Samsami Majid, Kouchak Hosseini Seyed Pedram, Khoshnoudi Hojatolah, Aghaei Mohammad, Parsaeian Fatemeh, Haghbin Toutounchi Alireza
Department of General Surgery, Imam Hosein Medical and Educational Center, Shahid Beheshti University of Medical sciences, Tehran, Iran.
Int J Surg Case Rep. 2023 Jun;107:108314. doi: 10.1016/j.ijscr.2023.108314. Epub 2023 May 10.
Ventral gallbladder hernia is a rare condition mostly related to past acquired abdominal wall defects, but spontaneous ones are scarce. It happens more in elderly patients. Etiology and causes are still unspecified, but the most related known causes of spontaneous gallbladder herniation are carcinoma, biliary tracked occlusion or abdominal wall weakness in elderly patients, respectively.
We have presented a complicated 90-year-old woman with a bulged and warm area at the right upper abdomen with tenderness and positive rebound tenderness. In help with imaging, we found a ventral gallbladder hernia perforated in the subcutaneous layer. Then cholecystectomy and herniation site repair was performed.
We have explained this infrequent scenario and reviewed recent similar papers to find further relevant information. The common presentations, probable causes, the role of imaging in diagnosis and the management are discussed for the best surgical planning.
The spontaneous ventral herniation of the gallbladder is an exceedingly uncommon occurrence. The diagnosis of this condition heavily relies on imaging, with computed tomography (CT) scan utilizing both intravenous and oral contrast being the optimal modality. Management of this condition can be accomplished via both laparoscopic and laparotomy approaches. It is our recommendation to perform cholecystectomy and hernia repair simultaneously and expeditiously in all cases. We advise against conservative management strategies.
腹侧胆囊疝是一种罕见病症，大多与既往获得性腹壁缺损有关，但自发性腹侧胆囊疝较为少见。此病在老年患者中更为常见。其病因尚不明确，但已知的与自发性胆囊疝最相关的病因分别是癌症、胆管阻塞或老年患者的腹壁薄弱。
我们报告了一名90岁的复杂病例，该女性右上腹有一个隆起且发热的区域，伴有压痛和反跳痛阳性。借助影像学检查，我们发现皮下层有一处腹侧胆囊疝穿孔。随后进行了胆囊切除术和疝修补术。
我们解释了这种罕见情况，并查阅了近期类似论文以获取更多相关信息。为了制定最佳手术方案，讨论了常见表现、可能病因、影像学在诊断中的作用以及治疗方法。
胆囊自发性腹侧疝极为罕见。这种病症的诊断很大程度上依赖于影像学检查，静脉内和口服造影剂的计算机断层扫描（CT）是最佳检查方式。这种病症的治疗可通过腹腔镜和开腹手术完成。我们建议在所有病例中同时迅速进行胆囊切除术和疝修补术。我们不建议采用保守治疗策略。
