scholarly journals Hepatic Haemangioma Masquerading as the Gallbladder in a Case of Gallbladder Agenesis: A Case Report and Literature Review

HPB Surgery ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
James A. Stephenson ◽  
Michael Norwood ◽  
Dhya Al-Leswas ◽  
Omer Al-Taan ◽  
Richard Beable ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Preoperative Imaging ◽  
Biliary Colic ◽  
Radiological Investigation ◽  
Hepatic Haemangioma ◽  
Gallbladder Agenesis ◽  
Operative Findings ◽  
Benign Liver ◽  
Unnecessary Intervention ◽  
Gallbladder Fossa

Gallbladder agenesis is uncommon. In contrast, liver haemangiomas are the most common type of benign liver lesions. We describe the first documented case of gallbladder agenesis where the clinical presentation was consistent with biliary colic, and radiological investigation suggested the presence of gallstones. Subsequent operative findings revealed a solitary haemangioma of the liver sited in the normal position of the gallbladder fossa but with absence of the gallbladder. It is important that clinicians should keep gallbladder agenesis in mind when the gallbladder appears abnormal on preoperative imaging studies and cannot be found at laparoscopy. As symptoms will improve in 98% of cases, it is very important to avoid unnecessary intervention in patients who have a negative laparoscopy. The clinical presentation, investigations, and operative findings are discussed with a review of other relevant reported cases in the literature.

scholarly journals Agenesis of the Gallbladder: Role of Clinical Suspicion and Magnetic Resonance to Avoid Unnecessary Surgery

2017 ◽  
Vol 10 (3) ◽  
pp. 819-825 ◽  
Author(s):  
Eugenio Tagliaferri ◽  
Heinrich Bergmann ◽  
Sebastian Hammans ◽  
Alireza Azizi ◽  
Eckhard Stüber ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Anatomical Variation ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Clinical Suspicion ◽  
Biliary Colic ◽  
Correct Treatment ◽  
Radiological Features ◽  
Gallbladder Agenesis ◽  
Unnecessary Intervention

Isolated agenesis of the gallbladder is usually a rare asymptomatic anatomical variation, with an estimated incidence of 10–65 per 100,000. Females are more commonly affected (ratio 3: 1), with the disease typically presenting in the second or third decade of their life. Despite an absent gallbladder, half of the patients present with symptoms similar to biliary colic, which is poorly understood. The rarity of this condition combined with its clinical and radiological features often lead to a wrong preoperative diagnosis so that many patients undergo unnecessary operative intervention. Herein, we present the case of a 56-year-old female with a typical biliary colic who was diagnosed to have gallbladder agenesis. Computed tomography and magnetic resonance cholangiopancreatography allowed correct treatment and prevented an unnecessary intervention.

T2 Gallbladder Cancer—Aggressive Therapy is Warranted

2016 ◽  
Vol 82 (6) ◽  
pp. 518-521 ◽  
Author(s):  
Mohd Raashid Sheikh ◽  
Houssam Osman ◽  
Susannah Cheek ◽  
Shenee Hunter ◽  
Dhiresh Rohan Jeyarajah
Keyword(s):  
Clinical Presentation ◽  
Radical Surgery ◽  
Radical Resection ◽  
Gall Bladder Cancer ◽  
Incidental Diagnosis ◽  
Radical Cholecystectomy ◽  
Node Positive ◽  
Operative Findings ◽  
Worse Prognosis

Treatment of gall bladder cancer (GBC) has traditionally been viewed with pessimism and lymph node positivity has been associated with worse prognosis. The aim of this study is to analyze the role of radical cholecystectomy in T2 tumors. All patients who underwent surgery for GBC between September 2005 and June 2014 were identified retrospectively. Data collected included clinical presentation, operative findings, and histopathological data. Twenty-five patients had incidental GBC diagnosis after cholecystectomy. Ten patients were T2 on initial cholecystectomy pathology and all underwent radical resection. Two patients were N1 on initial cholecystectomy pathology. Four were upstaged to N1 and two patients were upstaged to T3 after further surgery. Overall, 60 per cent patients with T2 disease had node positivity and 60 per cent were upstaged by further surgery. Eleven patients were diagnosed on imaging. Four of these patients were unresectable and six were either stage T3 or higher or node positive. Sixty per cent of T2 GBC was node positive and 60 per cent were upstaged with radical cholecystectomy. This finding supports the call for radical resection in patients with incidental diagnosis of T2 tumor on cholecystectomy. This study also emphasizes the role of radical surgery in accurate T staging.

