Heterotopic Pancreas In Gall Bladder Associated With Chronic Cholecystitis- Is A Rare Combination

Author(s):  
Dr Sangita Pal ◽  
Dr Parul Gupta ◽  
Dr Nirupma Lal ◽  
Dr Kshama Tiwari ◽  
Dr Sumaiya Irfan
2016 ◽  
Vol 8 (02) ◽  
pp. 126-128 ◽  
Author(s):  
Navjot Kaur ◽  
Bal Chander ◽  
Harjit Kaur ◽  
Rashmi Kaul

ABSTRACTHeterotopic pancreatic tissue in the gall bladder is an uncommon incidental finding in most cases. We hereby describe the case of a 45-year-old woman who presented with symptoms of acalculous cholecystitis. Pathological examination detected heterotopic pancreatic tissue, pseudopyloric metaplasia, and adenomyomatous hyperplasia in the gall bladder. This is a rare combination of three entities which is being reported for the first time. This case emphasizes that heterotopic pancreas might be the causative factor for cholecystitis.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lovenish Bains ◽  
Haraesh Maranna ◽  
Pawan Lal ◽  
Ronal Kori ◽  
Daljit Kaur ◽  
...  

Abstract Background Gall bladder cancer (GBC) is the fifth most common malignancy in the gastrointestinal system and the most common malignancy of the biliary system. GBC is a very aggressive malignancy having a 5 year survival rate of 19%. Giant Gall Bladder (GGB) is an uncommon condition that can result from cholelithiasis or chronic cholecystitis and rarely with malignancy. Case report A 65 year old lady presented with vague abdominal pain for 12 years and right abdominal lump of size 20 × 8 cms was found on examination. CT scan showed a circumferentially irregularly thickened wall (2.5 cm) of gall bladder indicative of malignancy. Per-operatively a GB of size 24 × 9 cm was noted and patient underwent radical cholecystectomy. It was surprise to find such a giant malignant GB with preserved planes. Histopathology, it was well differentiated adenocarcinoma of gall bladder of Stage II (T2a N0 M0). Discussion It is known that mucocoele of GB can attain large size, however chronic cholecystitis will lead to a shrunken gall bladder rather than an enlarged one. A malignant GB of such size and resectable is rare without any lymph node involvement or liver infiltration. Few cases of giant benign gall bladder have been reported in literature, however this appears to be the largest resectable gall bladder carcinoma reported till date as per indexed literature. Conclusion Giant GB is an uncommon finding. They are mostly benign, however malignant cases can occur. Radiological findings may suggest features of malignancy and define extent of disease. Prognosis depends on stage of disease and resectability, irrespective of size.


KYAMC Journal ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 184-187
Author(s):  
Md Abu Bakar Siddiue ◽  
Firoz Mahmud ◽  
M Fardil Hossain Faisal ◽  
Md Fazlur Rahman ◽  
Bidhan C Das ◽  
...  

Background: Cholecystectomy is one of the commonest surgeries in medical practice. Sometimes malignant condition cannot be assessed pre-operatively. Histopathology require for tissue diagnosis. Objective: To assess whether the histopathogical examination is really needed for all bladder specimens resected for cholelithiasis and cholecystitis. Materials and Methods: This observational study was carried out in the General Surgery Unit, Department of Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from May, 2016 to April, 2017. A total number of 95 patients were included in this study. Results: Total of 95 gallbladder specimens were submitted for histopathological examination where 33.7% were males and 66.3 % were females with mean age of 46+12.86 years. Chronic cholecystitis was the most common finding in 91.6% of cases whereas Xanthogranulomatous 2.1%. Six of the gall bladders showed adenocarcinoma (6.3%), of which four had changes on ultrasound and macroscopic gall bladder analysis (MGAS) disturbances were found in 5 cases and 1 case was found incidentally on histopathological examination. On ultrasound, only four (66.66%) and peroperative macroscopic examination by surgeon only 5(83.3%) had a clue of carcinoma. Conclusion: It could be concluded that , routine histopathological examination of gallbladder after cholecystectomy is necessary as USG sometimes can not differentiate neoplastic lesion from inflammatory one. KYAMC Journal Vol. 10, No.-4, January 2020, Page 184-187


Author(s):  
Sawant Abhijeet ◽  
◽  
D’mello Adrianna ◽  
Deogaonkar Namita Mbbs. P.D. ◽  
Sudeep R. Shah. Ms, Frcs ◽  
...  

2018 ◽  
Vol 5 (5) ◽  
pp. 1978
Author(s):  
Sowmya Murugesan ◽  
Chandru R. ◽  
Ramya Ramakrishnan ◽  
Rajiv Raj ◽  
Kishore Kumar G.

Porcelain gall bladder is a rare entity and a morphological variant of chronic cholecystitis. Dystrophic calcification along with inflammatory scarring of the wall gives the porcelain nature to the gall bladder. Patients are mostly asymptomatic and incidentally diagnosed on X-ray, ultrasound or CT abdomen. In the early stages they can be a surprise as only a histopathological diagnosis. Prophylactic cholecystectomy is recommended in view of high risk of malignancy.


