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.
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