An ectopically located gallbladder is a rare entity. Here, we present a case of an ectopic gallbladder with left hepatic lobe agenesis. In this study, we describe the case of a 56-year-old male who was a known diabetic patient. He presented with abdominal pain, which started two weeks prior. Computed tomography (CT) abdomen with contrast was advised by the primary team, which showed an incidental ectopic gallbladder along the right posterior-inferior margins of the liver. Associated with it, there was complete agenesis of the left hepatic lobe, including absent segments II, III, and IV. Most of the commonly encountered ectopic positions include intrahepatic, transverse, retrohepatic, retroperitoneal, suprahepatic, falciform ligament, or under the left liver lobe. Ectopic gallbladders have clinical significance as they alter the clinical presentation of cholecystitis. They create technical challenges during cholecystectomy and other biliary operations and cause misdiagnosis in imaging. A thorough inspection of the biliary tract in patients undergoing surgery is suggested before electrocoagulation. A radiologist must always inform the clinician about the existence of an aberrant gallbladder.
Corona Virus Disease (COVID-19) was pneumonia initially reported as epidemic in Wuhan, China due to novel Corona virus outbreak in late 2019. It has now assumed the status of pandemic with global infection spread. This infection has diversified clinical 1 -3 presentations ranging from milder symptoms like flu to severe symptoms as seen with severe respiratory distress syndromes (SARS) and middle east respiratory syndrome (MERS) having mortality rates of 10% and 37% respectively. Considering high contiguity of virus, 1,4,5 early differentiation between infected and noninfected patients is of extreme importance to prevent transmission of infection to non-infected population and health care providers. 6 Polymerase chain reaction (PCR) assay is the standard reference diagnostic modality for detection of infection
Afferent loop syndrome is an uncommon postoperative complication. Currently, we lack a therapeutic option for treatment of malignant afferent loop obstruction following procedures like Whipple's. Here we present a case of afferent loop obstruction in a known case of pancreatic carcinoma, status after Whipple's procedure, in which we used a percutaneous transhepatic approach to relieve the afferent loop obstruction using a self-expanding bare metal stent.
Background: Cesarean scar pregnancy is a rare type of ectopic pregnancy, which is potentially life-threatening if not diagnosed and treated timely, resulting in catastrophic complications. Early diagnosis is critical for the treatment. Transvaginal sonography has made possible early diagnosis and consequently preservation of the uterus and fertility. Intrauterine administration of methotrexate (MTX) is a conservative and nonsurgical method for ectopic pregnancy cessation. Methods: We describe two cases of live ectopic pregnancies managed with ultrasoundguided local injection of MTX complemented with potassium chloride (KCl). A 36-year-old woman with four previous cesarean scars, live and unruptured uterine ectopic scar pregnancy was referred to the Interventional Radiology Unit for evaluation and management. She underwent risk-benefit counseling. Under transvaginal sonographical guidance, puncture and injection of ectopic pregnancy was performed using a 22G Chiba device. Intrasacular MTX was injected, which was complemented with fetal intracardiac administration of KCl. We report another case of 34-year-old woman with 6 weeks ectopic pregnancy at the site of incision of lower-segment uterine scar pregnancy. Transducer guided 22G Chiba needle was advanced through the guide into gestational sac, approximately 1 ml of KCl was injected slowly. Afterward, 25 mg (1 ml) MTX was injected into the gestational sac. Results: Immediate cessation of fetal cardiac activity was noted. Weekly follow-up ultrasounds for a month remained uneventful with progressive resolution of gestational sac remnant. Conclusion: Unruptured live ectopic pregnancy can be successfully managed without surgical intervention through local injection of KCl and MTX preserving uterus.
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