scholarly journals Unresectable Carcinoma Pancreas : Efficacy of Imaging in Diagnosing and Labeling them as ‘Unresectable’

2013 ◽  
Vol 12 (3) ◽  
pp. 23-26 ◽  
Author(s):  
Md Abdullah Al Farooq ◽  
MA Mushfiqur Rahman ◽  
Tania Tajreen ◽  
Eqramur Rahman ◽  
Md Minhajuddin Sajid ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pancreatic Carcinoma ◽  
Imaging Modality ◽  
Preoperative Imaging ◽  
Mri Imaging ◽  
Medical College ◽  
Magnetic Resonance Imaging Mri ◽  
Carcinoma Pancreas ◽  
Operative Findings ◽  
Better Than

Background: Carcinoma pancreas is being diagnosed increasingly with the help of conventional imaging like ultrasonography (USG), computerized tomography (CT) scan and magnetic resonance imaging (MRI).Imaging also gives the opportunity to assess resectability. In our country MRI and CT scan are not widely available and most of the pancreatic carcinoma is too advanced for curative surgical resection when diagnosed. These are unresectable carcinoma pancreas (UCP). Objectives: To evaluate the efficacy of imaging in diagnosing carcinoma pancreas and to assess resectability after comparing them with peroperative findings. Methods: This retrospective study was carried out in the department of Hepato-Biliary-Pancreatic Surgery in Bangladesh Institute for Research and Rehabilitation in Diabetic Endocrine and Metabolic disorders (BIRDEM) hospital, Dhaka, Bangladesh from July 2004 to June 2006 (2 years). After laparotomy findings and histopathological confirmation 50 patients were labeled as UCP. Among 50 patients male were 28 & female patients were 22. Imaging modalities used before surgery was assessed and compared with per operative findings. USG were done in all patients and CTscan in 45 patients. MRI was done in 08 patients suspected clinically as pancreatic carcinoma where USG /CT scan had failed to reach a conclusion. Findings of the various imaging studies regarding diagnosis and unresectability were compared with per operative findings. Results: USG was able to diagnose 42 (84%) pancreatic carcinoma patients with unresectibility in 29 (69%). Forty five patients (90%) were diagnosed by CT scan and could label 38 (84.44%) as unresectable. MRI was 100% accurate to diagnose and label the entire 08 patient as unresectable carcinoma pancreas. Cumulative multimodal preoperative imaging was 91.33% accurate in diagnosing carcinoma pancreas and could tell the features of unresectibility in 73.59% patients. Conclusion: CT scan should be the primary imaging modality for diagnosing pancreatic carcinoma and its resectability. MRI is very promising for diagnosing and assessing UCP. Multimodal imaging is better than single imaging. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 23-26

scholarly journals CLINICAL PRESENTATION AND SURGICAL TREATMENT OF THYROGLOSSAL DUCT ANOMALIES (TGDAS).

1969 ◽  
Vol 1 (2) ◽  
pp. 60-63
Author(s):  
Mahid Iqba ◽  
Sanaullah ◽  
Muhammad Hussain ◽  
Gulshan Hussain ◽  
Sharafat Ali ◽  
...  
Keyword(s):  
Hyoid Bone ◽  
Clinical Presentation ◽  
Histopathological Study ◽  
Neck Swelling ◽  
Socioeconomic Condition ◽  
Thyroglossal Duct ◽  
One Year ◽  
Operative Findings ◽  
Sistrunk Operation

Objectives: To study the profdes of patients presenting with Thyroglossal duct anomalies and the outcomeof their surgical treatment.Study Design: Descriptive.Setting and duration of the study: Saidu Teaching Hospital Saidu Sharif Swat, from November 2005 toNovember 2006.Patients and methods: All patients were admitted through Out- patient department. They were analyzed onthe basis of location, age, sex, clinical presentation, operative findings, surgical procedure performed andduration of follow up. All the operations were done by the fellows of Oto-rhino-laryngology.Diagnosis was based on clinical examination in all cases. Ultrasound was carried out in all the patients tolocalize thyroid gland.Thyroid isotope scan and fistulogram are necessary preoperatively to find outfunctioning ectopic thyroid tissues and to see the extant of the tract. These investigations were not carriedout due to poor socioeconomic condition of the patients. Histopathological study was done in all the casesResults: A total of fifteen patients with clinically suspected thyroglossal duct anomalies were admitted fromNovember 2005 to Nov 2006. Out of the fifteen patients, one was female while the 14 cases were male.Age of the patients ranged from 2-16 years. Ten patients were below 8 years of age while 05 patients wereabove 8 years. Majority (53.5%) presented with neck swelling followed by discharging fistula (33.3%). Allpatients presented with midline swelling except one on the left side. Majority of swellings, i.e. 66% werepresent in the infra-hyoid region, while 26% presented at the pre-hyoid area. Per-operative findingsincludes 07 cases with tract up to the hyoid, 3 up to the tongue base, 3 tract attached to the hyoid bone, oneup to thyro-hyoid membrane, while in one case no tract was found.Conclusion; It is concluded from our study that most of the patients were below 8 years of age; malechildren were predominantly affected and majority of them presented with cystic swelling on one side ofneck.In 10 patients, the anomalies were situated in the infrahyoid region.No recurrence occurred viaperforming standard Sistrunck procedure at one year follow up.Key words; Key words: Thryoglossal duct anomalies, Sistrunk operation

