Embryological Basis and Clinical Correlation of the Rare Congenital Anomaly of the Human Gall Bladder: - “The Diverticulum” - A Morphological Study

Rajguru, Jaba; Jain, Shilpi; Khare, Satyam; Fulzele, R. R.; Ghai, Rashmi

doi:10.7860/jcdr/2013/5667.3445

Cited by 7 publications

(3 citation statements)

References 15 publications

(16 reference statements)

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“…True diverticulum is an outpouching of the gallbladder wall involving all 3 histological layers: mucosa, muscularis propria, and adventitia. The pathogenesis is unclear, but is thought to be congenital, which might lead to complications, but there are reported cases without symptoms or complications [ 5 , 15 ]. In contrast to false diverticulum, which is proven to be a consequence of gallstone luminal pressure and inflammation [ 18 ], differentiation between the 2 entities could be approached through histological examination.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, background knowledge of rare anomalies plays a crucial role in guiding the surgeon to choose the optimal method of management. We also highlight the associated complications that can accompany these anomalies, such as non-specific prolonged ailments, acalculous cholecystitis, cholecystitis and cholelithiasis, recurrent cholangitis, and carcinoma of the gallbladder [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Uncommon Presentation of Xanthogranulomatous Cholecystitis in a True Gallbladder Diverticulum: A Case Report and Literature Review

AL Saleem,

AlSaeed,

Alhashim

2024

Am J Case Rep

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Patient: Female, 38-year-old Final Diagnosis: True gallbladder diverticulum Symptoms: Right upper quadrant (RUQ) pain Clinical Procedure: — Specialty: Pathology • Surgery Objective: Rare coexistence of disease or pathology Background: The gallbladder develops from the hepatic diverticulum during the fourth week of gestation, which also give rise to the liver, extrahepatic biliary ducts, and ventral part of the pancreas. Infrequently, the gallbladder has malformation or disruption in embryogenesis, leading to congenital anomalies. There are various congenital anomalies that can arise in the gallbladder. True or congenital diverticulum of the gallbladder is a rare entity that accounts for only 0.06% of gallbladder congenital anomalies and 0.0008% of cholecystectomies at the Mayo Clinic. Case Report: Herein, we report a rare case of a 38-year-old woman who presented to Jubail General Hospital’s surgery clinic with right upper-quadrant (RUQ) pain associated with vomiting after meals for 1 month. Laparoscopic cholecystectomy was done and gallbladder tissue was sent to histopathology. Gross examination revealed an outpouching mucosa within the wall that was proven to consist of muscularis and serosa layers under light microscope. Interestingly, xanthogranulomatous inflammation was confined to the diverticulum, unlike the chronic inflammation involving the remaining gallbladder. Based on the above findings, the diagnosis of congenital diverticulum with xanthogranulomatous cholecystitis was made. Conclusions: Gallbladders associated with a true diverticulum are uncommonly found to be buried in the liver, leading to surgical difficulties during cholecystectomy. Therefore, background knowledge of occasional anomalies plays a crucial role in guiding the surgeon to choose the optimal method of management. We also discuss the associated complications that accompany these anomalies, such as non-specific prolonged ailments, acalculous cholecystitis, cholecystitis and cholelithiasis, recurrent cholangitis, and carcinoma of the gallbladder.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Uncommon Presentation of Xanthogranulomatous Cholecystitis in a True Gallbladder Diverticulum: A Case Report and Literature Review

AL Saleem,

AlSaeed,

Alhashim

2024

Am J Case Rep

View full text Add to dashboard Cite

show abstract

“…Differential diagnosis for a gallbladder diverticulum is folded gallbladder and Hartmann’s pouch [6]. Folded gallbladder represents a kink at the junction of fundus and body.…”

Section: Discussionmentioning

confidence: 99%