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一例胆囊发育不全导致胆总管损伤患者的病例报告。

A case report of a patient with gallbladder agenesis resulting in a common bile duct injury.

作者信息

Bahraini Anoosh, Odom John W, Talukder Asif

机构信息

Department of Medicine, Medical College of Georgia, Augusta, USA.

Department of Medicine, Medical College of Georgia, Augusta, USA.

出版信息

Int J Surg Case Rep. 2018;51:99-101. doi: 10.1016/j.ijscr.2018.07.024. Epub 2018 Jul 26.

Abstract

INTRODUCTION

Congenital agenesis of the gallbladder is a rare embryological defect of the biliary system. While occurring equally in men and women, gallbladder agenesis is found clinically twice as often in women. Patients present with symptoms suggesting biliary colic. Abdominal ultrasound and cholecintigraphy or HIDA scan are usually inconclusive and, in some cases, may be read as positive for biliary colic. Patients can undergo surgery based on characteristics of pain.

PRESENTATION OF CASE

We report the case of a 60-year-old female presenting with symptoms of recurrent biliary colic and subsequently undergoing laparoscopic cholecystectomy after inconclusive workup.

DISCUSSION

We offer a review of past reported cases as well as a new approach to such patients during the intraoperative period. An intraoperative decision should be made whether to continue and search for a possible ectopic gallbladder or investigate further with imaging studies.

CONCLUSION

Gallbladder agenesis is a rare clinical presentation that the surgeon must be aware of. With inconclusive studies, the surgeon should consider congenital absence of the gallbladder and pursue further imaging if the gallbladder cannot be localized during the intraoperative period.

摘要

引言

先天性胆囊缺如是一种罕见的胆道系统胚胎学缺陷。虽然在男性和女性中发生率相同,但临床上胆囊缺如在女性中更为常见,约为男性的两倍。患者表现出提示胆绞痛的症状。腹部超声、胆囊造影或HIDA扫描通常无法确诊,在某些情况下,可能被解读为胆绞痛阳性。患者可根据疼痛特征接受手术治疗。

病例介绍

我们报告一例60岁女性,反复出现胆绞痛症状,经检查无法确诊后接受了腹腔镜胆囊切除术。

讨论

我们回顾了既往报道的病例,并提出了术中处理此类患者的新方法。术中应决定是继续寻找可能异位的胆囊,还是进一步进行影像学检查。

结论

胆囊缺如是一种罕见的临床表现,外科医生必须有所认识。在检查结果不明确时,如果术中无法定位胆囊,外科医生应考虑先天性胆囊缺如,并进一步进行影像学检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c580/6111033/47e2629ab188/gr1.jpg

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