scholarly journals Multimodality imaging and interventional management of a complex congenital vascular malformation

2010 ◽  
Vol 14 (2) ◽  
pp. 32
Author(s):  
Aadil Ahmed
Keyword(s):  
Arteriovenous Malformation ◽  
Vascular Malformation ◽  
Clinical Presentation ◽  
Multimodality Imaging ◽  
Vascular Lesions ◽  
Liver Tumours ◽  
Congenital Vascular Malformation ◽  
Interventional Management ◽  
Benign Liver

Hepatic vascular lesions are not an uncommon finding in children, and represent the most common benign liver tumours to present in infancy. We present a case of a complex vascular malformation with an intrahepatic component suggestive of a venous/arteriovenous malformation as well as a large extrahepatic lesion. The extrahepatic mass was present in both sub- and supra-diaphragmatic locations ,with features of a congenital haemangioma. In view of the clinical presentation and different imaging appearances, this case was felt to be interesting in its radiological workup, management and eventual unusual pathology.

scholarly journals Surgicel on the post-operative CT: an old trap for radiologists

2019 ◽  
Vol 5 (4) ◽  
pp. 20190041
Author(s):  
Flavius Parvulescu ◽  
Gaurav Sundar ◽  
Milind Shortri
Keyword(s):  
Interventional Radiology ◽  
Correct Diagnosis ◽  
Duodenal Perforation ◽  
Routine Procedure ◽  
Unnecessary Procedures ◽  
Operative Notes ◽  
Unnecessary Intervention ◽  
Radiological Technique ◽  
Gallbladder Fossa ◽  
Ct Studies

Percutaneous drainage of post-operative collections following abdominopelvic surgery has become standard practice and is a routine procedure in many interventional radiology (IR) departments. Such collections are commonly diagnosed on CT studies where the presence of Surgicel ® can mimic an abscess and lead to unnecessary procedures. We present a case where a duodenal perforation was masked by post-operative Surgicel in the gallbladder fossa, which in turn was mistaken for an infected biloma and referred for percutaneous interventional radiology drainage. Careful imaging review, correlation with operative notes and good diagnostic radiological technique led to a correct diagnosis and avoided unnecessary intervention.

scholarly journals Surgical Resection of a Cervical Intramedullary Schwannoma: A Case Report and Literature Review

2017 ◽  
Vol 3 (3) ◽  
pp. 151-158
Author(s):  
Peihai Zhang ◽  
Zhenxing Sun ◽  
Dan Yuan ◽  
Yaxing Sun ◽  
Zhanquan Zhang ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Spinal Tumor ◽  
Common Type ◽  
Preoperative Imaging ◽  
Tumor Type ◽  
Resonance Imaging ◽  
Surgical Experience ◽  
The Central Nervous System ◽  
Intradural Extramedullary ◽  
Intramedullary Schwannoma

Schwannomas are the most common type of spinal tumor, and they most commonly occur in intradural extramedullary locations. Intramedullary schwannomas of the central nervous system are very rare and are difficult to diagnose using preoperative imaging. Here, we report a rare, tiny cervical intramedullary schwannoma and review the literature regarding the clinical presentation, magnetic resonance imaging, pathology, and surgical experience associated with this rare tumor type.

Duodenal Neuroendocrine Tumors: Location Matters!

