Spontaneous Cholecystocutaneous Fistula: A rare clinical Entity

2019 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Amit Gupta ◽  
Manoj Joshua ◽  
Navin Kumar ◽  
Udit Chauhan ◽  
Sweety Gupta
Keyword(s):  
Gall Bladder ◽  
Histopathological Examination ◽  
Open Cholecystectomy ◽  
Fistulous Tract ◽  
Gall Stone ◽  
Stone Disease ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
The Right ◽  
Operative Recovery

Introduction: Spontaneous Cholecystocutaneous Fistula occurs as a result of complication from untreated gall bladder stone disease infrequently seen in surgical practice due to early diagnosis of gall stone disease with imaging and appropriate and prompt antibiotic and surgical treatment. Case report: We report our experience with a 40-year-old woman who presented with a yellowish discharge from the umbilicus. Abdominal examination revealed a sinus opening at the umbilicus with the yellowish discharge and a vague mass in the right hypochondrium. CT fistulogram showed tract extending form the umbilicus to the gall bladder. Open cholecystectomy with excision of the fistulous tract was carried out. Histopathological examination showed chronic inflammation of the gall bladder with the fistulous tract lined by inflammatory granulation tissue. Post-operative recovery was normal and uneventful. The patient was normal in follow-up. Cholecystocutaneous fistula is a rare clinical entity. The diagnosis is established with CT and MRCP. Surgery remains the mainstay of treatment.

scholarly journals Multiple port sites metastasis after laparoscopic cholecystectomy: a case report

2017 ◽  
Vol 4 (12) ◽  
pp. 4096
Author(s):  
Farhanul Huda ◽  
Sudhir K. Singh ◽  
Arvind Gupta ◽  
Navin Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Radical Surgery ◽  
Histopathological Examination ◽  
Gall Stone ◽  
Stone Disease ◽  
Rare Occurrence ◽  
Port Site Metastasis ◽  
Gall Stone Disease ◽  
Incidental Gallbladder Cancer

Laparoscopic cholecystectomy is a surgical procedure of choice for gall stone disease. Incidental gallbladder cancer is found in about 0.25-3% of patients after routine cholecystectomy. Depending on the stage of tumour, additional radical surgery may be required. In recent years, several reports of port site metastasis have been published. Here, we report a case of a 55-year-old female patient who presented to us with simultaneous multiple port sites metastasis after an interval of 15 months of laparoscopic cholecystectomy for gall stone disease. We recommend the routine use of specimen bag for the retrieval of gall bladder during laparoscopic cholecystectomy and also to send the gall bladder for histopathological examination. To the best of our knowledge, metastasis to more than one port is a very rare occurrence.

scholarly journals Frequency of gall bladder metaplasia and its distribution in different regions of gall bladder in routine cholecystectomy specimens

2017 ◽  
Vol 6 (1) ◽  
pp. 149
Author(s):  
Renu Sharma ◽  
Bal Chander ◽  
Rashmi Kaul ◽  
Amit Rattan ◽  
Atal Sood ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Intestinal Metaplasia ◽  
Histopathological Examination ◽  
Gall Stone ◽  
Stone Disease ◽  
Premalignant Lesions ◽  
Very High Frequency ◽  
North East ◽  
The North ◽  
Gall Stone Disease

Background: In India, gall stone disease is more common in women in the north, north east and east as compared to other zones in the country. Gall bladder metaplasia has been documented as the precursor lesion of dysplasia and therefore carcinoma. Present study was conducted to ascertain the frequency and type of metaplasia along with distribution in different regions of gall bladder.Methods: All the post cholecystectomy gallbladder samples submitted for histopathology comprised the study material. Three sections were from body, fundus, and neck each. The five microns thick paraffin sections were cut with microtome and stained with Hemotoxylin and Eosin (H and E).Results: The present study was conducted on 119 cholecystectomy specimens submitted for histopathological examination. Amongst premalignant lesions, cholecystitis with metaplasia was seen in 55 (46.2%) cases. Pyloric metaplasia without intestinal metaplasia was most common metaplasia (30.2%) followed by combined metaplasia (12.60%) and only intestinal metaplasia (3.36%). Out of 55 cases, fundus showed metaplasia in 47 followed by body (44) and neck (36).Conclusions: Very high frequency of metaplasias was observed (46.2%) in routine cholecystectomy specimen with pyloric metaplasia as the predominant type and intestinal metaplasia was accompanied with pyloric metaplasia in most of the cases. Metaplasia was found to be more or less equally distributed in different regions of gall bladder.

