scholarly journals A rare case report: left-sided gall bladder without situs inversus viscerum

2021 ◽  
Vol 8 (6) ◽  
pp. 1928
Author(s):  
Shambhu Nath Agrawal ◽  
Amit Verma ◽  
Sunil Kedia ◽  
Amol Padegaonkar ◽  
Hari S. Mahobia
Keyword(s):  
Gall Bladder ◽  
Cystic Duct ◽  
Situs Inversus ◽  
Hepatic Duct ◽  
Lower Surface ◽  
Common Hepatic Duct ◽  
Acute Calculous Cholecystitis ◽  
Left Lateral Segment ◽  
Rare Case Report ◽  
The Common

Left-sided gall bladder without situs inversus viscerum is a rare clinical entity. A left-sided gall bladder is a rare congenital anomaly defined as a gall bladder attached to the lower surface of the left lateral segment of the liver, to the left of the inter-lobar fissure and round ligament. We reported our experience of one cases of left-sided gall bladder in a woman aged 45 years who underwent laparoscopic cholecystectomy for acute calculous cholecystitis. Left-sided gall bladder may provide an unusual surprise to the surgeons during laparoscopy as routine pre-operative studies may not always detect the anomaly. Awareness of the unpredictable confluence of the cystic duct into the common bile duct (CBD) and selective use of intraoperative cholangiography aid in the safe laparoscopic management of this unusual entity. One previous case reported had shown cystic duct opened into the common hepatic duct on its right side in a patient with left sided gall bladder.

scholarly journals Comparative Anatomical, Ultrasonographical and Radiological studies of the biliary system of Rabbits and Domestic cats in Egypt

2019 ◽  
Author(s):  
R.T. Reem ◽  
M.A. Maher ◽  
H.E. Alaa ◽  
H.A. Farghali
Keyword(s):  
Bile Duct ◽  
Gall Bladder ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Human Model ◽  
Common Hepatic Duct ◽  
Domestic Cats ◽  
Left Hepatic Duct ◽  
Right Lobe ◽  
The Right

ABSTRACTUnder the prevailing overall Conditions of all veterinarians for the diagnosis of biliary diseases, application of surgical procedures and liver transplantation in Cats as carnivorous pet animal, and Rabbits as herbivorous pet animal and also as a human model in research. The present study was constructed on twelve native breeds of rabbits (Oryctolagus cuniculus) and eighteen adult domestic cats (Felis catus domesticus). We concluded that, in brief; the rabbit gall bladder was relatively small, fixed by several small hepato-cystic ducts to its fossa. The rabbit bile duct was formed commonly by the junction of the left hepatic duct and the cystic duct. The cystic duct was commonly fairly large, received the right hepatic duct that collected the right lobe in its route to enter the duodenum, the bile duct receives the branch of the caudate process of the caudate lobe. The present study revealed other four anatomic variations dealing with the shape and size of the feline native breed’s gall bladder from fundic duplication, bilobed, truncated fundus and distended rounded fundus. Commonly, the bile duct was formed by the triple convergence of the left and the right hepatic ducts with the cystic duct. However, in some exceptional cases a short common hepatic duct was formed. Sonographically, the normal gall bladder in rabbit appeared small, elongated with anechoic lumen bordered by right lobe laterally and quadrate lobe medially and has no visible wall, but in cat varied in conformation, bordered by the right medial lobe laterally and the quadrate lobe medially surrounded by echogenic wall.

scholarly journals Bilirubin encephalopathy (kernicterus) in an adult cat

2019 ◽  
Vol 5 (1) ◽  
pp. 205511691983887
Author(s):  
Luís HG Saraiva ◽  
Maria C Andrade ◽  
Matheus VL Moreira ◽  
Letícia B Oliveira ◽  
Ágna F Santos ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Serum Alkaline Phosphatase ◽  
Hepatic Duct ◽  
Clinical Pathology ◽  
Brain Parenchyma ◽  
Common Hepatic Duct ◽  
Anatomical Site ◽  
The Common ◽  
Adult Cat ◽  
Conjugated Bilirubin

Case summary An adult cat presented with neurological signs and marked icterus. Clinical pathology tests detected increased serum alkaline phosphatase levels, as well as alanine aminotransferase, total bilirubin, unconjugated bilirubin and conjugated bilirubin above the normal reference intervals. Ultrasonography showed hepatomegaly and a dilated gall bladder. Following these results, the cat was referred for a cholecystectomy owing to a clinical suspicion of obstructive cholecystitis. The animal died in the postoperative period and was referred for necropsy. Grossly, the animal had marked icterus. On the cortical surface and in the brain parenchyma there were marked yellowish areas. The liver was diffusely reddish-orange, enlarged and the capsular surface was slightly irregular. The gall bladder was absent. At its anatomical site and surrounding the common hepatic duct, a whitish nodular neoplasia of 2.0 cm was found. Microscopically, a cholangioma was diagnosed in the region of the common hepatic duct. In the white matter of the cerebellar vermis, there was axonal degeneration associated with gliosis. In the Purkinje neuron layer there was slight multifocal necrosis. Some neurons contained amorphous and brownish pigment (bilirubin) in the cytoplasm. Clinical and pathological findings indicated hepatic and post-hepatic icterus from obstructive cholangioma, resulting in kernicterus. Relevance and novel information Kernicterus is a neurological disorder that is rarely diagnosed in animals, especially in adults. This report provides evidence that kernicterus can occur in adult cats, secondary to increased unconjugated and conjugated bilirubin concentrations.