2016 ◽  
Vol 82 (5) ◽  
pp. 386-389
Author(s):  
Mohd Raashid Sheikh ◽  
Houssam Osman ◽  
Susannah Cheek ◽  
Shanee Hunter ◽  
Dhiresh Rohan Jeyarajah
Keyword(s):  
Lymph Node ◽  
Neuroendocrine Tumors ◽  
Clinical Presentation ◽  
Positive Lymph Node ◽  
Factors Associated ◽  
Aggressive Surgical Approach ◽  
Duodenal Resection ◽  
Operative Findings ◽  
Duodenal Neuroendocrine Tumors ◽  
Transduodenal Excision

Duodenal neuroendocrine tumors (NETs) are rare. Historically, when feasible a less aggressive surgical approach is considered. The aim of this study was to identify factors associated with prognosis and the necessity for more aggressive surgical procedures. All patients who underwent surgery for duodenal NETs between September 2005 and June 2014 were identified retrospectively. Data collected included clinical presentation, operative findings, and histopathological data. Eighteen patients underwent surgical management for duodenal NETs. Two patients underwent transduodenal excision (11%), two patients had partial duodenal resection (11%), two patients had antrectomy including 1st part of duodenum (D1) resection (33%), and eight underwent pancreaticoduodenectomy [PD (44%)]. On analysis, 2nd part of duodenum (D2) location was the most common site of duodenal NETs (n = 9, 50%). The odds of having a PD were 10 times higher when the lesion was in D2 location. The odds of having a positive lymph node are nine times higher when the lesion is in D2 region. The odds of having a positive lymph node are three times higher when lesion is greater than T1. D2 location of NETs is associated with higher odds of lymph node positivity and need for more extensive procedures like PD.

Intermittent atlantoaxial subluxation caused by a prolapsing neurofibroma

2008 ◽  
Vol 8 (3) ◽  
pp. 288-291 ◽  
Author(s):  
Michael O. Kelleher ◽  
Nasir A. Quarishi ◽  
Gamaliel Tan ◽  
Abhijit Guha ◽  
Eric M. Massicotte
Keyword(s):  
Neurofibromatosis Type ◽  
Cord Compression ◽  
Preoperative Imaging ◽  
Cervical Cord ◽  
Unique Case ◽  
Unusual Lesion ◽  
Operative Findings ◽  
High Cervical ◽  
Cervicomedullary Compression

✓In this report, the authors describe a unique case of intermittent high cervical cord compression caused by a prolapsing neurofibroma at the C1–2 level. This 21-year-old man with known neurofibromatosis Type 1 presented with a mass between the anterior arch of the atlas and the odontoid peg, causing atlantoaxial dissociation and cord compression. The cervicomedullary compression appeared to be caused in part by the neurofibroma but also by the abnormal alignment and thickening of the ligaments between the clivus and C-2. Preoperative imaging repeated on the morning of surgery revealed that the atlantoaxial dissociation had reduced with relief of cord compression and the lesion prolapsed inferiorly. The authors discuss this unusual lesion and describe the associated operative findings and surgical management.

scholarly journals SAT-LB65 A Rare Existence

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jiselle Aimee Yaplito Bedia ◽  
Maria Honolina S Gomez
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Clinical Presentation ◽  
Renal Involvement ◽  
Preoperative Imaging ◽  
Biochemical Screening ◽  
Central Target ◽  
Target Organs ◽  
Postoperative Hypoparathyroidism ◽  
Parathyroid Adenomas

Abstract Primary hyperparathyroidism is a common endocrine disorder of metabolism usually due to a parathyroid adenoma. Although, the clinical presentation of primary hyperparathyroidism has changed from Albright’s description of a disease of bones and stones, the central target organs affected by this disorder continue to be the skeleton and kidneys. With the advent of routine biochemical screening, the typical diagnosis of primary hyperparathyroidism is no longer accompanied by overt skeletal and renal involvement. Majority of the cases of primary hyperparathyroidism are due to parathyroid adenomas. Giant glands were defined as greater than the 95th percentile, characterized as glands weighing > 3.5 grams. This present case in a 54-year old female is a rare case of primary hyperparathyroidism secondary to a giant parathyroid adenoma measuring 10.7 x 8.0 x 40.0 cm and weighing 145 grams, the largest giant parathyroid adenoma reported to date, with co-existent silent thymoma, multinodular goiter and osteosclerosis of the vertebral spine, metaphorically known as the “rugger-jersey spine”. The association between thymoma and parathyroid adenoma is rare, and only 3 cases have been reported in the literature. We characterized the correlation of preoperative imaging, intraoperative location, and postoperative course, including significant postoperative hypoparathyroidism, as compared to other patients with PHPT to determine whether giant adenomas represent a clinical entity with distinct clinical characteristics. Keywords: primary hyperparathyroidism, giant parathyroid adenoma, rugger-jersey spine, thymoma Abbreviation PHPT Primary hyperparathyroidism

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