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腹腔镜胆囊切除术时偶然发现的异位肝组织:一例报告

Ectopic Liver Tissue Encountered Incidentally During a Laparoscopic Cholecystectomy: A Case Report.

作者信息

Arora Gagandeep Singh, Kalra Shivam

机构信息

Department of General Surgery, Government Medical College, Patiala, IND.

Department of Internal Medicine, Trident Medical Center, North Charleston, USA.

出版信息

Cureus. 2023 Jul 20;15(7):e42220. doi: 10.7759/cureus.42220. eCollection 2023 Jul.

Abstract

A 60-year-old male patient who presented with right upper quadrant (RUQ) pain was diagnosed with acute cholecystitis after an ultrasound of the abdomen revealed multiple gallstones, gallbladder wall thickening, pericholecystic fluid, and a positive sonographic Murphy sign. The patient was admitted, administered IV fluids, antibiotics, and pain relief, and scheduled for laparoscopic cholecystectomy. During surgery, an incidental finding of ectopic liver tissue attached to the gallbladder was noted. Histopathology confirmed the presence of chronic cholecystitis and multifaceted cholesterol stones. Normal liver tissue was noted in the ectopic mass. Ectopic liver tissue is defined as liver tissue located outside the main liver parenchyma and is usually asymptomatic. They are usually detected at the time of autopsies, incidentally during surgeries, or during imaging done for other etiologies. They can occur at various sites in the body. Ectopic liver tissue can cause potential complications such as hepatocellular carcinoma and torsion, and in the event that they are incidentally detected, it is advised to remove them. The case report highlights the importance of dealing with incidental findings during laparoscopic cholecystectomy and creating awareness about it.

摘要

一名60岁男性患者因右上腹疼痛就诊,腹部超声显示多发胆结石、胆囊壁增厚、胆囊周围积液及超声墨菲氏征阳性,诊断为急性胆囊炎。患者入院后接受静脉输液、抗生素治疗及止痛处理,并安排进行腹腔镜胆囊切除术。手术过程中,意外发现胆囊附着有异位肝组织。组织病理学证实存在慢性胆囊炎和多面胆固醇结石。在异位肿块中发现正常肝组织。异位肝组织是指位于主要肝实质之外的肝组织,通常无症状。它们通常在尸检时、手术中偶然发现,或在因其他病因进行成像检查时被发现。它们可发生于身体的各个部位。异位肝组织可导致潜在并发症,如肝细胞癌和扭转,若偶然发现,建议将其切除。该病例报告强调了在腹腔镜胆囊切除术中处理意外发现并提高对此认识的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93e9/10359195/df2a4bd88bc4/cureus-0015-00000042220-i01.jpg

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