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胆囊切除术后胆囊结石掉落引起的异物肉芽肿和脓肿:4例经多模态成像诊断的病例

Foreign-body granulomas and abscesses caused by dropped gallstones after cholecystectomy: Four cases diagnosed with multimodality imaging.

作者信息

Sato Shigetaka, Inoue Akitoshi, Ota Shinichi, Furukawa Akira, Miyagawa Yoshihiro, Wakamiya Makoto, Hirose Tomohiro, Furuichi Kenji, Watanabe Yoshiyuki

机构信息

Department of Radiology, Shiga University of Medical Science, Seta, Tsukinowa-cho, Otsu-city, Shiga, 520-2192, Japan.

Department of Radiological Science, Tokyo Metropolitan University, 7-2-1, Higashioku, Arakawa-ku, Tokyo, 116-8551, Japan.

出版信息

Radiol Case Rep. 2020 Jul 3;15(9):1480-1484. doi: 10.1016/j.radcr.2020.05.073. eCollection 2020 Sep.

Abstract

Four cases (age range, 60-78 years, male:female = 1:3) who had undergone cholecystectomy presented with fever (n = 1), right abdominal pain with fever (n = 1), appetite loss with fever (n = 1), and absence of symptoms (n = 1). Computed tomography (CT) showed an irregular-shaped invasive mass or fluid collection in the right Morrison's pouch, right paracolic gutter, gallbladder fossa, subphrenic space, or abdominal wall. CT and ultrasound revealed gallstones in the granuloma in 3 cases and an abscess in one case. The inflammatory process induced by dropped gallstones may mimic peritoneal malignancies. Awareness of cholecystectomy and the detection of gallstones in the lesion are essential for the diagnosis of dropped gallstones.

摘要

4例(年龄范围60 - 78岁,男女比例为1:3)接受过胆囊切除术的患者,分别表现为发热(1例)、伴有发热的右侧腹痛(1例)、伴有发热的食欲减退(1例)以及无症状(1例)。计算机断层扫描(CT)显示在右侧莫里森窝、右侧结肠旁沟、胆囊窝、膈下间隙或腹壁有不规则形状的浸润性肿块或液体积聚。CT和超声检查显示3例肉芽肿中有胆结石,1例有脓肿。掉落的胆结石引起的炎症过程可能类似腹膜恶性肿瘤。了解胆囊切除术情况以及在病变中检测到胆结石对于诊断掉落的胆结石至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e3a/7339004/cc0df80d11b4/gr1.jpg

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