by Magnetic Resonance Cholangiography: Report of a Case and Review of the Literature

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Valeria Fiaschetti ◽  
Giovanna Calabrese ◽  
Silvia Viarani ◽  
Gabriele Bazzocchi ◽  
Giovanni Simonetti
Keyword(s):  
Congenital Anomaly ◽  
Magnetic Resonance ◽  
Adult Patient ◽  
Biliary Tract ◽  
Cystic Duct ◽  
Congenital Abnormalities ◽  
Review Of The Literature ◽  
Rare Congenital Anomaly ◽  
Biliary Tract Abnormality ◽  
Gallbladder Agenesis

Gallbladder agenesis (GA) is a rare congenital anomaly of the biliary system often associated with other congenital abnormalities. Patients become symptomatic in 23% of cases. GA is often misinterpreted as other diseases, therefore, leading to unnecessary surgery. We report a case of congenital GA associated to cystic duct absence and a biliary tract abnormality diagnosed by Magnetic Resonance with Cholangiopancreatography.

scholarly journals Type VI Choledochal Cysts—Case Report and Review of Literature

2019 ◽  
Vol 05 (03) ◽  
pp. e82-e86 ◽  
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.

The Value of Cholangiography through Jackson-Pratt Drains in the Management of Postoperative Biliary Injuries

2014 ◽  
Vol 80 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Francisco Igor B. Macedo ◽  
Victor J. Casillas ◽  
James S. Davis ◽  
Joe U. Levi ◽  
Danny Sleeman
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Common Hepatic Duct ◽  
Biliary Reconstruction ◽  
Biliary Injury ◽  
Endoscopic Retrograde ◽  
Distal Common Bile Duct ◽  
Potential Benefits

Iatrogenic biliary injury is the most significant complication after laparoscopic cholecystectomy. We present our experience with an alternative diagnostic approach using transcatheter cholangiography (TCC) through a Jackson-Pratt (JP) drain and discuss potential benefits and limitations of the technique. From March 2002 to February 2012, 40 patients with major postoperative biliary injury underwent biliary reconstruction at our institution. Mean age was 51.7 ± 18.1 years (range, 19 to 86 years) with 30 (75%) females. Seventeen (42.5%) injuries were detected intraoperatively and in 13 (32.5%) cases, JP drains were placed for biliary drainage. Lesions were classified according to Bismuth grade: I (10 patients [25%]), II (10 patients [25%]), III (six patients [15%]), IV (10 patients [25%]), and V (four patients [10%]). TCC was performed in seven patients with JP drains (53.8%). It fully defined the injury site in three cases of limited magnetic resonance cholangiopancreatography (MRCP) such as common hepatic duct and common bile duct leaks and in four cases (57.1%) that endoscopic retrograde cholangiopancreatography (ERCP) was limited as a result of clipping of the distal common bile duct. TCC showed promising results in cases of limited MRCP and ERCP such as fistulous orifices or leakage. It may represent an alternative adjunct in the diagnostic armamentarium of complex biliary injuries.

scholarly journals Hepatolitiasis: Kasus Serial di RSUD Dr. Soetomo

2018 ◽  
Vol 2 (1) ◽  
pp. 5 ◽  
Author(s):  
Made Mahayasa ◽  
Tommy Lesmana
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Common Bile Duct ◽  
Gall Bladder ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Common Hepatic Duct ◽  
Hepatic Bile ◽  
Hepatic Bile Duct

