Involvement Of Gallbladder Research Articles

Heteropic Pancreatic Rest in Gall Bladder: Is It Really Worrisome?

Abstract Heterotopia of pancreas is defined as an abnormal location of pancreatic tissue devoid of vascular and anatomical connections from main pancreas. The stomach is the most common site of such heterotopia, although the lesion can be encountered throughout the entire gastrointestinal tract. Involvement of gallbladder is extremely rare with few cases reported so far in the literature. We described a similar finding in a 28-year-old female patient, who presented with chronic abdominal pain.

Incidentally Detected Extramedullary Plasmacytoma of the Gallbladder: A Case Report and Literature Review.

Extramedullary plasmacytoma (EMP) can rarely occur in conjunction with multiple myeloma (MM). EMPs are usually detected in the upper aerodigestive tract (UAD) but can also occur along the digestive tract. However, the involvement of gallbladder is uncommon. Gastrointestinal tract symptoms often lead to the diagnosis of EMP in the gallbladder. An 81-year-old man was referred to our hospital with suspected primary gallbladder carcinoma. He was subsequently operated on, and the pathological findings showed EMP of the gallbladder without MM.

Secondary involvement of gallbladder by acute lymphoblastic leukemia presenting clinically as cholecystitis in a young patient: a case report

BackgroundPrimary lymphoma of the liver, gallbladder, and extrahepatic bile ducts or secondary involvement of these organs by leukemia is exceedingly rare. Patients with primary lymphoma or leukemic involvement of the biliary tract and liver often present with symptoms and signs of biliary tract obstruction or inflammation.Case presentationWe present a case of a 24-year-old male with biliary tract symptoms who underwent laparoscopic cholecystectomy. His precholecystectomy complete blood count performed on the same morning showed 72% lymphocytes while peripheral blood smears showed approximately 15% blasts. Surgeon went ahead with the procedure. Imaging done prior to surgery showed thickened gallbladder, while the liver, biliary tract, and pancreas did not show any thickening or mass lesion. However, the liver was enlarged. Grossly, the gallbladder wall did not show any stones or discrete mass involving the wall. Instead, there was subtle thickening of the gallbladder wall due to diffuse infiltration by the leukemic infiltrate. This lymphoid population reacted with PAX-5 and TdT immunohistochemical antibodies in a diffuse manner confirming precursor B-cell origin. This patient was found to have B-lymphoblastic leukemia involving his bone marrow on further clinical and diagnostic workup. Patient responded well to chemotherapy and is currently on maintenance treatment. He is well 1.5 years after his diagnosis.ConclusionThis case highlights a unique and rare scenario where a previously undiagnosed and unsuspected hematologic malignancy initially presented with clinical features of a chronic inflammatory condition involving an abdominal organ owing to secondary involvement by the malignant infiltrate.

Melanoma Metastases Arising at Unexpected Sites: Gallbladder and Uterus

Although malignant melanoma (MM) most frequently tends to metastasize to the regional lymph nodes, liver, lung and brain, several unusual sites of metastasis have been described in the literature. Among these, the metastatic involvement of gallbladder or uterus represents an exceptional event, usually associated with diffuse metastatic disease or observed as an autopsy finding. In this paper, we present two unusual cases of isolated MM metastasis to these anatomic sites, arising in a 71-year-old man and a 54-year-old woman, for whom no information on previous malignancies was known at the time of the histological examination. The clinico-pathologic features are described, emphasizing that MM metastasis must be included in the differential diagnosis when dealing with patients with a previous diagnosis of MM and onset of a novel mass/lesion even at unusual sites.