scholarly journals Incidental Carcinoma Gall Bladder in Patients Undergoing Cholecystectomy for Chronic Calculus Cholecystit is

2009 ◽  
Vol 22 (2) ◽  
pp. 223-226
Author(s):  
PK Biswas ◽  
PK Das ◽  
MH Rahman ◽  
DK Mahanta
Keyword(s):  
Gall Bladder ◽  
Imaging Techniques ◽  
Strong Association ◽  
Gall Stone ◽  
Stone Disease ◽  
Chronic Cholecystitis ◽  
College Hospital ◽  
Medical College ◽  
Carcinoma Gall Bladder ◽  
The Right

Carcinoma gall bladder (CaGb) is the most common neoplasm of biliary tract. Aetiology of this tumour is complex, but there is a strong association with gall stones. The symptoms are seldom suggestive of cancer and imaging techniques are usually equivocal. This study was conducted to see the frequency of cancer of gall bladder in patients undergoing surgery for chronic cholecystitis with cholelithiasis in different age and sex groups in our population. An observational study was conducted in the department of surgery unit-II Rajshahi Medical College Hospital and Mukti Clinic Rajshahi on the patients admitted with the diagnosis of chronic cholecystitis with cholelithiasis for surgery. Demographic, clinical presentation, imaging studies, operative intervention and histopathological results were examined. Over the period of 18 months 184 patients were admitted with the diagnosis of chronic calculus cholecystitis for cholecystectomy. 2 (1.09%) patients out of 184 admitted cases were diagnosed as carcinoma gall bladder after histopathology examination. Mean age was 38.5 (41h decade) years and both of them were female. The most common presenting complaints were pain in the right hypocondrium and dyspepsia (51.07%). Normal wall thickness with stone was the most common (63.04%) Ultrasonographic finding. Histologically all CaGb cases were adenocarcinoma. Gall bladder malignancy occurs commonly in 4th decade of life. The patients should be encouraged to have gall bladder surger y once diagnosed as gall stone disease. Every gall bladder specimen should be sent for histopathological examination.TAJ 2009; 22(1): 223-226

scholarly journals Gossypiboma Presenting as Coloduodenal Fistula – Report of a Rare Case With Review of Literature

2014 ◽  
Vol 99 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Sarath Chandra Sistla ◽  
Ananthakrishnan Ramesh ◽  
Vilvapathy Sengutuvan Karthikeyan ◽  
Duvuru Ram ◽  
Sheik Manwar Ali ◽  
...  
Keyword(s):  
Transverse Colon ◽  
Open Cholecystectomy ◽  
Abdominal Cavity ◽  
Gall Stone ◽  
Body Cavity ◽  
Stone Disease ◽  
Normal Diet ◽  
Diagnostic Challenge ◽  
The Right ◽  
Enhanced Computed Tomography

Abstract The term gossypiboma is used to describe a mass of cotton matrix left behind in a body cavity intraoperatively. The most common site reported is the abdominal cavity. It can present with abscess, intestinal obstruction, malabsorption, gastrointestinal hemorrhage, and fistulas. A 37-year-old woman presented with pain in the right hypochondrium for 2 months following open cholecystectomy. As she did not improve with proton pump inhibitors, an esophagogastroduodenoscopy (EGD) was done, which showed a possible gauze piece stained with bile in the first part of the duodenum. Contrast-enhanced computed tomography (CECT) of the abdomen revealed an abnormal fistulous communication of the first part of duodenum with proximal transverse colon, with a hypodense, mottled lesion within the lumen of the proximal transverse colon plugging the fistula, suggestive of a gossypiboma. Excision of the coloduodenal fistula, primary duodenal repair, and feeding jejunostomy was done. The patient recovered well and is now tolerating normal diet. Coloduodenal fistula is usually caused by Crohn's disease, malignancy, right-sided diverticulitis, and gall stone disease. Isolated coloduodenal fistula due to gossypiboma has not been reported in the literature so far to the best of our knowledge. We report this case of coloduodenal fistula secondary to gossypiboma for its rarity and diagnostic challenge.

