Agenesis of the gallbladder and the cystic duct is one of the rarest congenital abnormalities of the biliary system. Almost half of the patients develop common duct stones and 23% of them manifest signs and symptoms that mimic biliary colic. We present two cases of gallbladder agenesis. The first case is of a woman presenting symptoms of biliary colic. Laparoscopy failed to reveal either gallbladder or cystic duct. The procedure was continued to further search for ectopic sites of gallbladder. A gallbladder agenesis was suspected and then confirmed via post-operative magnetic resonance cholangio-pancreatography, who also objectified a cystic dilatation and septum of the main bile duct. The second case is of a woman with symptoms of biliary colic. A first abdominal ultrasonography objectified a "scleroatrophic" gallbladder; on the second ultrasonography a gallbladder agenesis was suspected and later confirmed via magnetic resonance cholangio-pancreatography. We report through these cases our experience with regard to the challenges associated with the diagnosis and management, and a brief review of the literature of this rare pathology.
Biliary tuberculosis is a very rare disease especially in its isolated form that can present with an obstructive jaundice mimicking other non-infectious causes such as cholangiocarcinoma. It poses difficulty in diagnosis and often requiressurgical intervention to exclude underlying malignancy. Here we report a case of obstructive jaundice which was initially thought to be due to a cholangiocarcinoma but postoperatively it was found to be tuberculosis.
Inflammatory pseudotumor of the spleen (IPTS) is an extremely rare benign condition of uncertain etiology. Preoperative diagnosis of this entity is usually difficult, only the histological study allows the diagnosis to be made. We report an observation of a 35-year-old women patient, hospitalized for left hypochondrium pain with vomiting. Physical examination noted tenderness of the left hypochondrium and splenomegaly, CT scan showed a large tissue mass, measuring 14x15x9.6 cm, probably at the expense of the upper pole of the spleen, containing central calcifications. Exploratory laparotomy revealed a splenic tumor. A splenectomy was performed. IPTS diagnosis was made after histological and immunohistochemical study of the splenectomy specimen.
Background: Mesenteric Fibromatosis (MF) is a proliferative fibroblastic lesion of small intestinal mesentery. It constitutes 8% of all desmoid tumours, which represent 0.03% of all neoplasm. It is histologically benign but may invade locally and recur after excision. It occurs sporadically or in association with familial adenomatous polyposis (FAP).Case Report: wepresent a case of a 59-year-old man presenting with three months inguinal hernia non-complicated.On physical exam, his abdomen was distended with abdomial mass. Ultrasonography and CT scan showeda retroperitoeal mass suggestive of GastroIntestinal Stromal Tumor. Colonoscopy and endoscopy showed no polyps. Exploratory laparotomy revealed a mass in ileal mesentery. It was excised along with 30cm of ileum and end to end anastomosis in two layers. Histopathologically was in favor of mesentericfibromatosis.Postoperative days were uneventful and discharged on 7th day. Follow-up for three years which included abdominal utrasonography and colonoscopy did not reveal any new pathological lesions.Considering the rarity of this tumour and difficulties in diagnostic and therapeutic ambit, we believe it is justified to describe this case which came to our observation.
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