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孕期诊断出胆囊缺如——病例报告及文献综述

Gallbladder agenesis diagnosed during pregnancy- Case report and a literature review.

作者信息

Pinto Mihindukulasuriya Yvonne Presadini, Neelankavil Shelbin

机构信息

Department of General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.

Department of General Surgery, Rockingham General Hospital, Rockingham, Western Australia, Australia.

出版信息

Int J Surg Case Rep. 2023 Apr;105:108019. doi: 10.1016/j.ijscr.2023.108019. Epub 2023 Mar 22.

Abstract

INTRODUCTION AND IMPORTANCE

Gallbladder agenesis (GA) is a rare congenital anomaly. It results from failure of the formation of gallbladder primordium from the bile duct. This cohort of patients can present with symptoms of biliary colic and get misdiagnosed as cholecystitis or cholelithiasis.

CASE PRESENTATION

Here we discuss a case of gallbladder agenesis presenting with symptoms of typical biliary colics in a 31 year old female patient during her second pregnancy. She underwent two ultrasound scans (USS) which couldn't visualise a gallbladder. She eventually had a magnetic resonance cholangiopancreatography (MRCP) which confirmed the absence of a gallbladder.

CLINICAL DISCUSSION

Diagnosis of gallbladder agenesis in adult life poses a diagnostic dilemma. This is partly due to misinterpretation of USS results. Still, some patients get diagnosed with this condition during attempted laparoscopic cholecystectomy. However, with a thorough understanding of the condition, unnecessary surgeries can be prevented.

CONCLUSION

Misdiagnosis is possible and can lead to unnecessary surgeries. Appropriate and timely investigations can diagnose GA. One should have high index of suspicion when an USS result shows a non-visualisation of the gallbladder, contracted or a shrunken gallbladder. It is prudent to further investigate this cohort of patients to rule out gallbladder agenesis.

摘要

引言与重要性

胆囊缺如(GA)是一种罕见的先天性异常。它是由于胆管未能形成胆囊原基所致。这类患者可能会出现胆绞痛症状,并被误诊为胆囊炎或胆结石。

病例介绍

在此,我们讨论一例31岁女性患者在第二次怀孕期间出现典型胆绞痛症状的胆囊缺如病例。她接受了两次超声扫描(USS),均未发现胆囊。最终,她进行了磁共振胰胆管造影(MRCP),证实胆囊缺如。

临床讨论

成年期胆囊缺如的诊断存在诊断难题。部分原因是对超声检查结果的误判。不过,仍有一些患者在尝试进行腹腔镜胆囊切除术时被诊断出患有这种疾病。然而,通过对该疾病的深入了解,可以避免不必要的手术。

结论

误诊是可能的,并且可能导致不必要的手术。适当且及时的检查能够诊断胆囊缺如。当超声检查结果显示胆囊未显影、萎缩或缩小的胆囊时,应高度怀疑。对这类患者进一步检查以排除胆囊缺如是谨慎的做法。

相似文献

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引用本文的文献

1
Congenital absence of the gallbladder in a child: a case report.儿童先天性胆囊缺如:一例报告
Front Pediatr. 2024 Jul 26;12:1440383. doi: 10.3389/fped.2024.1440383. eCollection 2024.

本文引用的文献

2
Anatomy and embryology of the biliary tract.胆道的解剖与胚胎学。
Surg Clin North Am. 2014 Apr;94(2):203-17. doi: 10.1016/j.suc.2014.01.001. Epub 2014 Feb 20.
9
Agenesis of the gallbladder: difficulties in management.胆囊缺如:管理上的困难。
J Gastroenterol Hepatol. 2005 May;20(5):671-5. doi: 10.1111/j.1440-1746.2005.03740.x.
10

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