COVID-19 with Acute Cholecystitis: A Case Report

Novel Coronavirus 2019 (COVID-19) also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped, non-segmented positive-sense RNA virus that belonging to the beta-coronaviridae family. Patients were said to had various symptoms of fever, cough, anosmia, and chest stuffiness in addition to other non-specific clinical manifestations, including diarrhea, vomiting, anorexia, abdominal pain, and so on. Although this gastrointestinal symptoms were present in COVID-19 case, there was not enough evidence about the involvement of gallbladder and biliary tract in literature to date. We report a rare case of Acute Cholecystitis on a COVID-19 patient in Jakarta, Indonesia. A case of 54-year-old female with COVID-19 confirmed by RT-PCR Test who had constant pain in the right upper quadrant of her abdomen during her arrival at the hospital that was finally diagnosed as Acute Cholecystitis. The Laboratory Findings revealed normal level of White Blood Cells(6.73 K/aeL). The Multidisciplinary team decided to treat COVID-19 infection with antiviral (Favipiravir, according to Indonesian COVID-19 Guideline) for 2 weeks until her RT-PCR was found to be negative then perform a laparoscopic cholecystectomy as the first treatment. During the administration of Favipiravir, there was a reduction of pain in the right upper quadrant abdomen and an overall clinical improvement.The precise mechanism of Acute Cholecystitis in COVID-19 Patients was still unclear. However, Acute Cholecystitis could be a possible complication of COVID-19 although there was not enough evidence whether the gallbladder might be vulnerable to COVID-19. In this case, the normal level of white blood cells could be a hint that Acute Cholecystitis was not caused by bacterial colonization and could be potentially triggered by COVID-19. Laparoscopic Cholecystectomy was chosen as the first management after RT-PCR COVID-19 was negative with 2-weeks of antiviral treatment. Although the lack of evidence and guidelines for Acute Cholecystitis management during The COVID-19 Pandemic, Laparoscopic Cholecystectomy remains the chosen treatment for Acute Cholecystitis Management on COVID-19 Patients. More research is needed to understand the possible relationship between Acute Cholecystitis and COVID-19.

Tuberculosis and Cancer Gallbladder in Endemic Zones: Diagnostic and Surgical Dilemma for the Physicians

Tuberculosis is an infectious disease widely prevelant in the developing world. The resurgence of tuberculosis is on rise even in the developed world as the chemotherapy and steroid use is increasing. Indo gangetic belt is endemic for both the tuberculosis and gallbladder cancer. Gallbladder cancer although rare pathology carries a high rate of morbidity and mortality. Involvement of gallbladder in tubercular infection is rare. However, when involved there is a significant overlap of the clinical and radiological signs in both these patients. The treating physicians in these areas are always in therapeutic dilemma for the management of these patients. The other benign gallbladder pathologies mimicking the cancer further add on to the challenge in these patients. This article embarks upon the various challenges that a surgeon encounters in the management of these patients.

Spontaneous gallbladder perforation in patient with COVID-19—a case report and review of literature

The Coronavirus 2019 disease (COVID-19) originated in Wuhan in China in December 2019 has evolved over the past year in terms of its pathophysiology, clinical presentation, imaging manifestations and management strategies. Though COVID-19 is predominantly a pulmonary illness, it is now established to show widespread extra pulmonary involvement. Gastrointestinal manifestations of COVID-19 are also well known. COVID-19 infection presenting with the involvement of gallbladder is extremely rare in medical literature. Gallbladder perforation should be thought of in COVID-19 patients complaining of with acute abdomen in with acute cholecystitis.

Primary tuberculosis of cystic duct lymph node

Tuberculosis (TC) is very common and significant cause of morbidity and mortality worldwide. Isolated cystic duct lymph node TC cases without involvement of gallbladder are exceedingly rare. It is difficult...

Gallbladder and muscular endometriosis: a case report

A 55-year-old woman referred to Radiology Department, with abdominal mass and chronic indefinite and vague abdominal pain, most severe in right hypochondrium and accentuated during menstruation. A history of two cesarean sections was revealed. The patient underwent an ultrasound and Computed Tomography with intravenous contrast media revealing the presence of gallbladder and abdominal wall hyperenhancing masses. Finally, Magnetic Resonance study with intravenous administration of paramagnetic contrast media confirmed the involvement of gallbladder by a solid tissue and the presence of a solid nodule on the abdominal wall. Considering imaging features and the contrast enhancement of the nodules, the patient was sent to surgery. Surgical removal of both gallbladder and abdominal solid implant was performed and histology confirmed the diagnosis of gallbladder and abdominal wall endometriosis.

