左侧胆囊并发腺肌瘤病1例。

IF 2 Q2 EMERGENCY MEDICINE
Mohamed Tolba, Hadeer Hafez, John Adel
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引用次数: 0

摘要

简介:胆囊(LSG)和腺肌瘤病(ADM)的共存是非常罕见的,提出了一个新的临床困境,以前没有文献记载。LSG是指胆囊位于圆形韧带左侧偏离其正常位置的异常。这种异常是罕见的,报道的发生率在0.04%到1.1%之间。在手术前识别LSG是一项挑战。它经常是偶然发现的过程中,需要外科专业知识,以安全管理解剖变异。病例介绍:我们报告一位有丙型肝炎、肝癌和肝硬化病史的老人,主诉突然胃痛。CT扫描显示她有先天性的LSG,是一种先天性异常。在胆囊切除术过程中,外科医生遇到了变化,并观察到ADM的存在使手术复杂化。病人术后恢复顺利。讨论:这个病例显示了LSG和adm合并的诊断和治疗是多么复杂。在手术前识别这些情况是困难的,因此外科医生经常不得不在手术过程中调整他们的方法。虽然腹腔镜胆囊切除术通常是安全的,但需要小心避免胆管损伤等问题。对于有风险的患者,保守治疗方法可能更好。在需要手术的情况下,外科医生需要调整他们的技术来解决独特的解剖问题。结论:lssg和ADM的联合使用具有复杂的挑战性。为了患者的健康和良好的结果,外科医生需要准备好有效地识别和处理这些异常。这个特殊的病例强调了在处理胆囊变异的手术中保持警觉和灵活的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Coexistence of adenomyomatosis in a left-sided gallbladder: a case report.

Introduction: The coexistence of gallbladder (LSG) and adenomyomatosis (ADM) is extremely uncommon presenting a novel clinical dilemma that has not been previously documented. LSG refers to a anomaly where the gallbladder is situated to the left of the round ligament deviating from its usual position. This anomaly is rare, with reported occurrences ranging between 0.04% and 1.1%. Identifying LSG before surgery poses challenges. It is often discovered incidentally during procedures necessitating surgical expertise to safely manage anatomical variations.

Case presentation: We report an old man with a history of hepatitis C, carcinoma and liver cirrhosis complained of sudden epigastric pain. A CT scan revealed the presence of an LSG, which's a congenital anomaly. During the cholecystectomy procedure surgeons encountered variations and observed the existence of ADM complicating the operation. The patient recovered smoothly post surgery.

Discussion: This case shows how complicated it can be to diagnose and treat the combination of LSG and ADM. Identifying these conditions before surgery is tough so surgeons often have to adjust their approach during the operation. Although laparoscopic cholecystectomy for LSG is usually safe it requires care to avoid problems like bile duct injuries. For patients at risk a conservative treatment approach might be better. In cases where surgery is necessary surgeons need to adapt their techniques to address the unique anatomical issues.

Conclusion: The combination of LSG and ADM in a setting poses an intricate challenge. Surgeons need to be ready to recognize and address these abnormalities effectively for the well being of the patient and favorable results. This particular case highlights the importance of staying alert and flexible during surgery when dealing with gallbladder variations.

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来源期刊
CiteScore
4.60
自引率
0.00%
发文量
63
审稿时长
13 weeks
期刊介绍: The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.
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