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一名西班牙裔女性在接受腹腔镜袖状胃切除术后分娩,出现严重扩张的胆囊并伴有多发胆结石。

A Severely Dilated Gallbladder With Multiple Gallstones After Concomitant Laparoscopic Sleeve Gastrectomy and Childbirth in a Hispanic Woman.

作者信息

Mvoula Lord, Khrisat Tarek, Melton Sherry

机构信息

Surgery, Lincoln Medical and Mental Health Center, Bronx, USA.

出版信息

Cureus. 2023 Aug 4;15(8):e42963. doi: 10.7759/cureus.42963. eCollection 2023 Aug.

Abstract

Independent studies have associated laparoscopic sleeve gastrectomy (LSG) and pregnancy with a higher incidence of gallstones, especially in Hispanic populations. However, the synergistic impact of these risk factors is currently unknown. We present the case of a 42-year-old Hispanic woman who initially identified intermittent upper right abdominal pain, which worsened over the last four days before the presentation. Abdominal ultrasound indicated hepatic steatosis, hepatomegaly, and cholelithiasis. A hydropic gallbladder with numerous gallstones, surrounding pericholecystic inflammatory changes, and mild intra-abdominal and pelvic ascites was confirmed by computed tomography. The patient underwent an uneventful robotic-assisted cholecystectomy. A gross examination of the gall bladder measuring 15.5 x 6 x 5.5 cm revealed multiple stones measuring 1.0-1.5 cm in the lumen, the largest of which was impacted in the neck. This case underscores the importance of considering ethnicity and pregnancy history while assessing the post-LSG risk of incident cholelithiasis.

摘要

独立研究表明,腹腔镜袖状胃切除术(LSG)和妊娠与胆结石发病率较高相关,尤其是在西班牙裔人群中。然而,目前尚不清楚这些风险因素的协同影响。我们报告一例42岁西班牙裔女性病例,该患者最初出现间歇性右上腹疼痛,在就诊前最后四天疼痛加剧。腹部超声显示肝脂肪变性、肝肿大和胆石症。计算机断层扫描证实胆囊积水,有大量胆结石,胆囊周围有炎症改变,腹腔和盆腔有轻度腹水。患者接受了顺利的机器人辅助胆囊切除术。对一个大小为15.5×6×5.5厘米的胆囊进行大体检查,发现腔内有多个直径为1.0 - 1.5厘米的结石,其中最大的一个嵌顿在颈部。该病例强调了在评估LSG术后发生胆石症风险时考虑种族和妊娠史的重要性。

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