[Duplication of the gallbladder with heterotopic mucosa: A case report and proposal for a classification for gastrointestinal duplications]

A rare case of the pancreas with heterotopic gastric mucosa detected by EUS (with video)

Pancreas with heterotopic gastric mucosa is a rare congenital malformation and hardly be detected.In the embryonic stages, primitive gut, including foregut, midgut and hindgut, originated in the gastrula endoderm. Stomach and pancreas were stemed from the ending of foregut. When abnormal differentiation occurred, pancreatic tissue was usually ectopic to the stomach, but heterotopic gastric mucosa of the pancreas was rare. This malformation was usually confirmed by post-operative pathology. We report a case of congenital malformation of heterotopic gastric mucosa of pancreas detected by EUS and contrast enhanced EUS. The manifestations in EUS are different from the pancreatic cyst lesion.

Complete laparoscopic cholecystectomy for a duplicated gallbladder: A case report

INTRODUCTION

Duplication of the gallbladder (GB) is a rare congenital abnormality occurring in 1 in 4000 to 5000 births. Three types have been reported: type I (split primordial GB), type II (2 separate GBs with their own cystic ducts), and type III (triple GBs drained by 1 to 3 separate cystic ducts). Patients with a duplicated GB are usually asymptomatic and are sometimes not diagnosed on preoperative imaging, which might increase the difficulty and risk of cholecystectomy. The key to successful treatment is total removal of the duplicated GB to avoid the recurrence of disease. Intraoperative cholangiography is recommended for identifying and resecting duplicated GBs. The final diagnosis depends on the histopathology.

PATIENT CONCERNS

A 62-year-old woman had recurrent upper abdominal pain and nausea for 1 year, with no fever, jaundice, or other symptoms. An ultrasound of the abdomen indicated polyps in the GB. Computed tomography (CT) revealed moderate dense structures attached to the wall of the GB and an unusual 47 × 21 mm elliptical structure with an extra tubule located above the main GB.

DIAGNOSIS

A diagnosis of duplicated GB was made based on the histopathology.

INTERVENTIONS

The patient underwent a laparoscopic cholecystectomy with total removal of the duplicated GB.

OUTCOMES

The patient's postoperative course was uneventful and she was discharged from the hospital on the second postoperative day. She had no upper abdominal pain at the 6-month follow-up.

CONCLUSION

Duplicated gallbladder is a rare congenital biliary anatomy, which is usually asymptomatic and sometimes cannot be diagnosed on preoperative imaging. With gallbladder disease, the duplicated GBs should be removed totally; a laparoscopic approach should be attempted first and cholangiography is recommended to aid in identifying and resecting the duplicated GBs. The final diagnosis depends on the histopathology. There is still insufficient evidence on the need to remove duplicated GBs found incidentally.

Peril of missing a double gall bladder: report of a patient who needed cholecystectomy two times over

Gall bladder (GB) duplication is a rare anomaly, not often seen in regular clinical practice. Though a vestigial organ, the presence of calculi within the GB can cause the patient to be acutely symptomatic with right hypochondriac pain, which can even be life threatening if not treated. The presence of two GBs means this pathology can be seen in both the GBs, highlighting the importance of diagnosing this condition, lest the patient returns years after a cholecystectomy with cholecystitis yet again!