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被误诊为残留胆囊炎的重复胆囊:一例病例报告及文献复习

Duplicate gallbladders misdiagnosed as residual cholecystitis: A case report and review of the literature.

作者信息

Ma Xian-Shi, Feng Mei-Fa, Ke Song, Yang Liu

机构信息

Department of Hepatobiliary Surgery, Yangxin People's Hospital, Yangxin, China.

出版信息

Medicine (Baltimore). 2024 Dec 20;103(51):e40367. doi: 10.1097/MD.0000000000040367.

Abstract

RATIONALE

Duplication of gallbladder is a rare anomaly in humans, as it is very rare for a duplication of gallbladder to be missed during the first cholecystectomy and thus require a second cholecystectomy.

PATIENT CONCERNS

A 42-year-old man came to our hospital with paroxysmal right upper abdominal pain for 10 days. In addition to the pain, he also had transient jaundice. He had undergone laparoscopic cholecystectomy (LC) 1 year ago. Magnetic resonance cholangiopancreatography showed gallstones, intrahepatic bile duct stones with cholangitis, no dilatation of the common bile duct, and a cystic structure was visible in the upper part of common bile duct. The patient underwent LC again, and the intraoperative diagnosis was duplication of gallbladder.

DIAGNOSIS

The patient was diagnosed with duplication of gallbladder during surgery.

INTERVENTIONS

The patient underwent LC again.

OUTCOMES

The patient underwent LC again, and was diagnosed with duplicated gallbladder during the operation. The operation was successful and the patient was discharged on the 5th day after the operation without other complications.

LESSONS

Our case and literature review showed that there are no specific signs of duplicated gallbladders, and ultrasound has a low sensitivity for the diagnosis of double gallbladders, so double gallbladders are easily missed. Patients with double gallbladders may have multiple missed diagnoses during diagnosis and treatment, as in this case. When patients experience upper abdominal pain again after gallbladder removal, we should be alert and consider the possibility of duplicated gallbladders.

摘要

理论依据

胆囊重复是一种罕见的人体异常情况,因为在首次胆囊切除术中极少会遗漏胆囊重复的情况,所以也就很少需要进行二次胆囊切除术。

患者情况

一名42岁男性因阵发性右上腹疼痛10天前来我院就诊。除疼痛外,他还出现了短暂性黄疸。他1年前接受过腹腔镜胆囊切除术(LC)。磁共振胰胆管造影显示有胆结石、肝内胆管结石伴胆管炎,胆总管无扩张,在胆总管上部可见一个囊性结构。患者再次接受LC手术,术中诊断为胆囊重复。

诊断

患者在手术中被诊断为胆囊重复。

干预措施

患者再次接受LC手术。

结果

患者再次接受LC手术,术中诊断为胆囊重复。手术成功,患者术后第5天出院,无其他并发症。

经验教训

我们的病例及文献回顾表明,胆囊重复没有特异性体征,超声对双胆囊的诊断敏感性较低,因此双胆囊很容易被漏诊。像本病例一样,双胆囊患者在诊治过程中可能会多次漏诊。当患者胆囊切除术后再次出现上腹部疼痛时,我们应提高警惕,考虑胆囊重复的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07be/11666152/b6bd210333a5/medi-103-e40367-g001.jpg

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