Magnetic resonance demonstration of gall bladder ascariasis

A 40-year-old man presented with right hypochondrial and epigastric pain and tenderness. There was no history of jaundice or vomiting. Serum alkaline phosphatase was mildly elevated (170 IU/L). His ultrasound was suggestive of gall bladder worms or stones. MRI revealed curvilinear hypointense structure in the gall bladder (Fig. 1); this suggested the diagnosis of gall bladder ascariasis. Common hepatic and bile ducts were normal. Stool examination revealed ova of Ascaris lumbricoides. The patient was given analgesics and albendazole (400 mg single dose). Three days later, he reported relief of symptoms and passage of worm in the stools. Ultrasound done 4 days later showed no worm in the gall bladder. The adult worm of ascariasis usually resides in the small bowel. It can occasionally migrate into biliary system. Involvement of gall bladder is rare because of the small size of cystic duct [1]. Ultrasound is the usual imaging modality for diagnosing gall bladder ascariasis which demonstrates it as curvilinear echogenic structure [1]. In cases which are inconclusive on sonography, MRI may show curvilinear hypointense structure in the gall bladder lumen, while gall stones typically appear as rounded objects of signal void [2]. MRI also allows simultaneous visualization of common hepatic and common bile ducts. Gall bladder ascariasis is usually treated by surgery and endoscopy. Occasionally, medical therapy may lead to spontaneous passage of worm, as happened in our case.

Isolated Involvement of the Gallbladder by Crohn's Disease Manifesting as Acute Cholecystitis

A 79-year-old female presented with acute cholecystitis. Having recovered on conservative management, elective laparoscopic cholecystectomy was performed. The diagnosis of Crohn's disease of the gallbladder was a histopathological surprise. Further detailed investigation indicated this to be the isolated involvement of gallbladder.

T cell lymphoplasmacellular and eosinophilic infiltration of the pancreas with involvement of the gallbladder and duodenum in non-alcoholic duct-destructive chronic pancreatitis

Non-alcoholic duct destructive chronic pancreatitis is a rare entity with specific pathological features. The majority of the patients are from Japan. We report a case with involvement of the distal bile duct, the gallbladder, the duodenum and the ampulla, and present a review of patients from Europe and the USA since 1997. A 56-year-old man presented with a 3-month history of mild acute pancreatitis and obstructive jaundice, followed by increasing weight loss, lethargy and epigastric pain. CT showed a mass in the head of the pancreas. ERCP demonstrated a smooth stricture of the intra-pancreatic main bile duct and an irregular, incomplete, stricture in the main pancreatic duct. A pancreatic cancer could not be reliably excluded, and, therefore, he underwent a pylorus-preserving Kausch-Whipple's pancreatoduodenectomy. Histopathology showed typical peri-ductal T cell-rich lymphoplasmacellular and eosinophilic infiltration of the pancreas, with involvement of the distal bile duct but, also, unusual inflammatory infiltration of the gallbladder, the duodenum and the ampulla. The inflammatory process in non-alcoholic duct-destructive chronic pancreatitis can affect the entire pancreato-biliary region and mimics pancreatic cancer. Currently, there are no definitive criteria for pre-operative diagnosis, so it is very difficult for one to avoid resection.

ACUTE CHOLECYSTITIS COMPLICATING SCARLET FEVER

Although it is known that the gallbladder may become involved in scarlet fever, little on this subject can be found in the literature. Of the 12,352 patients with scarlet fever treated in the Willard Parker Hospital during the ten years ending Dec. 31, 1936, in only 2 has the condition been thought to be complicated by acute cholecystitis. We present here the records of these 2 patients and a review of the literature on the subject. In the majority of cases reported, symptoms of involvement of the gallbladder became manifest in the second or third week of the disease. In the case recently observed by us, however, the gallbladder became involved in the first week of illness. As to the pathologic basis of the condition, those who have observed cases of cholecystitis as a complication of scarlet fever differ in opinion. Schottmuller expressed the opinion that the toxin of Streptococcus