scholarly journals Cartilaginous Choristoma of the Gingiva: A Rare Clinical Entity

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Ramalingam Suganya ◽  
Narasimhan Malathi ◽  
Subramani Vijaya Nirmala ◽  
Chinnaswami Ravindran ◽  
Harikrishnan Thamizhchelvan
Keyword(s):  
Connective Tissue ◽  
Histopathological Examination ◽  
Clinical Entity ◽  
Fibrous Connective Tissue ◽  
Rare Clinical Entity ◽  
Normal Cells ◽  
Connective Tissue Stroma

Choristomas are rare entities which are aggregates of microscopically normal cells or tissues in aberrant locations. They are a “heterotopic” rest of cells, as they appear as a tumor-like mass. Herein we report a case of cartilaginous choristoma in a 54-year-old male who presented with a swelling on right lower gingiva. The histopathological examination revealed features of a well circumscribed mass of mature cartilage in a dense fibrous connective tissue stroma.

scholarly journals Supraglottic Laryngeal Paraganglioma: A Rare Clinical Entity managed by Lateral Pharyngotomy Approach

2012 ◽  
Vol 2 (2) ◽  
pp. 69-73
Author(s):  
Sudhir M Naik
Keyword(s):  
Meta Analysis ◽  
Clinical Entity ◽  
Biological Behavior ◽  
Superior Thyroid Artery ◽  
Partial Laryngectomy ◽  
Rare Clinical Entity ◽  
Lateral Pharyngotomy ◽  
Superselective Embolization ◽  
Submucosal Mass ◽  
The Right

ABSTRACT Background/objectives Laryngeal paragangliomas are benign slow growing tumors with symptoms resembling squamous cell carcinoma. Hoarseness or dysphasia is the commonest presenting symptom and usually it presents as a submucosal mass on laryngoscopy. A total of 90% of these tumors occur in the supraglottic larynx and the rest in the glottis and the subglottic region. Functional activity is seen in a few (2.9%), none are associated with paraneoplastic syndromes. Setting Department of Head and Neck Oncosurgery, Kidwai Memorial Institute of Oncology, Bengaluru. Case report A 35-year-old male presented to us with hoarseness of voice since 4 months duration. Contrast arteriography demonstrated that the left superior thyroid artery supplied greater than 80% of the blood supply to the laryngeal mass. Superselective embolization was done from the right femoral under local anesthesia and sedation which was uneventful. Intervention The tumor was excised from lateral pharyngotomy approach with an elective tracheostomy. Microscopy suggested it to be paraganglioma and immunohistochemistry confirmed it. Conclusion Complete surgical resection or partial laryngectomy with meticulous dissection of surrounding tissues and preservation of neurovascular structures give an excellent prognosis as far as oncological clearance is concerned. Malignant paragangliomas of the larynx are rare and a major meta-analysis is necessary to provide a true biological behavior of this tumor. How to cite this article Naik SM. Supraglottic Laryngeal Paraganglioma: A Rare Clinical Entity managed by Lateral Pharyngotomy Approach. Int J Phonosurg Laryngol 2012;2(2): 69-73.

scholarly journals Primary Lymphangioma of the Tonsil: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Dimitrios G. Balatsouras ◽  
Alexandros Fassolis ◽  
George Koukoutsis ◽  
Panayotis Ganelis ◽  
Antonis Kaberos
Keyword(s):  
Case Report ◽  
Histological Examination ◽  
Clinical Examination ◽  
Lymphatic System ◽  
White Male ◽  
Clinical Entity ◽  
Benign Tumors ◽  
Rare Clinical Entity ◽  
Rare Occurrence ◽  
The Right