scholarly journals The Morphometry Extrahepatic Bile Ducts

2018 ◽  
Vol 24 (4) ◽  
pp. 184-189
Author(s):  
Trantu Dina Elena ◽  
Bordei Petru ◽  
Ispas Viorel
Keyword(s):  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Hepatic Duct ◽  
Common Hepatic Duct ◽  
Ct Scanner ◽  
A Value ◽  
Extrahepatic Bile Ducts ◽  
Biliary Ducts ◽  
The Common ◽  
The Right

Abstract The extrahepatic bile duct morphometry was determined by the analysis of the colangiographies performed at Medimar Imaging Services SRL of the “St. Andrei “in Constanta on a General Electric Brightspeed Select CT scanner 16 slides. For the left liver duct found a caliber of 3.5-6.6 mm, its length ranging from 4.2-24.9 mm, and the right hepatic duct had a caliber ranging from 4.2-7.2 mm, the length being between 3.0-25.0 mm. At the confluence of the two hepatic ducts an angle of 35.0-124.1° was formed. In the common hepatic duct we found a caliber of 3.9-9.7 mm, in length between 20.2-52.9 mm. Cystic duct having a size of 2.4 to 5.5 mm, finding a length ranging from 24.6 to 66.4 mm. The angle formed at the end of the cystic duct in the hepatic duct had a value between 6.2-55.8°, and between the cystic and biliary ducts an angle of between 88.5-170.4° was formed. The coledoc duct had a caliber of 3.1-14.7 mm and a length of 19.8-57.3 mm.

scholarly journals Left Sided Gallbladder - Case Report

2016 ◽  
Vol 62 (3) ◽  
pp. 376-377
Author(s):  
Török Árpád ◽  
Kantor Tibor ◽  
Borz Cristian ◽  
Márton István Dénes ◽  
Mureșan Mircea
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Gallstone Disease ◽  
Cystic Artery ◽  
Common Hepatic Duct ◽  
Consecutive Series ◽  
The Common ◽  
Abnormal Anatomy

AbstractLeft sided gallbladder is a rare anomaly that is often associated with other abnormal anatomy in the hepatobiliary system. One left positioned gallbladder was found in a consecutive series of 3290 patients undergoing laparoscopic cholecystectomy for gallstone disease in the Mure County Emergency Hospital’s 2nd Surgery Clinic between 2005 and 2015, a prevalence of 0.03 per cent. In case of left sided gallbladder the cystic artery always crosses in front of the common bile duct from right to left. The cystic duct may open on the left or right side of the common hepatic duct. Anterograde cholecystectomy is the best choice for precise exploration of the cystic duct and cystic artery.

Low Insertion of the Cystic Duct in the Common Hepatic Duct as a Coincidence with an Onset of a Pancreatic Cephalic Carcinoma

2015 ◽  
Vol 69 (2) ◽  
pp. 94-99
Author(s):  
Aleksandar Sumkovski ◽  
Stojan Gjosev ◽  
Ljubomir Ognjenovikj ◽  
Meri Trajkovska ◽  
Goce Spasovski
Keyword(s):  
Cystic Duct ◽  
Surgical Procedure ◽  
Average Length ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Whipple Procedure ◽  
Common Hepatic Duct ◽  
Observation Study ◽  
Long Time ◽  
The Common

AbstractIntroduction. The normal anatomy of the cystic duct (CD) has been described a long time ago, but the basic description is valid up today: average length 2-4 mm, caliber 1-1.5 mm, and reduced volume by the spiral mu­­cous folds of Heister. Anatomic variants of the CD and its aberrant insertion lead to confusion during pre­opera­tive imaging examinations, and particularly to un­­pleasant situation during surgery, when the surgeon has to confirm positive identification of the anatomical struc­tures, in order to avoid iatrogenic biliary lesion. The aim of this prospective observation study was to evaluate the eventual bond between the low insertion of the CD in the common hepatic duct (CHD) and the onset of the pan­creatic cephalic carcinoma (PCC).Methods. In this study we examined 21 patients with PCC. The inclusion criteria was diagnosed PCC in ope­rable stage. The method for estimation of both, the ope­ra­bility and the site of insertion of the CD into CHD cons­isted of: ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), CT and MRI. Finally, the surgical procedure was extensive duodenopan­cre­a­tectomy, Whipple procedure. The surgical procedure was supplemented with periarterectomy and bilateral coeliac ganglienectomy in purpose of radical treat­ment and denervation.Results. Of the total of 21 patients, we revealed low in­sertion of the CD (LICD) in 6 patients (28%). In 4 pa­tients (3 male and 1 female), the LICD was presented with complete dilatation of the biliary tree, including CD, CHD and the gallbladder, while in 2 patients the CD and its low insertion were absent on the images-ERCP, CT. In these 2 patients the appearance was amid the cranial infiltration and growth of the carcinoma.Conclusions. Comparison with other reference radiolo­gical and anatomical studies, our results significantly di­ffer in the frequency of the appearance of the LICD. This may partially be due to different definitions and criteria referring to LICD. On the other hand, the observed diffe­rences may be caused by the eventually present connec­tion between the LICD and PCC. Therefore, further stu­dies with a larger number of participants are necessary (anatomical, pathological and genetic), to confirm or to deny the predicted bond between the LICD and PCC.

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