2020 ◽  
Vol 22 (4) ◽  
pp. 233-237
Author(s):  
Rakesh Pathak ◽  
M Gupta ◽  
P Poudel ◽  
K Khadka

Gall bladder is one of the important digestive organ which encountered with different histopathological changes. Different changes in dietary habit, obesity, oral contraceptives, alcohal have shows increased pattern of cholecystitis and cholelithiasis and other pathological findings. Detail examination of gall bladder in cholecystectomy specimen helps to evaluate different histopathological pattern of gall bladder lesion and also help to differentiate non-neoplastic from neoplastic lesion and also helps in further management. This was a cross sectional study done in the Department of Pathology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal, during the study of period of six months (Feburary 2020 to July 2020). A total of 127 patients between 16 years to 63 years with mean age of 40.54±10.88 years. There were 127 cholecystectomy specimens were received during study period and out of which 94 were female and 33 were male. On histopathologial evaluation, chronic cholecystitis was most common findings followed by chronic cholecystitis with cholesterolosis. Other findings were chronic cholecystitis with adenomyosis, chronic cholecystitis with pyloric metplasia, chronic cholecystitis with intestinal metpalsia, chronic cholecystitis with polyp, acute on chronic cholecystitis, Xanthogranulomatous cholecytsitis and adenocarcarcinoma . Median age was 40.54 years. It was concluded that Chronic cholecystitis was the most common histopathologcial findings and the common groups was 41-50 years. Routine examination of cholecystectomy specimens grossly and microscopically is important for patient management Though a very few cases of carcinoma of Gall bladder is seen, it is very important to make sure that all cholecystectomy specimens undergone histopathological examination, with this, we can achieve timely diagnosis and early managements.


2021 ◽  
Vol 6 (4) ◽  
pp. 316-318
Author(s):  
Jaydeep N Pol ◽  
Neha M Bhosale ◽  
Mahendra Atmaram Patil ◽  
Vaishali J Pol

Follicular Cholecystitis (FC) is an extremely rare subtype of Chronic Cholecystitis (CC). It is characterized by hyperplastic lymphoid follicles along with prominent germinal centers. It constitutes about 2% of routine cholecystectomies. In this article, we report a case of FC in a 69 years lady. She had abdominal pain, clinically diagnosed as Calculus cholecystitis and managed by laparoscopic cholecystectomy. Grossly, thickening of the gall bladder wall was noted. Histopathological examination revealed gall bladder wall infiltrated by dense lymphoid infiltrate forming lymphoid follicles with prominent germinal centres. Hence, we rendered a diagnosis of FC. The purpose of presenting this case is to make pathologists aware about this entity. One should not mistake this lesion for lymphoma. A careful histopathological examination is diagnostic and Immunohistochemistry may be helpful in difficult cases.Follicular Cholecystitis is extremely rare variant of Chronic cholecystitis. It is characterized by at least 3 Lymphoid Follicles per cm of Gall Bladder tissue with inflammatory infiltrate composed almost exclusively of scattered well-formed Lymphoid Follicles. Pathologist must be familiar with this entity to avoid misdiagnosis of lymphoma.


Author(s):  
Sawant Abhijeet D. Dnb ◽  
◽  
D’mello Adrianna. ◽  
Deogaonkar Namita ◽  
Sudeep R. Shah.

2021 ◽  
Vol 8 (4) ◽  
pp. 1160
Author(s):  
Mohinder Singh ◽  
Dipesh Goel

Background: Surgery in chronic cholecystitis is very challenging because of inability to hold the gall bladder, dense adhesions, frozen Calot’s triangle and difficulty in applying clips. Precise and meticulous dissection is required to establish critical view of safety. There is no consensus among surgeons about appropriate intraoperative steps in difficult gall bladder (GB) surgery. The authors aim to present various intraoperative difficulties and strategies to overcome them.  Methods: A prospective study of 81 patients of chronic cholecystitis was done in our institution. They were divided in two groups. Group A in which surgery could be done easily. Group B in which surgery was difficult and different intraoperative strategies were applied to overcome them. Results: Total 42 patients were included in group A and 39 patients in group B. Various difficulties encountered while performing laparoscopic cholecystectomy in group B were adhesions (53.8 %), inability to grasp the fundus of GB (15.3%), frozen Calot’s triangle (15.3%), inability to grasp the Hartmann’s pouch (12.8%) and cystic duct edema (2.5%).  Conclusions: Intraoperative technique of identification of Rouviere′s sulcus first, followed by high peritoneal incision on the GB body. Subsequently blunt dissection of Calot’s triangle using gauze piece and hydro dissection by suction irrigation canula ventral to the sulcus. It created a retro gall bladder tunnel safely. It established the critical view of safety in all our cases. 


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