Latar Belakang: hepatolitiasis adalah batu empedu pada saluran empedu liver dengan insidensi 20-30% dari semua pasien yang menjalani operasi untuk penyakit batu empedu. Ada beberapa pilihan operasi hepatolitiasis, seperti hepatektomi, eksplorasi common bile duct (CBD), dan drainase saluran intrahepatik atau cholangioenterostomy (access loop procedures), dan teknik perkutaneus. Pada laporan kasus serial ini, akan dibahas aspek pemilihan operasi pada pasien dengan hepatolitiasis. Kasus: kasus pertama adalah laki-laki, 60 tahun, dirawat di Rumah Sakit Dr. Soetomo dengan nyeri abdomen kuadran kanan atas sejak 2 minggu. Diagnosis dengan USG (ultrasonografi) abdomen dan MRCP (magnetic resonance cholangiopancreatography) menunjukkan terdapat beberapa batu di IHBD (intra hepatic bile duct), CHD (common hepatic duct), CBD, GB (gall bladder), dan sistem bilier yang melebar. Pada pasien dilakukan tindakan kolesistektomi, eksplorasi duktus, dan by pass bilio-digestive Roux en Y (access loop procedures). Kasus kedua adalah perempuan, 45 tahun, dirawat di Rumah Sakit Dr. Soetomo dengan didiagnosis batu IHBD dan CBD. Penderita telah dilakukan kolesistektomi sejak 12 tahun yang lalu. Durante operasi ditemukan atrofi lobus kiri hati. Pada pasien, dilakukan operasi dengan eksplorasi duktus, by pass bilio-digestive Roux en Y (access loop procedures), dan hepatektomi lobus kiri. Simpulan: kasus hepatolitiasis jarang terjadi di Rumah Sakit Dr. Soetomo Surabaya. Diagnosis lengkap memerlukan kombinasi modalitas pencitraan. Pembedahan tetap menjadi pilihan utama pengobatan definitif. Menurut strategi terapeutik saat ini untuk hepatolitiasis, hepatektomi tampaknya merupakan pengobatan yang paling efektif untuk pasien dengan hepatolitiasis kiri yang terisolasi jika prosedur pembedahan lain tidak dapat mengatasi semua lesi terkait. Perawatan yang baik dapat memberikan luaran yang baik.

scholarly journals Congenital biliary web- a rare cause of obstructive jaundice in an infant: A case report

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Allah Ditta ◽  
Muhammad Bilal Mirza ◽  
Muhammad Waqas-ur-Rehman ◽  
Maria Fahim ◽  
Farrakh Mehmood Satar ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Tree ◽  
Postoperative Recovery ◽  
Common Hepatic Duct ◽  
Rare Entity ◽  
Case Presentation ◽  
Complete Obstruction ◽  
The Common

Background: Congenital biliary web of the extra-hepatic biliary tree is becoming exceedingly rare cause of obstructive jaundice in children. Case Presentation: We report a case of 5-month-old male baby who presented with acholic stools and persistent jaundice since birth. Magnetic resonance cholangiopancreatography (MRCP) showed contracted gall bladder and focal narrowing at mid portion of the common bile duct (CBD) with proximal dilatation of biliary channels. On exploration, a complete web was found just proximal to the confluence of cystic duct and common hepatic duct causing complete obstruction of biliary tree. A Roux-en-Y hepatico-jejunostomy was done. Postoperative recovery was uneventful. Conclusion: We conclude that congenital biliary web is a rare entity and should be considered in the dif­ferential diagnosis of biliary atresia.

scholarly journals Retrocaval Ureter: Report of Two Cases

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Henry Atawurah ◽  
Patrick Opoku Manu Maison ◽  
Mohammed Owusu-Ansah ◽  
Alvin Asante-Asamani
Keyword(s):  
Congenital Anomaly ◽  
Vena Cava ◽  
Abdominal Ultrasound ◽  
Flank Pain ◽  
Cape Coast ◽  
Rare Congenital Anomaly ◽  
Retrocaval Ureter ◽  
Ct Urogram ◽  
History Of ◽  
Laboratory Investigations

Retrocaval ureter (RCU) is a rare congenital anomaly in which the ureter passes posterior to the inferior vena cava (IVC). A little over 200 cases have been reported worldwide since Hochstetter’s first report in 1893. We present two cases of retrocaval ureter which were successfully managed at the Cape Coast Teaching Hospital in Ghana. Case 1. A 55-year-old woman presented with a history of dull right flank pain of 2 years duration. Physical examination and basic laboratory investigations performed on her were normal. Abdominal ultrasound showed right hydronephrosis and a retrograde right ureteropyelogram (RPG) showed right hydroureteronephrosis with an “S” shaped proximal ureter. A diagnosis of retrocaval ureter was made and confirmed at surgery. Case 2. A 25-year-old man presented with dull intermittent right flank pain of 1 year duration. Clinical examination and laboratory investigation were normal. Abdominal ultrasound showed right hydronephrosis and a CT urogram made a diagnosis of retrocaval ureter which was confirmed at surgery. Conclusion. Retrocaval ureter is a rare congenital anomaly that is now increasingly being reported. Surgical treatment of symptomatic cases successfully relieves symptoms.

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.

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