A previously well 50-year-old male presented with a six-year history of worsening right-sided upper abdominal pain, postprandial nausea, and early satiety. His blood tests, including full blood count, liver biochemistry, and serum amylase, were normal. CT of the abdomen with intravenous contrast demonstrated concentric segmental mural thickening of the body and fundus of the gallbladder, with intramural cystic foci (rosary sign). MRI of the abdomen demonstrated segmental gallbladder mural thickening with fluid-filled intramural diverticula (pearl necklace sign) and an hourglass configuration of the gallbladder, consistent with segmental gallbladder adenomyomatosis. The patient subsequently underwent laparoscopic cholecystectomy with histological confirmation of gallbladder adenomyomatosis, without evidence of malignancy. His postoperative recovery was uneventful.

No abstract

Cholelithiasis during pregnancy and the postpartum period has an incidence of 12%, with pregnancy being an important risk factor for gallstones. Patients with choledocholithiasis can experience complications, such as obstructive jaundice, cholangitis, and pancreatitis, which may be detrimental to both mother and fetus.A case of cholelithiasis in a second-trimester pregnancy was complicated by choledocholithiasis and obstructive jaundice. Ultrasonography (US), magnetic resonance cholangiopancreatography (MRCP), along with serial blood tests, confirmed the diagnosis. Treatment was safely achieved using endoscopic retrograde cholangiopancreatography (ERCP).In pregnancy, complicated cholelithiasis is investigated using blood tests, ultrasonography, and cholangiography. Evidence supports the use of intraoperative or endoscopic cholangiography for the management of such complicated gallstone disease in pregnancy.

An advanced abdominal pregnancy is defined as an extrauterine pregnancy over twenty weeks gestation with a fetus living, or showing evidence of having once lived, in the mother's abdominopelvic cavity. Our case is a 35-year-old patient with a 23-week extrauterine pregnancy, with a congenital head defect (scaphocephaly and hydrocephalus), located in the left side of the maternal abdomen with a period of gestation of 23 weeks, who underwent preoperative imaging with contrast-enhanced multidetector computed tomography (CE-MDCT). CT imaging provided significant information on the placenta and its arterial supply/venous drainage and confirmed the presence of an arteriovenous malformation of the right uterine artery. CT imaging also allowed planning of preoperative uterine artery coil embolization.