Benign tumors of the tonsils occur infrequently. Lymphangiomas are rare congenital tumors of the lymphatic system, and tonsillar lymphangioma is an extremely rare occurrence. Its pathogenesis is uncertain, but history, clinical examination, and histological examination should establish the diagnosis. We present a 17-year-old white male with lymphangioma of the right tonsil. The tonsils were excised and biopsy confirmed the diagnosis. Tonsillar lymphangioma is a rare clinical entity, which should be known to the otolaryngologist, in order to diagnose and treat it appropriately and avoid confusion with tonsillar malignancies.

scholarly journals Evaluation of relationship of body mass index with severity of cholecystitis

2019 ◽  
Vol 6 (3) ◽  
pp. 868 ◽  
Author(s):  
Varun V. Chauhan ◽  
Bhushan A. Shah ◽  
Shivaratna J. Mahadik ◽  
Rohan P. Videkar
Keyword(s):  
Risk Factor ◽  
Open Cholecystectomy ◽  
Gall Stone ◽  
Stone Disease ◽  
Established Risk Factor ◽  
Significant Difference ◽  
Conversion To Open Cholecystectomy ◽  
Gall Stone Disease ◽  
Total Body ◽  
A Prospective Study

Background: Obesity is an established risk factor for gall stone disease. Male sex has also been recently cited as a risk factor for severe symptomatic cholelithiasis. As a possible cause of several difference in regards to the severity of cholecystitis, many physiological differences between the two sexes can be examined. Many studies have been done on the risk factors for developing the gall bladder disease explaining its polygenic nature It is postulated that the total body fat, the main value of which is significantly higher for females than males, may contribute to this sex difference. Only a couple of studies are available on BMI and its effect on severity of cholecystitis hence depicting the need for this study in our setup.Methods: This is a prospective study carried out on 70 patients for cholecystitis whose weight and height measurements had been recorded on admission. Patients were placed in either group-Obese (BMI e” 25kg/m2) or Non-Obese (BMI <25kg/m2). The association between BMI and severity of cholecystitis was investigated.Results: 18% of the laparoscopic cholecystectomy surgeries required conversion to open cholecystectomy due to reasons like severe adhesions to an adjacent organ, etc. Pain in abdomen (100%) was the commonest complaint and was present in all the patients followed by dyspepsia (44%).69% of patients were having complaints for more than 72 hours. No significant difference observed among mean BMI of different grades of severity (p=0.963).Conclusions: There is negative correlation between BMI and grade of severity of cholecystitis and BMI is not a predictor for the conversion from laparoscopic to open cholecystectomy.

scholarly journals Calcified Right Ventricular Fibroma in an Adult: A Case Report

2021 ◽  
Author(s):  
Huanhuan Gao ◽  
Shuai Yuan ◽  
Zhiqiang Hu ◽  
Zhelan Zheng ◽  
Shengjun Wu
Keyword(s):  
Right Ventricular ◽  
Histopathological Examination ◽  
Tumor Resection ◽  
Anterior Wall ◽  
Benign Tumors ◽  
Troublesome Symptom ◽  
History Of ◽  
The Right ◽  
Operative Recovery

Background: Cardiac fibromas are rare benign tumors of the heart composed of fibroblasts and collagen. They are common among children and adolescents but are rarely present in adults. Case presentation: We here report the case of a fifty-seven-year-old man who complaining of a 2-year history of chest tightness at rest. Transthoracic echocardiography detected a severe calcified mass protruding outside the right ventricular anterior wall near the apex. The patient was referred for tumor resection. The calcified mass was determined to be a cardiac fibroma with postoperative histopathological examination. The patient experienced an unremarkable post-operative recovery and was discharged 8 days later. Subsequent follow-up has shown complete freedom from his troublesome symptom. Conclusions: Preoperative diagnosis with various imaging modalities and early surgery are the keys to improve prognosis of patients with cardiac fibromas.

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