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完全性胆囊系膜错位:一例罕见病例报告并文献复习。

Complete mesocolic malposition of the gallbladder: An unusual case report with literature's review.

机构信息

Department of Surgical Oncology, Çukurova University Faculty of Medicine, Adana-Turkey.

Department of General Surgery, Çukurova University Faculty of Medicine, Adana-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2022 Apr;28(4):557-561. doi: 10.14744/tjtes.2020.09274.

Abstract

Anatomic variations and congenital anomalies involving the gallbladder position, shape, and number are frequently encountered on routine abdominal imagings and at surgery. However, most have no clinical significance, but their recognition is important because they may predispose to gallbladder diseases, serve as a potential source of confusion and diagnostic pitfalls for radiologists and surgeons, and increase the risk of inadvertent injury during biliary tract surgery or intervention. We observed an intra-mesocolic gallbladder found unexpectedly during the cholecystectomy in a 65-year-old male patient who was being operated on for acute calculous cholecystitis. An abdominal ultrasonography and computed tomography scan reported no anomalous or malpositioned gallbladder pre-operatively. As the location of this organ could not be definitely clarified in his previous operation elsewhere, we performed an explorative lapa-rotomy. There was no gallbladder at the normal position. The organ was found embedded deeply within the proximal portion of the transverse mesocolon, and then it was successfully excised. We established the diagnosis of an ectopic gallbladder in mesocolic position.

摘要

在常规腹部影像学检查和手术中,经常会遇到涉及胆囊位置、形状和数量的解剖变异和先天性异常。然而,大多数情况下这些变异没有临床意义,但识别它们很重要,因为它们可能导致胆囊疾病,成为放射科医生和外科医生诊断陷阱和混淆的潜在来源,并增加胆道手术或介入过程中意外损伤的风险。我们在一名 65 岁男性患者的胆囊切除术中意外发现了一个位于肠系膜内的胆囊,该患者因急性胆石性胆囊炎而接受手术治疗。术前腹部超声和 CT 扫描均未报告异常或胆囊位置不正。由于该器官在他之前在其他地方的手术中的位置无法明确确定,我们进行了剖腹探查术。正常位置没有胆囊。该器官被发现深深地嵌入横结肠系膜的近端,然后成功切除。我们诊断为位于肠系膜内的异位胆囊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f88f/10521002/803a7f3aa24c/TJTES-28-557-g001.jpg

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