Acalculous Phrygian cap cholecystitis

Al-Ashqar, Mohammad; Maliyakkal, Ajay Kumar; Shiwani, Muhammad Hanif; Anwar, Suhail

doi:10.1136/bcr-2013-009921

Cited by 6 publications

(6 citation statements)

References 2 publications

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“…In our case of the 48-year-old female during a Whipple's procedure, incidental Phrygian cap discovery was observed. In contrast, in the 53-year-old female case reported by Al-Ashqar et al, laparoscopic cholecystectomy following diagnostic laparoscopy confirmed the presence of a Phrygian cap [12]. Both these cases show the importance of proper diagnosis and surgery in managing incidental findings, which helps manage the patient's condition and treatment properly.…”

Section: Discussionmentioning

confidence: 82%

“…In the case of a 53-year-old female reported by Al-Ashqar et al, she initially presented with a three-month history of right upper quadrant abdominal pain radiating to her back, accompanied by nausea and unintentional weight loss [12]. Diagnostic laparoscopy confirmed the presence of a folded fibrous cap on the gallbladder fundus, consistent with a Phrygian cap, alongside microscopic evidence of chronic cholecystitis.…”

Section: Discussionmentioning

confidence: 86%

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Incidental Discovery of a Phrygian Cap During Whipple's Procedure: A Case Report

Navandhar,

Gharde,

Shinde

et al. 2024

Cureus

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Obstructive jaundice, characterised by yellow discolouration of the skin and mucous membranes due to reduced bile flow, often necessitates surgical intervention for resolution. This article provides a comprehensive literature review to contextualise the management of obstructive jaundice, focusing on common treatment modalities such as common bile duct (CBD) stenting and Whipple's procedure for pancreatic head cancer. Additionally, the incidental finding of a Phrygian cap of the gallbladder during surgical intervention for pancreatic head cancer is described in detail. A case presentation of a 48-year-old female with obstructive jaundice and pancreatic head cancer is outlined, detailing the diagnostic process, treatment decisions, and surgical interventions. The patient underwent CBD stenting followed by Whipple's procedure to address the pancreatic head cancer, during which the incidental discovery of a Phrygian cap of the gallbladder was noted. The discussion of the incidental finding highlights the complexity it adds to surgical interventions and emphasises the importance of adaptability and precision in managing anatomical variations. A comparison with similar cases underscores varying approaches to managing incidental findings, ranging from conservative observation to surgical excision based on clinical indications. This case underscores the significance of thorough diagnostic evaluation and surgical intervention in managing incidental findings such as the Phrygian cap, ensuring appropriate patient management and favourable clinical outcomes in complex surgical scenarios.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 86%

Incidental Discovery of a Phrygian Cap During Whipple's Procedure: A Case Report

Navandhar,

Gharde,

Shinde

et al. 2024

Cureus

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“…[ 7 ] A similar phenomenon has been described in Phrygian cap acute cholecystitis. [ 4 ] The altered dynamics due to stricture in a dumbbell gallbladder can certainly confound the interpretation of hepatobiliary scintigraphy, and without careful anatomic correlation, can result in misdiagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, focal inflammatory disease of the gallbladder in anatomic variant gallbladders has also been suggested, namely, Phrygian cap acute cholecystitis. [ 4 ] Here, we present a case of inflammatory pathology of an alternative anatomic variant resulting in incomplete gallbladder filling – a focal inflammation of the distal end of a dumbbell-shaped gallbladder.…”

