Alkatout Ibrahim, Henopp Tobias, Moritz Jörg Detlev, Nikischin Werner, Klöppel Günter, Engler Sylvia
Department of General and Thoracic Surgery, Division of Pediatric Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
J Pediatr Surg. 2008 Nov;43(11):e41-4. doi: 10.1016/j.jpedsurg.2008.07.016.
Anomalies of the biliary system are rare. Anomalies of the gallbladder and anomalies of the bile ducts are distinguished. We observed a newborn with a gallbladder in an extraabdominal malposition, an anomaly that has not been previously described. Ultrasonography revealed a cystic structure with a ductlike connection with the interior surface of the liver and connecting blood vessels. On the bottom side of the liver, there was no orthotopic gallbladder. As the nature of this lesion could not be definitely clarified, an explorative laparotomy was performed. Histologic examination established the diagnosis of an ectopic gallbladder. Malformations of the extrahepatic bile passages are difficult to assess, as only a small percentage of such anomalies produce symptoms. Knowledge of the wide range of possible abnormalities in position, shape, and number of the gallbladder can help in cases where the diagnosis is unclear. Abnormally positioned gallbladders should be removed. The possibility of an ectopic gallbladder must be kept in mind when a suspicious cystic area is encountered in an atypical location, when the gallbladder is not seen in its normal location, or the preoperative diagnostic workup does not confirm the typical clinical symptoms of gallbladder disease.
胆道系统异常较为罕见。可分为胆囊异常和胆管异常。我们观察到一名新生儿胆囊处于腹外异位，这种异常此前尚未有过描述。超声检查显示一个囊性结构，与肝脏内表面有管状连接并有相连的血管。在肝脏底部未发现正常位置的胆囊。由于该病变的性质无法明确确定，遂进行了探查性剖腹手术。组织学检查确诊为异位胆囊。肝外胆管畸形难以评估，因为此类异常中只有一小部分会产生症状。了解胆囊在位置、形状和数量上可能存在的广泛异常情况，有助于诊断不明确的病例。位置异常的胆囊应予以切除。当在非典型位置遇到可疑的囊性区域、在正常位置未见到胆囊或术前诊断检查未证实胆囊疾病的典型临床症状时，必须考虑到异位胆囊的可能性。