Section: Introductionmentioning

confidence: 99%

Dumbbell gallbladder cholecystitis on tc-99m diisopropyliminodiacetic acid hepatobiliary imaging

et al. 2017

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We present a case of a 79-year-old immunocompromised female admitted for abdominal pain and sepsis, who had an abdominal computed tomography (CT) showing distal gallbladder fundus wall thickening, pericholecystic edema, and a right posteroinferior hepatic abscess. Subsequent hepatobiliary scintigraphy with Tc-99m diisopropyliminodiacetic acid showed gallbladder filling of the proximal gallbladder fundus, yet no radiotracer filling of the distal gallbladder fundus. Further correlation with the initial CT showed a partial gallbladder stricture and a resultant altered morphology resembling a dumbbell-shaped gallbladder. Percutaneous cholangiogram also confirmed this dumbbell morphology. Nonfilling of radiotracer into the distal end of the dumbbell gallbladder correlating with CT findings of focal gallbladder inflammation indicated that there was a focal inflammation suggesting a distal dumbbell gallbladder cholecystitis. This case demonstrates a unique finding of focal inflammatory pathology involving an anatomic variant - the dumbbell-shaped gallbladder, and the challenges this anatomic variant presents in hepatobiliary scintigraphy image interpretation.

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“…136 Το 2013, ο Al-Ashqar και οι συνεργάτες του, δημοσίευσαν ένα περιστατικό, όπου διαγνώστηκε αλιθιασική χολοκυστίτιδα, σε ασθενή με πτύχωση του τοιχώματος της κύστης δίκην φρυγικού σκούφου. 139 Ο van Kamp και οι συνεργάτες του, περιέγραψαν μία περίπτωση τυχαίας ανεύρεσης πτύχωσης της χοληδόχου κύστης, κατά την διάρκεια επέμβασης σε ασθενή με καρκίνωμα του κόλου και ηπατική μετάσταση. Αυτή η ανωμαλία είχε παρατηρηθεί και σε προεγχειρητική απεικόνιση με μαγνητική τομογραφία.…”

Section: πτύχωση της χοληδόχου κύστης δίκην 'φρυγικού σκούφου'unclassified

Διερεύνηση Ανοσοϊστοχημικών Δεικτών Με Συμμετοχή Στο Επιθήλιο Της Χοληδόχου Κύστης Στη Λιθογένεση

Οικονόμου¹

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Σκοπός της παρούσας μελέτης ήταν η διερεύνηση της έκφρασης των τριών ανοσοϊστοχημικών δεικτών Beclin1, LC3a και Ki67 στο επιθήλιο της χοληδόχου κύστης και η συσχέτιση της φλεγμονώδους διεργασίας με την οξεία χολοκυστίτιδα, την αυτοφαγική διαδικασία και την χολολιθίαση. Πραγματοποιήθηκε παθολογοανατομική εξέταση και ανοσοϊστοχημεία σε δείγματα χοληδόχων κύστεων 100 ασθενών που χωρίστηκαν σε δύο ομάδες, την ομάδα Α και την ομάδα Β. Η ομάδα Α περιλάμβανε 70 ασθενείς που υποβλήθησαν σε χολοκυστεκτομή λόγω χολολιθίασης, ενώ η Β 30 ασθενείς με αλιθιασικό επιθήλιο χοληδόχου κύστης. Υψηλότερη έκφραση του Beclin 1 και Ki67 παρατηρήθηκε στους ασθενείς της ομάδας Α και παράλληλα η αύξηση της έκφρασης του Beclin1 προήγαγε την έκφραση του LC3a στην ίδια ομάδα. Σύμφωνα με τα αποτελέσματα μας, η παρουσία χολόλιθων πιθανολογείται ότι προάγει την φλεγμονή και την αυτοφαγία στο επιθήλιο της χοληδόχου κύστης και ο μηχανισμός της αυτοφαγικής ρύθμισης πιθανότατα διαδραματίζει σημαντικό ρόλο στην χρόνια φλεγμονή και στην πιθανή εξαλλαγή του επιθηλίου.

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Acalculous Phrygian cap cholecystitis

Cited by 6 publications

References 2 publications

Incidental Discovery of a Phrygian Cap During Whipple's Procedure: A Case Report

Incidental Discovery of a Phrygian Cap During Whipple's Procedure: A Case Report

Dumbbell gallbladder cholecystitis on tc-99m diisopropyliminodiacetic acid hepatobiliary imaging

Διερεύνηση Ανοσοϊστοχημικών Δεικτών Με Συμμετοχή Στο Επιθήλιο Της Χοληδόχου Κύστης Στη Λιθογένεση

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